Author: Chan, Po Shan Alice
Title: Developing local core sets for persons with spinal cord injury in the long-term context based on the international classification of functioning, disability and health
Advisors: Tam, W. C. Eric (BME)
Degree: DHSc
Year: 2019
Subject: Hong Kong Polytechnic University -- Dissertations
Spinal cord -- Wounds and injuries
Disability evaluation -- China -- Hong Kong
Health status indicators -- Classification
Department: Faculty of Health and Social Sciences
Pages: xiv, 336 pages : color illustrations
Language: English
Abstract: Introduction: The International Classification of Functioning, Disability and Health (ICF) has been widely adopted as the conceptual framework in spinal cord injury (SCI) rehabilitation and researches but local use has not been found. Cross-cultural adaptation is essential to address differences in cultural values and social norms in different countries and societies. Objective: The objective of the study is to validate and examine the psychometric properties of the local ICF-Comprehensive Core Set (ICF-CCS) for SCI in Long-term Context (LT) and to describe the functioning and performance profile of the local SCI population. Method: Content validation of the local ICF-CCS for SCI (LT) was performed by 12 healthcare professionals in an expert panel review followed by cognitive debriefing by 5 persons with SCI. Test-retest reliability was performed by 10 persons with SCI from the community. Forty-three individuals with SCI from the community were interviewed using the local ICF-CCS for SCI (LT), and other SCI measures including American Spinal Injury Association Impairment Scale (AIS), motor-Functional Independence Measure (motor-FIM), Community Integration Questionnaire (CIQ) and Craig Hospital Inventory of Environmental Factors-Short Form (CHIEF-SF). The validated local ICF-CCS for SCI (LT) was used to describe the functioning and performance profile of the local SCI population.
Results: The local ICF-CCS for SCI (LT) contains 128 ICF categories. ICF categories which were considered as irrelevant (b Temperament and personality functions, d810 Informal education, d840 Apprenticeship, e330 People in position of authority, etc.), duplicate (d4500 Walking short distances, d4501 Walking long distances, d4600 Walking within around the home, etc.) and 'incomprehensible' (b2803 Radiating pain in a dermatome, b720 Mobility of bone function, etc.) were removed. The local ICF-CCS for SCI (LT) was found to have excellent agreement among panel members (Cronbach's α= 0.98), test-retest reliability (ICC = 0.93, 95% CI: 0.57-0.97) and internal consistency (Cronbach's α= 0.95). For concurrent validity, moderate to high correlations were found between ICF categories from 'Activities and Participation' (d) with selected motor-FIM and CIQ items (r = 0.30-0.95, p ≤ 0.05). Few ICF categories from 'Environmental Factors' (e) correlated significantly with selected CHIEF-SF items (r = 0.34-0.48, p ≤ 0.05). For construct validity, most ICF categories from 'Body Functions' (b) and 'Activities and Participation' (d) correlated well with motor-FIM total (r = 0.30-0.88, p ≤ 0.05). A few ICF categories from 'Body Functions' (b), 'Activities and Participation' (d) and 'Environmental Factors' (e) correlated significantly with CIQ total (r = 0.31-0.56, p ≤ 0.05). Few ICF categories in Chapter 'e5 Services, Systems and Policies' from 'Environmental Factors' (e) correlated significantly with CHIEF-SF total (r = 0.32-0.51, p ≤ 0.05). The local ICF Brief Core Set (ICF-BCS) for SCI (LT) contains 46 ICF categories from the 2nd level, with principle components extracted from local ICF-CCS for SCI (LT). It contains more 2nd level ICF categories, especially from 'Environmental Factors' (e), when compared to the original one. Persons with tetraplegia are shown to have more difficulties in ICF categories from 'Activities and Participation' (d), 'Body Structures' (s) and 'Body Functions' (b). Both groups do not differ much statistically in experiencing many environmental factors as facilitators or barriers. Conclusions: The local ICF-CCS for SCI (LT) contains 128 ICF categories instead of 168 categories in the original ICF-CCS for SCI (LT). It has been shown that the local ICF-CCS for SCI (LT) is useful for describing the characteristics of persons with SCI in Hong Kong. The local adaptation and validation of the ICF-CCS for SCI (LT) facilitate the application of ICF in daily clinical practice and SCI researches. This allows a better understanding of the real needs of the local SCI population, contributing to better healthcare service and policy planning and development. Additionally, the application of local ICF-CSs for SCI (LT) allows the use of a universal language which enhances information exchange for the advancement of local practice standard.
Rights: All rights reserved
Access: restricted access

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