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Development and appropriateness of a scoring method for International Classification of Functioning, Disabilities,
Shigehito Shiota1,2, Toshiro Kitagawa3,4, Naoya Goto2
1Heart Failure Center, Hiroshima University Hospital, Hiroshima, Japan sshiota@hiroshima-u.ac.jp.
Insights
A new scoring method using the International Classification of Functioning, Disability and Health (ICF) was developed for older heart failure (HF) patients in Japan. This ICF-based approach was found appropriate for comprehensive patient assessment.
Area of Science:
- Gerontology
- Rehabilitation Medicine
- Public Health
Background:
- Increasing prevalence of heart failure (HF) in older adults in Japan presents a significant social challenge.
- A need exists for standardized healthcare assessment tools using a common language.
Purpose of the Study:
- To develop and validate an International Classification of Functioning, Disability and Health (ICF)-based scoring methodology for 43 ICF categories.
- To assess the appropriateness of this scoring system for older patients with heart failure.
Main Methods:
- A modified Delphi method, incorporating the RAND/University of California at Los Angeles (UCLA) Appropriateness Method, was employed.
- A multidisciplinary expert panel (n=26) reviewed and scored 43 ICF categories via a Likert scale questionnaire.
- Iterative Delphi rounds were conducted until consensus was achieved.
Main Results:
- An expert panel of 21 members reached consensus on all 43 ICF categories after modifications in the second Delphi round.
- The developed ICF-based scoring methodology was deemed appropriate for older individuals with HF.
- Initial consensus issues were resolved through expert feedback and adjustments.
Conclusions:
- The developed ICF-based scoring method is appropriate for assessing older heart failure patients.
- Further research is required to determine if this comprehensive ICF assessment improves information sharing and reduces hospital readmissions.
Objective:
The number of older patients with heart failure (HF) is increasing in Japan and has become a social problem. There is an urgent need to develop a comprehensive assessment methodology based on the common language of healthcare; the International Classification of Functioning, Disability and Health (ICF). The purpose of this study was to develop and confirm the appropriateness of a scoring methodology for 43 ICF categories in older people with HF.
Design:
Cross-sectional survey. We applied the RAND/University of California at Los Angeles (UCLA) Appropriateness Method with a modified Delphi method.
Setting And Participants:
We included a panel of 26 multidisciplinary experts on HF care consisting of home physicians, cardiovascular physicians, care managers, nurses, physical therapists, a pharmacist, occupational therapist, nutritionist and a social worker.
Measures:
We conducted a literature review of ICF linking rules and developed a questionnaire on scoring methods linked to ICF categories in older people with HF. In the Delphi rounds, we sent the expert panel a questionnaire consisting of three questions for each of the 43 ICF categories. The expert panel responded to the questionnaire items on a 1 (very inappropriate) - 9 (very appropriate) Likert scale and repeated rounds until a consensus of 'Appropriate' and 'Agreement' was reached on all items.
Results:
A total of 21 panel members responded to all the Delphi rounds. In the first Delphi round, six question items in four ICF categories did not reach a consensus of 'Agreement', but the result of our modifications based on panel members' suggestions reached to a consensus of 'Appropriate' and 'Agreement' on all questions in the second Delphi round.
Conclusion:
The ICF-based scoring method for older people with HF developed in this study was found to be appropriate. Future work is needed to clarify whether comprehensive assessment and information sharing based on ICF contributes to preventing readmissions.
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