ICF: A Comprehensive Model for Health and Functioning

International classification of function

The International Classification of Functioning,Disability and Health   In 2001 the World Health Organization (WHO) published a revised model of the   International Classification of Functioning, Disability and Health (ICF)    The ICF is the result of an international and multidisciplinary effort to   provide  a  common  language  for  the  classification  and  consequences  of  health  conditions .Rather than focusing on disability, the intent of the ICF is to describe  how people live with their health condition.

A. The model of disablement, as described by Nagi, showing the relationship among pathology, impairments, functional limitations and disability.

ICF MODEL

  a  comprehensive  representation  of  health  and  health-related domains based on the relationships among health condition ❑ body functionsand structures ❑ activities and ❑  participation.

The ICF holds a parallel to the disablement model .   Health conditions correspond to pathology;    body functions/structures correspond to impairments;    activity corresponds to functional limitation; and    participation corresponds to disability

Which better Nagi model or ICFmodel   The ICF may be more useful, however, to understand and measure health outcomes, looking beyondmortality and disease. It shifts the focus  to  "life,"  and  describes  how  people  live  with  their  health condition.    This context makes the model useful for health promotion as well as illness and disability.    The ICF has been evaluated in a variety of patient populations,   cultures, age groups and diagnoses

Each of the components of the ICF can be described in positive or negative terms   body systems or anatomical structures will be intact or impaired.    Individuals will be able to perform specific activities or they will demonstrate difficulties in executing specific tasks, described as activity limitations.    They will either be able to participate in life roles or they may experience participation restrictions.   Environmental and personal factors will either facilitate function or create barriers

capacity to act versus actual performance ❑ The activity and participation domains can be further conceptualized in terms of  an  individual's  capacity  to  act  versus  actual  performance;  that  is,  what  one  is  able to do versus what one actually does. ❑   These  elements  are  defined  with  reference  to  the  environment  in  which  assessment is taking place.

❑ Performance relates to the "current" or actual environment in which the individual participates. ❑  Capacity relates to a "standardized“  optimum environment,

  the  gap  between  capacity  and  performance  reflects  the  impact  of  the environment on an individual's ability to perform.    an individual with rheumatoid arthritis may   have joint deformities (impairments),    have difficulty walking (activity limitation) and    unable  to  perform  work  activities  because  of  inappropriate  height  of  furniture (participation restriction and environmental barrier).    The  individual  may  have  the  capacity  to  do  the  work,  but  cannot  perform  the activities  in  the  current  environment.  However,  if  the  office  environment  is modified,  this  individual  may  be  able  to  perform  activities  without  pain,  and therefore, her performance and participation level will improve.