Aspects of functioning and environmental factors in medical work capacity evaluations of persons with chronic widespread pain and low back pain can be represented by a combination of applicable ICF Core Sets

BMC Public Health

Bruno Trezzini³  Gerold Stucki⁴  Wout Ernst Lodewijk De Boer²  Veronika Lay³  Andrea Glässel³  Christine Boldt¹  Jessica Anner²  Urban Schwegler⁴ 

[1]Department of Applied Social Sciences, University of Applied Sciences Munich, München, Germany

[2]asim, Academy of Swiss Insurance Medicine, University Hospital Basel, Basel, Switzerland

[3]Swiss Paraplegic Research (SPF), Nottwil, Switzerland

[4]Department of Health Sciences and Health Policy, University of Lucerne and SPF, Nottwil, Switzerland

关键词: Standardization;    Low back pain;    Chronic widespread pain;    Work capacity evaluation;    Disability and Health (ICF);    International Classification of Functioning;   

Others  :  1162720
DOI  :  10.1186/1471-2458-12-1088

 received in 2012-07-21, accepted in 2012-12-06,  发布年份 2012

【 摘 要 】

Background

Medical work capacity evaluations play a key role in social security schemes because they usually form the basis for eligibility decisions regarding disability benefits. However, the evaluations are often poorly standardized and lack transparency as decisions on work capacity are based on a claimant’s disease rather than on his or her functional capacity. A comprehensive and consistent illustration of a claimant’s lived experience in relation to functioning, applying the International Classification of Functioning, Disability and Health (ICF) and the ICF Core Sets (ICF-CS), potentially enhances transparency and standardization of work capacity evaluations. In our study we wanted to establish whether and how the relevant content of work capacity evaluations can be captured by ICF-CS, using disability claimants with chronic widespread pain (CWP) and low back pain (LBP) as examples.

Methods

Mixed methods study, involving a qualitative and quantitative content analysis of medical reports. The ICF was used for data coding. The coded categories were ranked according to the percentage of reports in which they were addressed. Relevance thresholds at 25% and 50% were applied. To determine the extent to which the categories above the thresholds are represented by applicable ICF-CS or combinations thereof, measures of the ICF-CS’ degree of coverage (i.e. content validity) and efficiency (i.e. practicability) were defined.

Results

Focusing on the 25% threshold and combining the Brief ICF-CS for CWP, LBP and depression for CWP reports, the coverage ratio reached 49% and the efficiency ratio 70%. Combining the Brief ICF-CS for LBP, CWP and obesity for LBP reports led to a coverage of 47% and an efficiency of 78%.

Conclusions

The relevant content of work capacity evaluations involving CWP and LBP can be represented by a combination of applicable ICF-CS. A suitable standard for documenting such evaluations could consist of the Brief ICF-CS for CWP, LBP, and depression or obesity, augmented by additional ICF categories relevant for this particular context. In addition, the unique individual experiences of claimants have to be considered in order to assess work capacity comprehensively.

【 授权许可】

   
2012 Schwegler et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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