Laying the foundation for an International Classification of Functioning, Disability and Health Core Set for community-dwelling elderly adults in primary care: the clinical perspective identified in a cross-sectional study

Objectives Having more information about the biopsychosocial functioning of their geriatric patients might help physicians better balance medical interventions according to patients’ needs. For this reason, we aimed to develop an easy-to-handle International Classification of Functioning, Disability...

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Main Authors: Thomas Kuehlein, Johanna Tomandl, Stephanie Book, Gudrun Ulbrecht, Susann Gotthardt, Ellen Freiberger, Elmar Graessel
Format: Article
Language:English
Published: BMJ Publishing Group 2020-11-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/11/e038434.full
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author Thomas Kuehlein
Johanna Tomandl
Stephanie Book
Gudrun Ulbrecht
Susann Gotthardt
Ellen Freiberger
Elmar Graessel
author_facet Thomas Kuehlein
Johanna Tomandl
Stephanie Book
Gudrun Ulbrecht
Susann Gotthardt
Ellen Freiberger
Elmar Graessel
author_sort Thomas Kuehlein
collection DOAJ
description Objectives Having more information about the biopsychosocial functioning of their geriatric patients might help physicians better balance medical interventions according to patients’ needs. For this reason, we aimed to develop an easy-to-handle International Classification of Functioning, Disability and Health (ICF) Core Set for community-dwelling geriatric patients aged 75 and older in primary care. In this empirical study, we describe the functioning and health of community-dwelling patients aged 75 and older in primary care in Germany and identify the most common problems encountered by these individuals when using the ICF.Design In this exploratory, cross-sectional study, a health professional conducted semi-structured interviews.Setting Community-dwelling older adults aged 75 and older in Germany.Participants 65 participants (mean age=80.2, SD=3.6).Outcome measures Extended ICF Checklist V.2.1a, patients prioritised chapters of the ‘activities and participation’ component.Results The three most common impairments for ‘body functions’ were visual system functions (ICF-code b210; 89%), blood pressure functions (b420; 80%) and sensations associated with hearing and vestibular functions (b240; 59%). For ‘body structures’, they were eyes, ears and related structures (s2; 81%), structure of mouth (s320; 74%) and structures related to the digestive, metabolic and endocrine systems (s5; 49%). For the ‘activities and participation’ component, adequate aids compensated for activity limitations to a certain degree. Still, after having adequate aids, the category in which the participants had the most difficulty was walking (d450; 35%). Participants rated the ‘mobility’ chapter as the most important of all chapters. ‘Environmental factors’ were facilitators of participants’ functioning.Conclusions This empirical study provides a list of ICF categories relevant to older adults from the clinical perspective. Along with lists from the other three preparatory studies, it will form the basis for the development of an ICF Core Set for community-dwelling older adults in primary care.Trial registration details The trial is registered in ClinicalTrials.gov (NCT03384732).
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spelling doaj-art-3f455a4a189143f1939bcffe304f5fd52024-11-26T17:50:13ZengBMJ Publishing GroupBMJ Open2044-60552020-11-01101110.1136/bmjopen-2020-038434Laying the foundation for an International Classification of Functioning, Disability and Health Core Set for community-dwelling elderly adults in primary care: the clinical perspective identified in a cross-sectional studyThomas Kuehlein0Johanna Tomandl1Stephanie Book2Gudrun Ulbrecht3Susann Gotthardt4Ellen Freiberger5Elmar Graessel62 Institute of General Practice, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, GermanyInstitute of General Practice, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, GermanyCentre of Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany1 Center for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany3 Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Nürnberg, GermanyInstitute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, GermanyCentre of Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, GermanyObjectives Having more information about the biopsychosocial functioning of their geriatric patients might help physicians better balance medical interventions according to patients’ needs. For this reason, we aimed to develop an easy-to-handle International Classification of Functioning, Disability and Health (ICF) Core Set for community-dwelling geriatric patients aged 75 and older in primary care. In this empirical study, we describe the functioning and health of community-dwelling patients aged 75 and older in primary care in Germany and identify the most common problems encountered by these individuals when using the ICF.Design In this exploratory, cross-sectional study, a health professional conducted semi-structured interviews.Setting Community-dwelling older adults aged 75 and older in Germany.Participants 65 participants (mean age=80.2, SD=3.6).Outcome measures Extended ICF Checklist V.2.1a, patients prioritised chapters of the ‘activities and participation’ component.Results The three most common impairments for ‘body functions’ were visual system functions (ICF-code b210; 89%), blood pressure functions (b420; 80%) and sensations associated with hearing and vestibular functions (b240; 59%). For ‘body structures’, they were eyes, ears and related structures (s2; 81%), structure of mouth (s320; 74%) and structures related to the digestive, metabolic and endocrine systems (s5; 49%). For the ‘activities and participation’ component, adequate aids compensated for activity limitations to a certain degree. Still, after having adequate aids, the category in which the participants had the most difficulty was walking (d450; 35%). Participants rated the ‘mobility’ chapter as the most important of all chapters. ‘Environmental factors’ were facilitators of participants’ functioning.Conclusions This empirical study provides a list of ICF categories relevant to older adults from the clinical perspective. Along with lists from the other three preparatory studies, it will form the basis for the development of an ICF Core Set for community-dwelling older adults in primary care.Trial registration details The trial is registered in ClinicalTrials.gov (NCT03384732).https://bmjopen.bmj.com/content/10/11/e038434.full
spellingShingle Thomas Kuehlein
Johanna Tomandl
Stephanie Book
Gudrun Ulbrecht
Susann Gotthardt
Ellen Freiberger
Elmar Graessel
Laying the foundation for an International Classification of Functioning, Disability and Health Core Set for community-dwelling elderly adults in primary care: the clinical perspective identified in a cross-sectional study
BMJ Open
title Laying the foundation for an International Classification of Functioning, Disability and Health Core Set for community-dwelling elderly adults in primary care: the clinical perspective identified in a cross-sectional study
title_full Laying the foundation for an International Classification of Functioning, Disability and Health Core Set for community-dwelling elderly adults in primary care: the clinical perspective identified in a cross-sectional study
title_fullStr Laying the foundation for an International Classification of Functioning, Disability and Health Core Set for community-dwelling elderly adults in primary care: the clinical perspective identified in a cross-sectional study
title_full_unstemmed Laying the foundation for an International Classification of Functioning, Disability and Health Core Set for community-dwelling elderly adults in primary care: the clinical perspective identified in a cross-sectional study
title_short Laying the foundation for an International Classification of Functioning, Disability and Health Core Set for community-dwelling elderly adults in primary care: the clinical perspective identified in a cross-sectional study
title_sort laying the foundation for an international classification of functioning disability and health core set for community dwelling elderly adults in primary care the clinical perspective identified in a cross sectional study
url https://bmjopen.bmj.com/content/10/11/e038434.full
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