Wiśniowska-Szurlej Agnieszka, Sozańska Agnieszka, Brożonowicz Justyna, Wilmowska-Pietruszyńska Anna, Sozański Bernard
Faculty of Health Sciences and Psychology, Collegium Medicum, University of Rzeszow, Rzeszow, 35-310, Poland.
Donum Corde Rehabilitation and Medical Care Center, Budy Głogowskie 835B Street, Głogów Małopolski, 36-060, Poland.
BMC Health Serv Res. 2025 Aug 5;25(1):1027. doi: 10.1186/s12913-025-13048-2.
Monitoring a patient's functional status in the rehabilitation process is essential for the ongoing improvement of the quality of the rehabilitation services offered. This possibility is provided by the use of the International Classification of Functioning, Disability and Health (ICF) and the ICF Core Sets developed on its basis. The purpose of this study was to validate and evaluate the use of the ICF Rehabilitation Set in rehabilitation patients in clinical practice in southeastern Poland.
This study included patients who required comprehensive rehabilitation in a tertiary care rehabilitation centre. The study used the Polish version of a rating reference guide for the ICF Rehabilitation Set and the Barthel Index. The assessment was carried out by an interdisciplinary team, which established the ICF qualifier values by consensus. Interrater reliability was assessed using intraclass correlation coefficients (ICCs). Convergent validity was assessed using Spearman correlation coefficients between the Disability Index (DI) and the Barthel Index (BI). To assess the effectiveness of rehabilitation in the study group, a paired Wilcoxon test was used to compare the measurements of the two ICF codes.
This study demonstrated the consistency and reliability of the reference guide for the ICF Rehabilitation Set. The ICC values were very high (for B620; D450; D640, the ICC was 1.000) and high (for E155, the ICC was 0.793). The individual entries from the ICF Rehabilitation Set were found to have very high concordance for assessing individual qualifiers between researchers (the ICC for the DI was 0.995). The ICF Rehabilitation Set scores and the calculated DI were correlated with the BI scores. The ICF Rehabilitation Set is sensitive to changes in the functional status of patients undergoing rehabilitation and is consistent with the results obtained by the BI measure. There was also a statistically significant improvement in patients' functional status after rehabilitation.
The ICF Rehabilitation Set and the developed rating reference guide are reproducible, consistent and relevant and can be used in clinical settings to collect health information from people undergoing rehabilitation. Further research is needed to strengthen the evidence to validate the ICF in Poland.
The study was registered in the clinical trial registry at ClinicalTrials.gov (NCT06718036, date of registration 2024-11-30, retrospectively registered).
在康复过程中监测患者的功能状态对于持续提高所提供的康复服务质量至关重要。使用《国际功能、残疾和健康分类》（ICF）及其在此基础上制定的ICF核心集提供了这种可能性。本研究的目的是在波兰东南部的临床实践中验证和评估ICF康复集在康复患者中的使用情况。
本研究纳入了在三级护理康复中心需要全面康复的患者。研究使用了ICF康复集和巴氏指数的波兰语版评分参考指南。评估由一个跨学科团队进行，该团队通过共识确定ICF限定值。使用组内相关系数（ICC）评估评分者间信度。使用残疾指数（DI）和巴氏指数（BI）之间的斯皮尔曼相关系数评估收敛效度。为了评估研究组康复的有效性，使用配对威尔科克森检验比较两个ICF编码的测量值。
本研究证明了ICF康复集评分参考指南的一致性和可靠性。ICC值非常高（对于B620；D450；D640，ICC为1.000）且较高（对于E155，ICC为0.793）。发现ICF康复集的各个条目在评估研究人员之间的个体限定值方面具有非常高的一致性（DI的ICC为0.995）。ICF康复集评分和计算出的DI与BI评分相关。ICF康复集对接受康复治疗患者的功能状态变化敏感，并且与BI测量获得的结果一致。康复后患者的功能状态也有统计学上的显著改善。
ICF康复集和制定的评分参考指南具有可重复性、一致性和相关性，可用于临床环境中收集接受康复治疗者的健康信息。需要进一步研究以加强在波兰验证ICF的证据。
该研究已在ClinicalTrials.gov的临床试验注册中心注册（NCT06718036，注册日期2024年11月30日，追溯注册）。
