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Validating the International Classification of Functioning, Disability and Health Comprehensive Core Set for Rheumatoid Arthritis from the patient perspective: A qualitative study

Division of Rheumatology, Department of Internal Medicine III, Vienna Medical University, Vienna, Austria.
Arthritis & Rheumatology (Impact Factor: 7.87). 06/2005; 53(3):431-9. DOI: 10.1002/art.21159
Source: PubMed

ABSTRACT To validate the International Classification of Functioning, Disability and Health (ICF) Comprehensive Core Set for Rheumatoid Arthritis (RA) from the patient perspective.
Patients with RA were interviewed about their problems in daily functioning. Interviews were tape recorded and transcribed verbatim. Interview texts were divided into meaning units. The concepts contained in these meaning units were linked to the ICF according to 10 established linking rules. Of the transcribed data, 15% were analyzed and linked by a second health professional. The degree of agreement was calculated using the kappa statistic.
Twenty-one patients were interviewed. Two hundred twenty different concepts contained in 367 meaning units were identified in the qualitative analysis of the interviews and linked to 109 second-level ICF categories. Of the 76 second-level categories from the ICF RA Core Set, 63 (83%) were also found in the interviews. Twenty-five second-level categories, which are not part of the current ICF RA Core Set, were identified in the interviews. The result of the kappa statistic for agreement was 0.62 (95% boot-strapped confidence interval 0.59-0.66).
The validity of the ICF RA Core Set was supported by the perspective of individual patients. However, some additional issues raised in this study but not covered in the current ICF RA Core Set need to be investigated.

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    • "routine, which require complex and coordinated actions; for example, d630 preparing meals, d640 doing housework and d650 caring for household objects. This has also been observed in patients with rheumatoid arthritis (Stamm et al., 2005). The activities moving around using equipment (d465), using transportation (d470) and assisting others (d660) were also not reported by the participants in the current study. "
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    • "Author's personal copy quantify disease burden holistically (Helliwell et al., 2005). Therefore, in line with conceptual models such as the International Classification of Function and Disability (ICF), additional information related to personal and environmental factors can be measured (Stamm et al., 2005). These include important patient-focused areas such as footwear problems related to fit and comfort and the contribution of foot problems to independent living (Helliwell et al., 2005). "
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    • "Author's personal copy quantify disease burden holistically (Helliwell et al., 2005). Therefore, in line with conceptual models such as the International Classification of Function and Disability (ICF), additional information related to personal and environmental factors can be measured (Stamm et al., 2005). These include important patient-focused areas such as footwear problems related to fit and comfort and the contribution of foot problems to independent living (Helliwell et al., 2005). "
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