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24/03/2018

By: Johannes.P
Reviewed By: Johannes Purwanto 1 Reviewed By: Johannes Purwanto 2

FOUNDATIONS OF THE ICF DISEASES VS FUNCTIONING


Human Functioning - not merely disability
Universal Model - not a minority model
Integrative Model - not merely medical or social
Interactive Model - not linear progressive
Parity - not etiological causality
Context - inclusive - not person alone
Cultural applicability - not western concepts
Operational - not theory driven alone
Life span coverage - not adult driven
SAME HEALTH CONDITION
• Diseases vs Functioning DIFFERENT FUNCTIONING
• Medical model vs Social Model
• Biological model vs Bio-Psycho-Social Models
Reviewed By: Johannes Purwanto 3 Reviewed By: Johannes Purwanto 4

DISEASES VS FUNCTIONING DISEASES VS FUNCTIONING

SAME HEALTH CONDITION


DIFFERENT HEALTH CONDITION DIFFERENT ENVIRONMENT
SAME FUNCTIONING DIFFERENT FUNCTIONING

Reviewed By: Johannes Purwanto 5 Reviewed By: Johannes Purwanto 6

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DISEASES VS FUNCTIONING ICF MODEL


Health Condition
(disorder/disease)

Body function
Activities Participation
and structure
(Limitation) (Restriction)
(Impairment)

SAME HEALTH CONDITION


DIFFERENT EQUIPMENT Environmental Personal Factors
DIFFERENT FUNCTIONING Factors
Reviewed By: Johannes Purwanto 7 Reviewed By: Johannes Purwanto 8

DEFINITION ICF COMPONENTS


Impairment Loss or abnormality in body structure or Body functions Physiological functions of body
function (including mental function) systems
Body Structures Structural or anatomical parts of the
Activity Limitations Difficulties individual may have in body
executing activities in terms of quantity or
quality Activities Execution of a task or action by an
individual (individual perspective)
Participation Problems an individual may experience
Participation Persons involvement in a life situation
Restrictions in involvement in life situations
(societal perspective)

Facilitators & Barriers Environmental factors may be a facilitator Environmental Factors All aspects of the external world that
for one person & barrier impact on the person’s functioning
for another

Reviewed By: Johannes Purwanto 9 Reviewed By: Johannes Purwanto 10

ICF COMPONENTS STRUCTURE OF THE ICF


ICF Classification
Body Functions Activities & Environmental Factors
& Structures Participation
Part 1: Part 2:
Functioning and Contextual Parts
Disability Factors

Body Functions Activities and Environmental Personal Components


and Structures Participation Factors Factors

Change in Change in Constructs/


Performance Facilitator/
Body
Functions
Body
Structures
Capacity
Barrier qualifiers

Functions Capacity Barriers Item Item Item Item Item Domains and
levels: levels: levels:
levels:
1st 1st
levels:
1st 1st 1st categories
Structures Performance Facilitators 2nd 2nd 2nd 2 nd 2nd at different levels
3rd 3rd 3rd 3 rd 3rd
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AIMS OF ICF APPLICATIONS OF ICF


• To provide a scientific basis for consequences of • As a statistical tool
health conditions
• To establish a common language to improve • As a research tool
communications
• To permit comparison of data across: • As a clinical tool


countries
health care disciplines
• As a social policy tool


services
time • As an educational tool
• To provide a systematic coding scheme for health • Social action
information systems

Reviewed By: Johannes Purwanto 13 Reviewed By: Johannes Purwanto 14

WHY IS THERE A NEED FOR AN ICF FOR


NEED FOR ICF-CY CHILDREN & YOUTH?
Functioning, Activities, Participation & • Nature and form of functioning in children different
Environments different from those of adults from that of adults
• Main volume of ICF lacking precursors of adult
characteristics
• Child as a “moving target” in
• Indicators of functional risk factors crucial for
prevention and early intervention
• ICF version for children and youth provides continuity
of documentation in transitions from child to adult
services
• classification of function
Reviewed By: Johannes Purwanto 15 Reviewed By: Johannes Purwanto 16

ICF-CY TEAM MEMBERS

• Mats Granlund • Travis Threats


• Professor in Psychology at • Saint Louis University,
Jönköping University, School of International, World Health
Health Science, Organization (2006)
Swedish Institute for Disability • Classifications adopted by
Research ASHA, physical and
• Researcher Reviewed By: Johannes Purwanto occupational therapists 17 Reviewed By: Johannes Purwanto 18

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BODY FUNCTION, code (b) BODY STRUCTURE, code (s)

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ACTIVITIES and PARTICIPATION, code (d) ENVIRONMENTAL FACTORS, code (e)

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BODY FUNCTION, code (b)

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BODY STRUCTURE, code (s)

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ACTIVITY AND PARTICIPATION, code: (d)

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ENVIRONMENTAL FACTOR, code (e)

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Reviewed By: Johannes Purwanto 55 Reviewed By: Johannes Purwanto 56

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CODE STRUCTURE
1st level b2 Sensory functions
and pain

2nd level b210 Seeing function

3rd level b2102 quality of vision

4th level b21022 Contrast


sensitivity

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BODY FUNCTION CODING (b) BODY FUNCTION CODING (b)

• Body functions are coded with one qualifier


that indicates the extent or magnitude of the
impairment.
• The presence of an impairment can be
identified as a loss or lack, reduction, addition
or excess, or deviation.

Reviewed By: Johannes Purwanto 61 Reviewed By: Johannes Purwanto 62

QUALIFIERS FOR BODY FUNCTION (b) BODY STRUCTURE CODING (s)


• Body structures are coded with three
xxx.0 NO problem (none, absent, negligible…) 0–4 %
qualifiers.
xxx.1 MILD problem (slight, low….) 5–24%
xxx.2 MODERATE problem (medium, fair…) 25–49% • The first qualifier describes the extent or
xxx.3 SEVERE problem (high, extreme…) 50–95% magnitude of the impairment,
xxx.4 COMPLETE problem (total…) 96–100% • The second qualifier is used to indicate the
xxx.8 not specified
nature of the change,
xxx.9 not applicable
• The third qualifier denotes the location of the
impairment.

Reviewed By: Johannes Purwanto 63 Reviewed By: Johannes Purwanto 64

BODY STRUCTURE CODING (s) QUALIFIERS FOR BODY STRUCTURE (s)

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ACTIVITY AND PARTICIPATION CODING (d) ACTIVITY AND PARTICIPATION CODING (d)
• Activities and Participation is coded with two
qualifiers: the performance qualifier, which
occupies the first digit position after the point,
and the capacity qualifier, which occupies the
second digit position after the point.
• The code that identifies the category from the
Activities and Participation list and the two
qualifiers form the default information matrix.

Reviewed By: Johannes Purwanto 67 Reviewed By: Johannes Purwanto 68

QUALIFIERS FOR
ENVIRONMENT CODING (e)
ACTIVITY AND PARTICIPATION (d)
• Environmental factors are to be coded from the
perspective of the person whose situation is
being described
• The qualifier indicates the extent to which a
factor is a facilitator or a barrier
• The following is the negative and positive scale
that denotes the extent to which an
environmental factor acts as a barrier or a
facilitator

Reviewed By: Johannes Purwanto 69 Reviewed By: Johannes Purwanto 70

ENVIRONMENT CODING (e) QUALIFIER FOR ENVIRONMENT (e)

environmental factor as a barrier or a facilitator

e130

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PRACTICE
http://apps.who.int/classifications/icfbrowser/

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