[Personal and Environmental Contextual Factors in Socio-Medical Orthopedic Evaluation Reports]

The personal and environmental contextual factors of the ICF describe not only physical and mental health but also (occupational) participation. So far, the extent to which these contextual factors are taken into account in the socio-medical evaluation has not been clarified. Contextual factors can guide allocation to disability pension or rehabilitative interventions in an individualized and targeted manner. The aim of this study was to determine the frequency of ICF contextual factors in socio-medical evaluation.

A frequency analysis of contextual factors in socio-medical reports for musculoskeletal disorders was performed. Contextual factors mentioned several times were coded once in the report. In the frequency ranking, each environmental and personal factor was categorized as "frequent," "moderate," and "rare."

215 socio-medical reports with musculoskeletal diagnoses starting from 2017 were retrospectively analyzed. All socio medical reports were analyzed for the occurence of personal contextual and environmental factors. In particular, personal factors were identified, which provide information about general personal characteristics or the general state of health. Almost half of the environmental factors were rarely identified.

Many ICF contextual factors are constantly recorded in the analyzed reports. The important influence of these factors on return to work is well known. Thus, the absence or low presence of the ICF contextual factors from the chapters Attitudes (i4), Basic Skills (i4) and Support & Relationships (e3), which are also contextual to the assessed person's experience of the world of work, was surprising. The relevance of the frequently and rarely identified contextual factors for the socio-medical evaluation of musculoskeletal disability pension applicants must be questioned.