ICF Core Set for Vocational Rehabilitation

Friday, 11 June 2010 15:47

Authors

Robin Pickard
Rehabilitation Counsellor / Operations Director with Obair Associates

Jain Holmes
Rehabilitation Counsellor / Operations Director with the WHP

In May this year Jain Holmes and Robin Pickard travelled to the Swiss Paraplegic Centre in Nottwil, Switzerland along with 21 other Vocational Experts from around the world. These experienced academics and practitioners from around the world (America, Europe, South America, Asia, Australia and the Middle East) were invited by the World Health Organization (WHO) International Classification of Functioning, Disability and Health (ICF), for a consensus conference to establish a Core Set of comprehensive and brief standards for Vocational Rehabilitation using the ICF classification.

So what is the ICF?

The ICF is the World Health Organisation’s (WHO) International Classification of Functioning, Disability and Health and it provides a unified and standard language to describe how people with a health condition or health-related condition function in their everyday life. It is a biopsychosocial framework and provides a way of describing people relative to how they function rather than having to rely on describing people by their medical diagnosis. The ICF classification complements WHO’s International Classification of Diseases-10th Revision (ICD-10), which contains information on diagnosis and health condition, but not on functional status. The ICD and ICF constitute the core classifications in the WHO Family of International Classifications (WHO-FIC). The ICF is the successor to the ICIDH (International Classification of Impairments, Disability and Handicaps, 1980).

The ICF classification includes more than 1,400 categories divided into:

  • Body Functions
  • Body Structures
  • Activities and Participation
  • Environmental Factors
  • Personal Factors (not yet defined fully)

As well as being a universal language to more clearly communicate about people, the ICF has other practical applications such as:

  • Statistical tool for collecting and recording data for example in population studies.
  • Research tool to measure outcomes, quality of life or environmental factors.
  • Clinical tool in assessing needs, rehabilitation and outcome evaluation.
  • Social policy tool in compensation systems, policy design and implementation.
  • Educational tool in curriculum design and to raise awareness of undertaking social action.

(2001, World Health Organisation)

What is an ICF Core Set?

An ICF Core Set is an agreed list of ICF categories that relate to a specific conditions and rehabilitation situations in order to make the ICF more useable. The agreed list should include, “as few categories as possible to be practical, but as many as necessary to be sufficiently comprehensive.” (Cieza, Ewert, Unstun, Chatterji, Konstanjsek, Stucki, 2004). There are 2 types of core sets:

  • Brief ICF Core Set that can be used with all service users.
  • Comprehensive ICF Core Set to guide multidisciplinary assessments and interventions.

The ICF Core Set Project is a collaboration between the WHO and the ICF Research Branch, WHO FIC, Germany and many other partner organizations including the World Federation of Occupational Therapists. There are currently ICF Core Sets for a number of chronic conditions including low back pain, depression, breast cancer, multiple sclerosis, traumatic brain injury, stroke and others.

The most recent aim was to establish an ICF Core Set for Vocational Rehabilitation. The ICF Core Set can serve as a reference framework and a practical tool to classify and describe a individual functioning more efficiently. A major advantage is the integration of the medical and social aspects of the individual’s health condition in the ICF classifications using all aspects of an individual’s life (development, participation, and environment) are incorporated into the ICF instead of solely focusing on his or her diagnosis (ICD-10).

To develop the ICF Core Set for Vocational Rehabilitation, the ICF Core Set team, lead by Dr Reuben Escorpizo based at the Swiss Paraplegic Research (SPF), undertook empirical research in 2009 to provide preliminary data before the expert consensus conference. Firstly the ICF Core Set team undertook a literature review of Vocational Rehabilitation in regards to the ICF classification.  Secondly they also undertook an online expert survey which went out to over 600 experts in the Vocational Rehabilitation in the world.  Thirdly and fourthly the individual experiences and opinions of service users were investigated. This preliminary research reduced the 1400 categories of the ICF to about 240 categories that were believed to be important in vocational rehabilitation.

This data was used during the 3-day Consensus Conference by the Vocational Rehabilitation experts in Switzerland to develop the Comprehensive ICF Core Set and the Brief ICF Core Set for Vocational Rehabilitation.  We are pleased to announce that from the 1,400 current ICF categories the 23 experts came to an agreement on 90 ICF categories for the Comprehensive Core Set for Vocational Rehabilitation and 13 categories for the Brief Core Set for Vocational Rehabilitation.

This means that we all now have a unified language by which to communicate with each other about the Vocational Rehabilitation needs of our service users. To date the ICF has been used beneficially in multidisciplinary teams to facilitate clinical reasoning (McIntyre, Tempest, 2007). The second part to the ICF Core Set development is that of utility i.e. how practitioners will put these core sets into use.

A question frequently asked is how does the various vocational rehabilitation standards (PAS 150, CARF, VRA etc) fit in with the current UK environment? This question will continue to be pondered over for the coming months and years and it is pleasing to see discussion and dialog taking place within the sector on this subject. We would encourage usage of the ICF Core Set of Vocational Rehabilitation as a reference framework. There will continue to be much work needed to develop the field of vocational rehabilitation both globally and within the UK. We will be keeping abreast of these developments and will keep you up to date with examples of the ICF Core Set usage over the coming months and years.

Download the ICF Comprehensive and Brief Core Sets for Vocational Rehabilitation:


If you require any additional information please feel free to contact  Robin This e-mail address is being protected from spambots. You need JavaScript enabled to view it