Date Presented 04/05/19
OT older adult interventions employed in a skilled-nursing facility were linked to Level III ICF categories using a specific and precise linking process. This study revealed that the majority of the interventions employed were linked to the ICF category exercise tolerance functions. This study demonstrated how the ICF may be used in OT practice. The results of this study reflect the focus of OT practice in two skilled-nursing facilities.
Primary Author and Speaker: Janel Anne Belarmino
Additional Authors and Speakers: Vanessa Jewell
PURPOSE: Occupational therapy practitioners are encouraged to explore and compare occupational therapy constructs to universally known frameworks such as the International Classification of Functioning, Disability and Health (ICF) to facilitate interprofessional collaboration and communication (Stamm et al., 2002). The ICF is a framework that describes and measures health and disability (World Health Organization, 2002). It also offers a common language that may facilitate communication and collaboration within and across health disciplines. Occupational therapy assessments, interventions, and conceptual models were linked to the ICF to determine congruence, or lack thereof, and to demonstrate focus of occupational therapy related information. However, there is scant evidence regarding the linkage of the ICF and older adult occupational therapy interventions. Thus, this study aimed to identify the focus of older adult occupational therapy interventions using the ICF. Specifically, this study aimed to answer this research question: What ICF categories are linked to older adult occupational therapy interventions in skilled nursing facilities? This study aimed to contribute to the body of knowledge in older adult interventions and the ICF.
DESIGN: This study employed a descriptive secondary analysis of a data set of field notes from a previous study regarding occupational therapy interventions used in short-term rehabilitation in skilled nursing facilities. The data set included 57 occupational therapy interventions that were previously observed in two skilled nursing facilities.
METHOD: This study used a data extraction table to identify health related information to be linked to the ICF. The analysis involved a specific and precise ICF linking process developed by Cieza et al. (2016). This linking process involved: (1) identifying and preparing health related information to be linked and (2) linking health information to specific ICF categories using the ICF linking tree as a guide. Using the data extraction table, 132 main and secondary concepts were extracted from the 57 occupational therapy interventions. Two researchers linked the 132 main and secondary concepts from the occupational therapy interventions to the ICF level three categories.
RESULTS: Of the 132 main and secondary concepts, the most number (14%; n=18) were linked to ICF category: exercise tolerance functions; general physical endurance and ICF code: b4550. This was followed by: Muscles of shoulder; s7202 (11%; n=15); Muscles of upper arm; s73002 (11%; n=15); and Maintaining one’s health; d5702 (8%; n=10). Some of the interventions that were least employed were linked to ICF category: toileting, unspecified, ICF code: d5309 (1%; n=1) and ICF category: standing; ICF code: 14014 (1%; n=1).
CONCLUSION: This study revealed that occupational therapy interventions can be linked to ICF language. Majority of the older adult skilled nursing interventions were linked to exercise tolerance functions followed by muscles of shoulder, muscles of arm, and maintaining of one’s health. This study reflects the focus of exercise in older adult interventions in skilled nursing facilties.
IMPACT STATEMENT: The ICF can be used to assist occupational therapists to articulate the focus of interventions, which may improve interprofessional communication and collaboration.
References
Cieza, A., Fayed, N., Bickenbach, J., & Prodinger, B. (2016). Refinements of the ICF linking rules to strengthen their potential for establishing comparability of health information [online]. Disability and Rehabilitation, 0(0), 1-10. doi: http://dx.doi.org/10.3109/09638288.2016.1145258
Stamm, T. A., Cieza, A., Machold, K., Smolen, J. S., & Stucki, G. (2006). Exploration of the link between conceptual occupational therapy models and the international classification of functioning, disability and health. Australian Occupational Therapy Journal, 53, 9-17. doi:10.1111/j.1440-1630.2005.00513.x
World Health Organization. (2002). Towards a common language for functioning, disability and health: ICF. Retrieved from http://www.who.int/classifications/icf/icfbeginnersguide.pdf
