Academic journal article The Journal of Rehabilitation

The International Classification of Function, Disability and Health (ICF) and Its Application with AIDS

Academic journal article The Journal of Rehabilitation

The International Classification of Function, Disability and Health (ICF) and Its Application with AIDS

Article excerpt

The family of international classifications of the World Health Organization (WHO) provides a uniform language to convey a wide range of health-related information and promote communication between various health related disciplines and sciences. The International Classification of Disease, Tenth Revision (ICD-10) offers an etiological framework for classifying health conditions (i.e., disease, disorder, injury, or trauma or other health-related status). The International Classification of Impairments, Disabilities, and Handicaps (ICIDH), developed in 1980, served as a classification of the consequences of a disease (World Health Organization, 1980). Within the two decades of its use, the ICIDH has been translated into 13 languages and utilized for a number of purposes: (a) as a statistical tool for disability data collection, (b) as a research tool to measure health service outcomes and quality of life, (c) as a clinical tool for needs identification and treatment planning, and (d) and as a social policy tool to aid in social welfare planning and human rights advocacy (Bickenbach, Chatterji, Badley, Ustun, 1999; World Health Organization, 2002).

Since 1992, the WHO has been developing a new version of the ICIDH, which led to the International Classification of Functioning, Disability and Health, known as the ICF (or formerly as ICIDH-2). One of the primary goals of the revision was to provide a classification system with a neutral conception of "components of health" instead of "consequences of a disease" that were often characterized through negative terminology in the ICIDH (World Health Organization, 2001). "Consequences of a disease" may simply focus on the impact of a disease or injury, while "components of health" encompass all aspects of health and some health-related components of well-being, such as education and employment, In addition, there frequently were concerns of the applicability of the ICIDH for specific age groups (e.g., children) and diagnostic groups (e.g., multiple sclerosis; Halbertsma, Heerkens, Hirs, de Kleijn-de Vrankrijker, Van Ravensberg, & Napel, 2000). The ICF aimed to extend its scope of the classification to cover a wide range of functioning and disability manifested by different groups of people. Additionally, to emphasize the dynamic and reciprocal nature of person-environment interactions within the health paradigm, contextual factors are currently included in the ICF as a separate, but interrelated part of the taxonomy. The ICE thus, is used to identify health states associated with all health conditions at body, individual, and societal levels. When applied to the field of rehabilitation or other health care settings, the conceptual framework of the ICF provides a sound basis for understanding and studying the different dimensions of disablement as the consequences of health conditions and/or environmental interactions. In addition, its systematic coding scheme, along with the uniform terminology used, can serve to enhance communications between health care professionals and people with disabilities and to improve the comparability of data across countries, sectors, disciplines, services, and time.

To facilitate the understanding of "components of health" as a construct as well as the practical usefulness of the ICF, this article: (a) provides an explicit overview of the ICF system including its conceptual framework and the coding scheme, (b) applies the system to the analysis of health outcomes and disablement of persons living with HIV/AIDS, and (c) demonstrates a number of potential ICF codes for identifying the various areas of HIV/AIDS disabling condition frequently discussed in the literature.

The Conceptual Framework of the ICF

In general, the ICF organizes information into two parts: (a) Functioning and Disability, and (b) Contextual Factors (World Health Organization, 2001). "Functioning" and "Disability" serve as two umbrella terms encompassing the components of human functioning (i. …

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