Functioning in schizophrenia: Comparison between six health

professions
Georgina Guilera1, Maite Barrios1, Emilio Rojo2, Juana Gómez-Benito1, and Laura Nuño3
1Institute of Neurosciences, University of Barcelona, Barcelona (Spain)
2Benito Menni CASM, Sant Boi de Llobregat (Spain)
3Clinic Institute of Neurosciences, Hospital Clínic de Barcelona, Barcelona (Spain)

Introduction: The International Classification of Functioning, Objectives: This study aims a) to identify the most common
Disability and Health (ICF) offers a framework for describing problems of patients with schizophrenia from the experts’
functioning and disability in any health condition such as perspective using the ICF, and b) to compare health
schizophrenia. professions in terms of ICF categories reported as relevant
Methods: Six 3-round worldwide electronic-mail surveys, based for describing functioning in schizophrenia.
on a consensus-building Delphi method, were independently Results: A total of 790 experts representing all six World Health
conducted with psychiatrists, psychologists, nurses, Organization regions participated in the Delphi study, of whom
occupational therapists (OT), social workers (SW) and 638 finished the third round.
physiotherapists experienced in the treatment of individuals with
Table 1. Description of participants in the 1st round by health
schizophrenia. Experts were asked about the problems they profession and completion rate.
commonly treat in patients with schizophrenia. Experts’ responses
Years of
were linked to the ICF system using stablished linking rules. The n (% experience in 3rd round
Health profession
Delphi process is illustrated in Figure 1. female) schizophrenia n (%)
Mean (Min-Max)
Psychiatrist 352 (28.1) 19.5 (4-55) 303 (86.1)
Psychologist 175 (62.9) 11.7 (1-42) 137 (78.3)
Nurse 101 (63.4) 20.7 (2-52) 79 (78.2)
Occupational therapist 92 (82.6) 9.9 (1-44) 73 (79.0)
Social worker 57 (68.4) 10.8 (1-27) 36 (63.2)
Physiotherapist 13 (46.2) 10.5 (1-30) 10 (76.9)

Problems in functioning. Overall, health professionals

identified a wide range of problems in functioning of persons
with schizophrenia (114 ICF categories) related to Body functions
(e.g., attention; 22 cat.), Body structures (e.g., brain; 2 cat.),
Activities and participation (e.g., interpersonal interactions; 50
cat.), and Environmental factors (e.g., family support; 40 cat.).
Table 2 shows percentages of commonalities and discordances
between health professions.

Table 2. Number of categories identified by each profession

(diagonal) and percentage of common (green) and discrepant (red)
categories between them.

Commonalities
Psychiatr. Psychol. Nurse OT SW Physioth.

Psychiatr. 91 81.5% 88.0% 82.5% 85.9% 81.6%

Discrepancies

Psychol. 18.5% 76 76.5% 73.0% 77.9% 71.6%

Nurse 12.0% 23.5% 97 84.8% 82.7% 73.6%

OT 17.5% 27.0% 15.2% 97 82.7% 72.0%

SW 14.1% 22.1% 17.3% 17.3% 93 76.5%

Figure 1. The Delphi method. Physioth. 18.4% 28.4% 26.4% 28.0% 23.5% 87

Comparison between health professions. A total of 65 ICF categories were common across all health professions, i.e., 12 Body
functions, 1 Body structures, 31 Activities and participation, and 21 Environmental factors. Two-by-two percentages of common
categories identified by the different health professions range between 71.6% (psychologists vs. physiotherapists) and 88.0%
(psychiatrists vs. nurses).

Conclusions: This study has identified the most common problems of patients with schizophrenia from the experts’ perspective. In
general, the six different health professions coincide in most of the ICF categories reported as relevant for functioning in schizophrenia.

EPA19-1995 Copyright © 2019 Guilera, Barrios, Rojo, Gómez-Benito, Nuño Contact to: Georgina Guilera (gguilera@ub.edu)