Implementation of the ERAS protocol in gynecology and oncogynecology - evaluation of a pilot study.

OBJECTIVE: To describe the implementation process and evaluate the success of compliance with the recommended ERAS protocol in the Czech healthcare system. METHODS: The study included 163 patients from March to September 2022, a total of 7 months. Patients were divided into three groups according to the type of surgery. Clinical protocol: Oncogynecology, hysterectomy and laparoscopy. The implementation was realized in three phases (preparation, implementation of the protocol itself and evaluation). RESULTS AND CONCLUSIONS: The cumulative adherence rate was 90% or more in all three groups. Based on the pilot results at our department, we evaluated the ERAS concept as a well-implemented tool for gynaecological departments in the Czech healthcare system.

20 Years of ICF-International Classification of Functioning, Disability and Health: Uses and Applications around the World.

The International Classification of Functioning Disability and Health (ICF) was approved in 2001 and, since then, several studies reported the increased interest about its use in different sectors. A recent overview that summarizes its applications is lacking. This study aims to provide an updated overview about 20 years of ICF application through an international online questionnaire, developed by the byline authors, and sent to each World Health Organization Collaborating Centers of the Family of International Classifications (WHO-FIC CCs). Data was collected during October 2020 and December 2021 and descriptive content analyses were used to report main results. Results show how, in most of the respondent countries represented by WHO-FIC CCs, ICF was mainly used in clinical practice, policy development and social policy, and in education areas. Despite its applications in different sectors, ICF use is not mandatory in most countries but, where used, it provides a biopsychosocial framework for policy development in health, functioning and disability. The study provides information about the needs related to ICF applications, that can be useful to organize targeted intervention plans. Furthermore, this survey methodology can be re-proposed periodically to monitor the use of the ICF in the future.

Application of International Classification of Functioning, Disability and Health (ICF), Functional Health and Disability.

The International Classification of Functioning, Disability and Health (ICF) is a common language for different professions in the health, social, educational and vocational systems for lawyers, decision makers and politicians. It deals with how to describe health conditions, functional health and disability. It gives detailed operational definitions of different functions that constitute health. From body function and body structure to activities of daily living and participation in society. ICF has brought international consensus on definitions and provided a framework to describe public health and disability.

Functioning and disability in traumatic brain injury.

PURPOSE: To describe functioning and disability in patients with traumatic brain injury (TBI) according to the model endorsed by the International Classification of Functioning Disability and Health (ICF). METHODS: Adult patients with acquired TBI were consecutively enrolled. The Functional Independence Measure (FIM), the WHO Disability Assessment Schedule II (WHO-DAS II) and the ICF checklist were administered in individual sessions. Descriptive analyses were performed to report on FIM and WHO-DAS II scores. ICF categories reported as a problem by more than 20% of patients were described in detail. RESULTS: One hundred patients (66 males, mean age 36.1) were enrolled. Mean WHO-DAS II score was 16.8, mean FIM was 116.5 and 87 ICF categories were selected: 27 Body Functions (mainly mental and movement-related) and Structures, 43 Activities and Participation (mainly connected with mobility) and 17 Environmental Factors. Negligible difference between capacity and performance qualifiers was observed. CONCLUSIONS: The ICF can be successfully implemented in clinical and rehabilitation of patients with TBI, because it enables to describe the variety of problems they encounter: ICF-derived data provide a holistic view of disability and enable the impact of service interventions on functioning and participation, and enable clinicians to tailor intervention according to patient's actual needs.

Functioning and disability in multiple sclerosis.

PURPOSE: To describe functioning and disability in patients with multiple sclerosis (MS) according to the model endorsed by the International Classification of Functioning Disability and Health (ICF). METHODS: Adult patients with MS were consecutively enrolled. The Expanded Disability Status Scale (EDSS), the WHO Disability Assessment Schedule II (WHO-DAS II) and the ICF checklist were administered in individual sessions. Descriptive analyses were performed to report on EDSS and WHO-DAS II scores. ICF categories reported as a problem by more than 20% of patients were described in detail. RESULTS: One hundred patients (70 females, mean age 41.7), 73 with relapsing-remitting MS were enrolled. Mean WHO-DAS II score was 10.6 and 58 ICF categories were selected: 23 Body Functions and Structures, 21 Activities and Participation and 14 Environmental Factors. CONCLUSIONS: The ICF can be successfully implemented in clinical and rehabilitation of patients with MS, because it enables to describe its multiple facets. Little differences between capacity and performance in ICF categories connected with activities of daily living, and presence of technical aids and other environmental factors are reported. On the contrary, in categories related to relationships, performance was worse than capacity thus revealing attitudinal barriers.