Disablement Models and the International Classification of Functioning, Disability and Health (ICF)

Disablement Models
-Benefits to health professions through organization of clinical practice and research activities
-Creation of a common language among health care professionals
-Facilitation of the delivery of patient-centered, whole-person health care
– Justification of interventions based on a comprehensive assessment of the effect of illness or injury on a person’s overall health-related quality of life
NAGI Model (1969)
Correlates Impairments to Functional Limitations. A pathology resulting in impairment, functional limitation and disability. Focus was on impairments, not on function.
International Classification of Functioning, Disability and Health – ICF (2001)
Delineates how a health condition may have an impact on an individual’s ability to function and well-being, instead of focusing on the individual’s specific health condition. APTA endorsed the use of ICF framework in 2010. The language of the Guide to Physical Therapist Practice 3.0 is consistent with the ICF.
The ICF
-Provides common language that could be used worldwide to describe health-related conditions and their interaction with functioning
-Based on a medical model and a social model
-Determine how a disability or disease might affect or limit an individual’s ability to function and perform within a society and/or his or her environment
-Can be used to organize data for research-based activities or in educational programs as an adjunct to clinical decision-making processes
-Provides a means for proper reimbursement by third-party payers such as Medicare, Medicaid, HMOs, PPO’s and private insurance
According to the World Health Organization
Disabilities is an umbrella term, covering impairments, activity limitations, and participation restrictions. An impairment is a problem in body function or structure; an activity limitation is a difficulty encountered by an individual in executing a task or action; while a participation restriction is a problem experienced by an individual in involvement in life situations.
Two main components: Functioning and Disability and
Contextual Factors provide?
A description/classification of the functioning of an individual and standard language for function and disability for all agencies to utilize.
What are the two main components that classificates the functioning of an individual?
-Functioning and Disability
-Contextual Factors
Functioning and Disability resembles
-Body Function
-Body Structure
-Activity
-Participation
Contextual Factors resembles
-Environmental Factors
-Personal Factors
Body Functions
includes the individual ability to perform an activity ( e.g. movement-related functions, sensory issues…)
Body Structures
Includes the anatomical or physiological body part related to the disability or disease ( e.g. organs, nervous or cardiovascular systems..)
Activity
Includes what the individual can do related to his or her ability to function in the areas such as mobility, communication, self care…
Participation
Includes the individual’s ability to take part in his or her daily routine (e.g. skills required by an employer or on the job, responsibilities as a parent or spouse…)
Environmental Factors
Includes the environment in which the individual lives and works
Personal Factors
Includes those related to age, ethnicity, occupation, and so forth.
NAGI and ICF
NAGI and ICF
NAGI Model
NAGI Model
ICF Model
An impairment is?
a problem in body function or structure
An activity limitation is
a difficulty encountered by an individual in executing a task or action
A participation restriction is
a problem experienced by an individual in involvement in life situations
The Nagi consist of
Impairment
Fuctional Limitation
Disability
The ICF consist of
Impairment
Activity Limitation
Participation Restriction
World Health Organization (WHO) are
The authority for health-care issues within the United Nations system and the global health matter
ICD-9
International Classification of Diseases 9th Revision
ICF
International Classification of Functioning, Disability, and Health
The ICF universal approach treats the patient as an
Individual and describes her/her functions, rather than using specific disease for identification
For practicing PT/PTA, the ICF provides
a common language that can be utilized across all nations and in health care service
In NAGI model, pathology means
Illness or disgnosis
In NAGI model, impairment occurs at what level
Tissue
In the NAGI model, the function of limitation is the
Inability to do a task due to an impairment
In the NAGI Disablement model, disability means
Social context
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