Improving Primary Health Care Data With ICPC-3: From a Medical to a Person-Centered Perspective.

The World Organization of Family Doctors (WONCA) developed the third edition of the International Classification of Primary Care (ICPC-3) to support the shift from a medical perspective to a person-centered perspective in primary health care. The previous editions (ICPC-1 and ICPC-2) allowed description of 3 important elements of health care encounters: the reason for the encounter, the diagnosis and/or health problem, and the process of care. The ICPC-3 adds function-related information as a fourth element, thereby capturing most parts of the encounter in a single practical and concise classification. ICPC-3 thus has the potential to give more insight on patients' activities and functioning, supporting physicians in shifting from a strict medical/disease-based approach to care to a more person-centered approach. The ICPC-3 is also expanded with a new chapter for visits pertaining to immunizations and for coding of special screening examinations and public health promotion; in addition, it contains classes for programs related to reported conditions (eg, a cardiovascular program, a heart failure program) and can accommodate relevant national or regional classes. Classes are selected based on what is truly and frequently occurring in daily practice. Each class has its own codes. Less frequently used concepts pertaining to morbidity are captured as inclusions within the main classes. Implementation of the ICPC-3 in an electronic health record allows provision of meaningful feedback to primary care, and supports the exchange of information within teams and between primary and secondary care. It also gives policy makers and funders insight into what is happening in primary care and thus has the potential to improve provision of care.

Primary care functioning scale showed validity and reliability in patients with chronic conditions: a psychometric study.

OBJECTIVES: We evaluated the psychometric properties of a newly developed self-report questionnaire that aims for a more person-centered approach in primary care for patients with chronic conditions, the Primary Care Functioning Scale (PCFS). STUDY DESIGN AND SETTING: To test the measurement properties of the PCFS, we asked patients with diabetes, cardiovascular disease, and chronic pulmonary disease to complete the PCFS questionnaire. The PCFS is entirely based on the International Classification of Functioning, Disability, and Health (ICF), consisting of 52 ICF-related items covering body functions, activities and participation, environmental factors, and personal factors. We analyzed three hypotheses representing different item sets of the 34 ICF-related items that assess the level of functioning (body functions, activities, and participation). We tested for unidimensionality, differential item functioning, reliability, and criterion-related validity. RESULTS: Five hundred and eighty-two patients completed the questionnaire. The total scores of the polytomous and dichotomized items from the overall set 'body functions, activities and participation' demonstrated unidimensionality, good reliability (>0.80), and stability over time without bias from background variables. CONCLUSION: In sum, the PCFS can be used as a valid and reliable instrument to measure functioning in patients with chronic morbidity in primary care.

Toward a Harmonized WHO Family of International Classifications Content Model.

An overarching WHO-FIC Content Model will allow uniform modeling of classifications in the WHO Family of International Classifications (WHO-FIC) and promote their joint use. We provide an initial conceptualization of such a model.

Perceived usefulness of the International Classification of Functioning, Disability and Health (ICF) increases after a short training: A randomized controlled trial in master of advanced nursing practice students.

The Master program of Advanced Nursing Practice (MANP) educates nurses to become a nurse practitioner. Nurse practitioners are health care professionals focusing on the intersection of cure and care. However, a clear model covering that area is lacking. The use of the International Classification of Functioning, Disability and Health (ICF) may be considered for incorporation in curricula due to its focus on the integration of cure and care. The purpose of this study is to test the effects of a short (= 4-h instructor-led) ICF training on perceived usefulness of the ICF. In a randomized controlled trial, 76 MANP students were randomly allocated to intervention or control group. Data were collected using an 'ICF survey and learning assessment tool'. Data of 56 students were included for analysis. Perceived usefulness of the ICF increased significantly in the intervention group immediately after training (p = 0.001) but no longer at 3-months follow-up (p = 0.388). Attitude and knowledge related to the ICF were significantly increased in the intervention group at both post-training assessments (p < 0.001 and 0.02). The positive influence of the ICF training on perceived usefulness of the ICF is relevant for including ICF in MANP curriculum.

Past and future use of the ICF (former ICIDH) by nursing and allied health professionals.

PURPOSE: This study describes the use of the ICIDH by allied health professionals and the nursing professions in The Netherlands. It is an example for showing how in recent years the application of the ICIDH has developed within professions. The data elements of patient descriptors documented by nurses and allied health professionals using the ICIDH, as a shared terminology, are presented. METHOD: The study contains an overview of former and present application of the ICIDH and a systematic description of (possible) use of the ICIDH and its successor, the ICF. RESULTS AND CONCLUSION: Although former and present use prove to be valuable, the level of detail needed for a richer description of the functioning of a patient does not yet exist within the ICIDH nor within the ICF. This and other arguments are given for the innovation process of the ICF and the need for the development of a (multidisciplinary) clinical modification, the ICF-CM.