ICF Model and Documentation Flashcards

1
Q

What is health?

A

-biomedical model: absence of disease; treat the symptoms, treat the disease -WHO: physical, mental, social well-being (our approach); works with the living better aspect, not necessarily living longer; looks at person as a whole, we treat function not diseases

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2
Q

What is disability?

A

-relevance of environmental and personal factors in manifestations of a “disability” -how do we define it? Inability or limitation in performing socially defined roles and/or tasks that would normally be expected of an individual within a given culture and/or environment (self care skills, function in home, attain gainful employment, participate in community events)

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3
Q

Nagi Model of Disability

A

Pathology Impairments Functional Limitations Disability -pathology: interruption or interference with normal processes (ex: spinal cord injury) -impairments: anatomical, physiological, mental or emotional abnormality or loss (ex: weakness, muscle tightness) -functional limitations: limitation in performance at level of person (ex: stairs) -disability: limitation in performance of socially defined roles and tasks within environment (limits them from going out into society in a way they normally would)

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4
Q

ICIDH

A

-International Classification of Impairments, Disease, and Handicap -disease –> impairment –> disability –> handicap -disease: cellular, tissue, organ level -impairment: anatomy, physiology, emotional abnormalities -disability: limitation in components of physical function -handicap: societal expectation roles

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5
Q

ICF Upgrades

A

-impairment=body function and structure -disability-activity -handicap-participation -bidirectional arrows -visual representation of concept that any aspect of function can affect another -addition of contextual factors (factors about life, context in which they function: how they move through the environment, personal factors like how they react to change): environmental and personal allows a more comprehensive picture of the patient

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6
Q

ICF

A

-practice drawing ICF model with examples and definitions

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7
Q

Health Condition Definition

A

-disease, disorder, trauma, congenital abnormality, genetic predisposition, stress, aging

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8
Q

Body Function/Structure Definition

A

-physiologic function of the body systems -in other models, impairment

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9
Q

Activities Definition

A

-execution of a task or action by an individual

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10
Q

Participation Definition

A

-involvement in a life situation

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11
Q

Contextual Factors Definition

A

-physical, societal, personal, environmental

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12
Q

Contextual Factors: Environmental

A

-external influences on function and disability -facilitating or hindering aspects of physical, social, attitudinal world -ex: stairs, curbs, wheelchair ramps, opinions of others, financial assets, expectations within a culture -someone’s feelings may be perceptible to a person with a disability that may dissuade them from going out into the world

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13
Q

Contextual Factors: Personal

A

-internal influences on function and disability -impact of attributes of the person -ex: age, race, gender, fitness level, comorbidities, height, weight, personal coping mechanisms

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14
Q

Clinical Usefulness of ICF

A

-emphasis on disease vs. health -capacity (what they can do in ideal environment) vs. performance (what they can do in given environment) -personalize evaluation: selection of outcome measures-interest and function of patients -create universal terminology for clinicians -link between ICF and documentation

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15
Q

Clinical Implications of ICF

A

-personalize assessment -personalize intervention: promotes family involvement, goals derived from patient interest-motivation -prevention of secondary impairments -captures relevant environments -managerial decision (policy development) -universal understanding of health related information in research -DOCUMENTATION

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16
Q

ICF and Documentation

A

-consistency in terminology -identification of impairment is not enough-need to link impairment with consequences of disease: not just about functional consequences!! link to participation

17
Q

Reasons for Documeting

A
  • record patient-client interaction
  • communicate with others
  • demonstrate clinical problem solving
  • support reimbursement and need for services
  • provide proof that care is reasonable and necessary
  • provide proof of skilled care
  • facilitae administrative duties
  • serve as legal record of care
18
Q

Prove Reasonable and Necessary

A
  • accepted standards of medical practice for the condition
  • services are at a level of complexity that can be provided only by a PT (or PTA under supervison of PT)
  • condition requires services be provided by PT (condition may require PT, but condition alone does not mandate medical necessity)
  • expectation that condition will improve in a reasonable/predictable time
  • amount, frequency, duration reasonable under accepted standards
19
Q

Skilled Care

A
  • ex: patient amb 50’ with WBQC and min A1
  • patient amb 50’ with WBQC while PT provided physical A1 tactile cues to facilite swing/prevent toe drag
  • maintenance service: intermittent to advance HEP, safety concerns, when is maintaining gaining?, progressive disease: need to prove that they’re not getting worse
20
Q

Final Remarks About ICF

A
  • profession neutral: walking activity means something different to each discipline; orthopedics-surgical outcome, neurologists-pharmacologic outcome, PT-effect of rehab
  • delineates the complexity and individuality of health condition in the presence of disease
  • personalizes care