Original article
Measuring Participation as Defined by the International Classification of Functioning, Disability and Health: An Evaluation of Existing Measures

https://doi.org/10.1016/j.apmr.2008.11.010Get rights and content

Abstract

Resnik L, Plow M. Measuring participation as defined by the International Classification of Functioning, Disability and Health: an evaluation of existing measures.

Objectives

The content and theoretic underpinning of measures designed to assess participation, disability, and handicap vary widely, and few authors have attempted to compare the content of existing measures. The objectives of this study were to use the International Classification of Functioning, Disability and Health (ICF) taxonomy to (1) evaluate the participation content of measures and (2) identify the most comprehensive measures.

Design

We searched PubMed, Cumulated Index of Nursing and Allied Health Literature, and Health and Psychosocial Instruments databases to identify appropriate measures. Content analysis was conducted by classifying participation-related items of each measure into 1 or more of the 9 activities and participation chapters of the ICF taxonomy.

Setting

Not applicable.

Participants

We evaluated 40 generic and condition-specific self-report measures that met study inclusion criteria.

Interventions

Not applicable.

Main Outcome Measures

The most comprehensive measures were identified and coded by using second- and third-level ICF codes.

Results

Five measures containing participation items linked to all 9 chapters were the Community Living Skills Scale, the Assessment of Life Habits, Mayo-Portland Adaptability Inventory, the participation measure for postacute care, and the Psychosocial Adjustment to Illness Scale. The breadth and coverage of these 5 measures were compared.

Conclusions

We identified 5 measures that had items that were linkable to all 9 chapters of activities and participation; however, these measures differed in specifics of coverage and the approach to assessing participation. These findings can be used by clinicians and researchers to select the most comprehensive participation outcome measure for their populations.

Section snippets

Search Strategy

We searched PubMed, Cumulated Index of Nursing and Allied Health Literature, and Health and Psychosocial Instruments databases to locate articles describing the development and validation of measures of social functioning to identify appropriate measures. Because the terms participation, social participation, and handicap are not used in PubMed's MESH vocabulary for indexing articles, we used combinations of MESH terms that we believed were closest in meaning to the ICF term of participation in

Results

We identified a total of 40 measures that met the inclusion criteria for initial review. Content analysis of these measures revealed that several were broader measures of QOL and health and did not focus on the measurement of participation and/or its negative connotation disability. Thus, the team decided to exclude from our report those measures that did not contain a majority of items that were linkable to participation. Table 1 lists the 34 measures that were included in our initial

Discussion

We reviewed self-report measures containing items related to 2 or more chapters of activities and participation as defined by the ICF. Our review was unique in that we included both generic and condition-specific measures developed for diverse populations including those with head injury, mental illness, and physical disabilities. We believe that our analysis of content and dimension coverage can be used by clinicians and researchers to inform their choice of the most appropriate measure for

Conclusions

We reviewed 40 self-report measures containing items that assess 2 or more chapters of participation. We identified only 5 measures whose items were linked to all 9 chapters of activities and participation: the Community Living Skills Scale,48 the LIFE-H,49 the MPAI,60 the participation measure for postacute care,51 and the PAIS.52 We described each of these measures and performed detailed linking of items within each of these measures to subcategories within the ICF activities and

Acknowledgments

The authors would like to acknowledge the invaluable technical assistance of Debra Kelty, MPA, Regina Lynch, BA, BS, and Melanie Parente, BA.

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    Supported by the Veteran's Administration Health Services Research and Development Service (grant no.TRP-04-179), Rhode Island Foundation (grant no. 20052665), and National Research Service Award (grant no. HS00011-22).

    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

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