A review of participation instruments based on the International Classification of Functioning, Disability and Health

To identify and review instruments which assess participation as defined by the International Classification of Functioning, Disability and Health (ICF).

A systematic search of the literature was conducted. Data related to the content, administration, scoring, reliability, validity and responsiveness was abstracted.

Eleven instruments met the inclusion criteria. Seven instruments include questions with content from Chapters 4 to 9 in the ICF activities and participation component. Four instruments exclude Chapter 5 (self-care). Most of the instruments assess subjective aspects of participation. Evidence on reliability was available for 10 instruments and the majority met the criteria for group level comparisons for internal consistency and reproducibility in the health conditions assessed. In terms of validity, dimensionality was assessed in eight instruments, with six using modern measurement methods. Participation instruments have been compared with various generic and/or disease-specific instruments, but they have not been compared with each other. Evidence on responsiveness was only available for four instruments.

There has been considerable interest in developing instruments to measure participation. To date, the World Health Organisation Disability Assessment Schedule II has undergone the most psychometric testing. Future research must continue to assess these instruments in persons with various health conditions to advance the conceptualisation and measurement of participation.