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Toward a framework for developing an ICF-based documentation system in spinal cord injury-specific rehabilitation based on routine clinical practice: a case study approach

Abstract

Study design

Case study.

Objective

To present a framework for developing an International Classification of Functioning, Disability and Health (ICF)-based documentation system in spinal cord injury (SCI)-specific rehabilitation.

Setting

Data collection took place at Maharaj Hospital, Thailand. The preparatory studies and analysis were performed at Swiss Paraplegic Research, Switzerland.

Methods

Data collected from interviews and health records of four SCI cases across the continuum of care (acute, post-acute, early and late long term) were linked to ICF categories using established ICF linking rules. The resulting categories were compared with selected ICF sets (ICF Generic-30, ICF core sets for SCI and multiple sclerosis) to determine the extent of coverage. Furthermore, the context of applicable services was described systematically.

Results

Less than half of the ICF categories in the defined ICF sets were covered by clinical assessment tools. Low correspondence was found predominantly in acute and late long-term phase. Least well covered were categories of activities and participations and environmental factors. The correspondence of categories increased when considering the additional ICF categories identified from patient interviews. The description of rehabilitation services provided in each case classified according to the dimensions of service provider, funding, and service delivery.

Conclusions

There is a need to promote the systematic and standardized assessment of functioning among health professionals working in the field of SCI in developing countries. This study describes basic steps toward developing a standardized ICF-based system for assessing and reporting functioning outcomes in SCI rehabilitation and across the continuum of care.

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Fig. 1: Methodology of data collection and analysis.
Fig. 2: Linking process based on the ICF Linking Rules [22].
Fig. 3: Selection of the ICF sets based on ICF framework across the continuum of care in SCI rehabilitation (no ICF Core Set for the acute phase of SCI has been provided, no ICF Core Set for the acute and post-acute phases of multiple sclerosis have been provided.).

Data availability

The materials used in this study are all public domain. Detailed linking sheets can be requested by the authors.

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Acknowledgements

The authors thank to Roxanne Maritz who supported the linking process.

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Authors

Contributions

KP contributed to the design of the study, conducted the data collection and analyses of the study, and played an important role in interpreting the results. She drafted the paper and approved the final version. MS designed the work and played a significant role in identifying the relevant materials for analyses and in interpreting the results. She revised earlier versions of the paper and approved the final version. AK played an important role in recruiting participants for this study and identifying relevant materials and provided valuable feedback in interpreting the results. She revised earlier versions of the paper and approved the final version. BP designed the work, contributed to the identification of the relevant materials, supervised the analyses and interpretation of the results, as well as the drafting of the paper. She revised the paper and approved the final version. All authors agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Kannit Pongpipatpaiboon.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Ethical approval was obtained from Ethical Committee of Faculty of Medicine, Chiang Mai University.

Informed consent

All participants signed informed consent before participating.

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Pongpipatpaiboon, K., Selb, M., Kovindha, A. et al. Toward a framework for developing an ICF-based documentation system in spinal cord injury-specific rehabilitation based on routine clinical practice: a case study approach. Spinal Cord Ser Cases 6, 33 (2020). https://doi.org/10.1038/s41394-020-0283-8

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