ICF Core Set for geriatric patients in early post-acute rehabilitation facilities.
ABSTRACT The aim of this consensus process was to decide on a first version of the ICF Core Set for geriatric patients in early post-acute rehabilitation facilities.
The ICF Core Set development involved a formal decision-making and consensus process, integrating evidence gathered from preliminary studies including focus groups of health professionals, a systematic review of the literature and empiric data collection from patients.
Fifteen experts selected a total of 123 second-level categories. The largest number of categories was selected from the ICF component Body Functions (51 categories or 41%). 14 (11%) of the categories were selected from the component Body Structures, 30 (29%) from the component Activities and Participation, and 28 (23%) from the component Environmental Factors.
The Post-acute ICF Core Set for geriatric patients is a clinical framework to comprehensively assess patients in early post-acute rehabilitation facilities, particularly in an interdisciplinary setting. This first version of the ICF Core Set will be further tested through empiric studies in German-speaking countries and internationally.
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ABSTRACT: Patients undertaking inpatient rehabilitation comprise a diverse group, including patients with stroke and other neurological conditions, patients who have fallen with or without a resulting fracture, and patients with joint replacements, general debility, or various cardiopulmonary conditions. It is not clear whether diagnosis has an impact on discharge destination in a heterogeneous patient group. The purpose of this study was to determine whether diagnostic category matters or whether it is rehabilitation length of stay (LOS), ability on the 10-Meter Walk Test (10MWT), or Balance Outcome Measure for Elder Rehabilitation (BOOMER) at discharge that predicts discharge destination in elderly patients undergoing rehabilitation who had previously lived at home. A retrospective audit was undertaken at a single rehabilitation facility in South East Queensland, Australia, that serviced 4 local short-term care hospitals. Participants were admitted consecutively to the facility between June 2010 and March 2012 who met inclusion criteria. These included a primary diagnosis category of orthopedic conditions, debility, stroke, and other neurological conditions according to the Australasian Rehabilitation Outcomes Centre and older than 60 years (n = 248). Interventions while being a rehabilitation inpatient comprised usual care physiotherapy individually tailored and incorporating elements of balance, strengthening, and functional exercise. Main outcome measures were discharge to residential aged care facility (RACF) versus home, differences between diagnostic categories in terms of discharge destination, LOS, and performance on outcome measures. Prediction of discharge destination by LOS, 10MWT, and BOOMER performance at discharge was explored. A total of 28 patients (12.3%) were discharged to RACF. Diagnosis was not correlated with discharge destination (Pearson χ = 1.26, P = .74). The variables rehabilitation LOS, an inability to perform the 10MWT at discharge, and discharge BOOMER score of less than 4 can predict discharge destination with 86.4% accuracy (P = .002). This model had a sensitivity of 71.4% (discharge to RACF) and specificity of 93.3% (discharge home). To return home after rehabilitation, patients need to be able to walk at least 10 m and undertake tasks such as moving from sitting to standing, turning around, as well as managing steps. The study revealed that a standardized suite of measures of functional ability and balance may not be appropriate for patients in all diagnostic categories undergoing rehabilitation. Therefore, just as intervention needs to be tailored for the individual patient, the measure of their progress also should be unique.Journal of geriatric physical therapy (2001). 11/2013;
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ABSTRACT: This study evaluated the significant contents and concepts of the Biopsychosocial Assessment Method (MAB) as they relate to the International Classification of Functioning, Disability, and Health (ICF) and the connection between the Geriatric Core Set (GCS) and the different issues of the MAB. We linked the 56 items of the MAB to ICF and GCS categories according to published rules. The most significant concepts included in the MAB enabled the connection of 83 items to the ICF's categories. It was possible to establish a connection with all the components of the ICF except the Body Structures component. Of the 123 categories in the GCS, about 30% did not establish connections with MAB items. The results of this study show that—much like the ICF—the MAB is a tool based on the biopsychosocial model, allowing for a comprehensive and integrated assessment of the different components of functioning. Now, the MAB is the most utilized tool for the evaluation of the geriatric population in Portugal. Thus, it is of the utmost importance that we analyze its results in order to enhance its capabilities. It can then contribute to the creation of a shortened Core Set by the World Health Organization (WHO).Educational Gerontology 01/2014; 40(9). · 0.39 Impact Factor
Article: Rehabilitation in der Geriatrie[Show abstract] [Hide abstract]
ABSTRACT: Die geriatrisch rehabilitative Behandlung ist in allen stationären, teilstationären und ambulanten geriatrischen Versorgungsformen für ältere Patienten integraler Bestandteil. Geriatrische Patienten sind aufgrund ihrer Multimorbidität verstärkt von Pflegebedürftigkeit und Verlust der häuslichen Selbstständigkeit bedroht. Ziel der Rehabilitation in der Geriatrie ist es, ergänzend zur kurativen Versorgung die krankheitsbedingten Fähigkeitsstörungen zu behandeln, um die Mobilität, die Aktivitäten des täglichen Lebens und die Teilhabe möglichst im häuslichen Umfeld zu erhalten oder zu verbessern. Kennzeichnende Strukturmerkmale in allen geriatrischen Einrichtungen sind das geriatrische Assessment und das geriatrische Team. Die geriatrisch rehabilitative Behandlung ist funktionsorientiert (ICF) und kann deshalb bei einem breiten Spektrum von Erkrankungen indiziert sein. Die demografische Entwicklung erfordert einen weiteren Ausbau geriatrischer Versorgungsstrukturen mit innovativen Konzepten wie beispielsweise gerontotraumatologische Abteilungen oder geriatrische Praxisverbünde und eine bessere Vernetzung der Behandlungsangebote.Der Internist 10/2010; 51(10). · 0.33 Impact Factor