Validation and evaluation of the application of the ICF Rehabilitation Set: a Polish clinical perspective

Abstract Background Monitoring a patient’s functional status in the rehabilitation process is essential for the ongoing improvement of the quality of the rehabilitation services offered. This possibility is provided by the use of the International Classification of Functioning, Disability and Health...

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Main Authors: Agnieszka Wiśniowska-Szurlej, Agnieszka Sozańska, Justyna Brożonowicz, Anna Wilmowska-Pietruszyńska, Bernard Sozański
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Health Services Research
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Online Access:https://doi.org/10.1186/s12913-025-13048-2
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author Agnieszka Wiśniowska-Szurlej
Agnieszka Sozańska
Justyna Brożonowicz
Anna Wilmowska-Pietruszyńska
Bernard Sozański
author_facet Agnieszka Wiśniowska-Szurlej
Agnieszka Sozańska
Justyna Brożonowicz
Anna Wilmowska-Pietruszyńska
Bernard Sozański
author_sort Agnieszka Wiśniowska-Szurlej
collection DOAJ
description Abstract Background Monitoring a patient’s functional status in the rehabilitation process is essential for the ongoing improvement of the quality of the rehabilitation services offered. This possibility is provided by the use of the International Classification of Functioning, Disability and Health (ICF) and the ICF Core Sets developed on its basis. The purpose of this study was to validate and evaluate the use of the ICF Rehabilitation Set in rehabilitation patients in clinical practice in southeastern Poland. Methods This study included patients who required comprehensive rehabilitation in a tertiary care rehabilitation centre. The study used the Polish version of a rating reference guide for the ICF Rehabilitation Set and the Barthel Index. The assessment was carried out by an interdisciplinary team, which established the ICF qualifier values by consensus. Interrater reliability was assessed using intraclass correlation coefficients (ICCs). Convergent validity was assessed using Spearman correlation coefficients between the Disability Index (DI) and the Barthel Index (BI). To assess the effectiveness of rehabilitation in the study group, a paired Wilcoxon test was used to compare the measurements of the two ICF codes. Results This study demonstrated the consistency and reliability of the reference guide for the ICF Rehabilitation Set. The ICC values were very high (for B620; D450; D640, the ICC was 1.000) and high (for E155, the ICC was 0.793). The individual entries from the ICF Rehabilitation Set were found to have very high concordance for assessing individual qualifiers between researchers (the ICC for the DI was 0.995). The ICF Rehabilitation Set scores and the calculated DI were correlated with the BI scores. The ICF Rehabilitation Set is sensitive to changes in the functional status of patients undergoing rehabilitation and is consistent with the results obtained by the BI measure. There was also a statistically significant improvement in patients’ functional status after rehabilitation. Conclusions The ICF Rehabilitation Set and the developed rating reference guide are reproducible, consistent and relevant and can be used in clinical settings to collect health information from people undergoing rehabilitation. Further research is needed to strengthen the evidence to validate the ICF in Poland. Trial registration The study was registered in the clinical trial registry at ClinicalTrials.gov (NCT06718036, date of registration 2024-11-30, retrospectively registered).
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spelling doaj-art-e82a2fcf6ec34a46b6e94ace28b7e6b92025-08-20T04:01:56ZengBMCBMC Health Services Research1472-69632025-08-012511910.1186/s12913-025-13048-2Validation and evaluation of the application of the ICF Rehabilitation Set: a Polish clinical perspectiveAgnieszka Wiśniowska-Szurlej0Agnieszka Sozańska1Justyna Brożonowicz2Anna Wilmowska-Pietruszyńska3Bernard Sozański4Faculty of Health Sciences and Psychology, Collegium Medicum, University of RzeszowFaculty of Health Sciences and Psychology, Collegium Medicum, University of RzeszowFaculty of Health Sciences and Psychology, Collegium Medicum, University of RzeszowFaculty of Medicine, Lazarski UniversityFaculty of Medicine, Collegium Medicum University of RzeszowAbstract Background Monitoring a patient’s functional status in the rehabilitation process is essential for the ongoing improvement of the quality of the rehabilitation services offered. This possibility is provided by the use of the International Classification of Functioning, Disability and Health (ICF) and the ICF Core Sets developed on its basis. The purpose of this study was to validate and evaluate the use of the ICF Rehabilitation Set in rehabilitation patients in clinical practice in southeastern Poland. Methods This study included patients who required comprehensive rehabilitation in a tertiary care rehabilitation centre. The study used the Polish version of a rating reference guide for the ICF Rehabilitation Set and the Barthel Index. The assessment was carried out by an interdisciplinary team, which established the ICF qualifier values by consensus. Interrater reliability was assessed using intraclass correlation coefficients (ICCs). Convergent validity was assessed using Spearman correlation coefficients between the Disability Index (DI) and the Barthel Index (BI). To assess the effectiveness of rehabilitation in the study group, a paired Wilcoxon test was used to compare the measurements of the two ICF codes. Results This study demonstrated the consistency and reliability of the reference guide for the ICF Rehabilitation Set. The ICC values were very high (for B620; D450; D640, the ICC was 1.000) and high (for E155, the ICC was 0.793). The individual entries from the ICF Rehabilitation Set were found to have very high concordance for assessing individual qualifiers between researchers (the ICC for the DI was 0.995). The ICF Rehabilitation Set scores and the calculated DI were correlated with the BI scores. The ICF Rehabilitation Set is sensitive to changes in the functional status of patients undergoing rehabilitation and is consistent with the results obtained by the BI measure. There was also a statistically significant improvement in patients’ functional status after rehabilitation. Conclusions The ICF Rehabilitation Set and the developed rating reference guide are reproducible, consistent and relevant and can be used in clinical settings to collect health information from people undergoing rehabilitation. Further research is needed to strengthen the evidence to validate the ICF in Poland. Trial registration The study was registered in the clinical trial registry at ClinicalTrials.gov (NCT06718036, date of registration 2024-11-30, retrospectively registered).https://doi.org/10.1186/s12913-025-13048-2International Classification of FunctioningDisability and HealthRehabilitationClinical toolICF Rehabilitation SetInterrater reliability
spellingShingle Agnieszka Wiśniowska-Szurlej
Agnieszka Sozańska
Justyna Brożonowicz
Anna Wilmowska-Pietruszyńska
Bernard Sozański
Validation and evaluation of the application of the ICF Rehabilitation Set: a Polish clinical perspective
BMC Health Services Research
International Classification of Functioning
Disability and Health
Rehabilitation
Clinical tool
ICF Rehabilitation Set
Interrater reliability
title Validation and evaluation of the application of the ICF Rehabilitation Set: a Polish clinical perspective
title_full Validation and evaluation of the application of the ICF Rehabilitation Set: a Polish clinical perspective
title_fullStr Validation and evaluation of the application of the ICF Rehabilitation Set: a Polish clinical perspective
title_full_unstemmed Validation and evaluation of the application of the ICF Rehabilitation Set: a Polish clinical perspective
title_short Validation and evaluation of the application of the ICF Rehabilitation Set: a Polish clinical perspective
title_sort validation and evaluation of the application of the icf rehabilitation set a polish clinical perspective
topic International Classification of Functioning
Disability and Health
Rehabilitation
Clinical tool
ICF Rehabilitation Set
Interrater reliability
url https://doi.org/10.1186/s12913-025-13048-2
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