Developing an ICF core set for post-stroke disability assessment and verification in Taiwan: a preliminary study

Abstract

Purpose: The purpose of this study was to develop an ICF core set for post-stroke disability assessment and verification of bio-psycho-social problems. Method: Using the Delphi method, a consensus process was conducted. In total, 24 multidisciplinary experts from different institutions completed the consensus process. The questionnaire for the study comprised 144 ICF second-level, stroke-relevant categories. A 5-point Likert-type scale was used by participants to weight the impact of each category on activities of daily life after a stroke. Consensus of ratings was assessed with Spearman’s rho and semi-interquartile range indices. The core set for post-stroke disability assessment and verification was developed from those categories with a mean score ≥4.0 found in the third round of the Delphi exercise. Results: The core set for post-stroke disability assessment and verification contained 51 categories. Of these, 18 categories were from the component body functions, one from body structures, 22 from activities and participation, and 10 from environmental factors. The mean (standard deviation) Spearman’s rho was 0.72 (0.14), and Cronbach’s α was 0.98. Conclusions: The preliminary core set for post-stroke disability assessment and verification can offer comprehensive information on the performance of daily-life activities of chronic stroke survivors. Further validation is required.

Implications for Rehabilitation

• To identify stroke patients with permanent difficulties in Taiwan, the ICF core set for post-stroke disability assessment and verification (PSDV) focused on chronic stroke survivors in the community.

• The PSDV core set which is closely linked to the Barthel Index and Functional Independence Measure can offer comprehensive information on activities of daily living in stroke patients in Taiwan.

• With the PSDV core set, stroke patients with hemineglect or dysphagia can be assessed.

Keywords::

• Stroke
• ICF
• disability
• classification
• cerebrovascular accident
• Taiwan

Acknowledgements

The authors gratefully acknowledge Rune J. Simeonsson and Chia-Chin Lin for their professional assistance and editing. We also highly appreciate the contributions made by the following experts in the Taiwan ICF Team over the three Delphi rounds: Li-Ming Lien, Han-Cheng Wang, Wei-Hung Chen, Jiann-Shing Jeng, Chaur-Jong Hu, Ming-Dar Tsai, Sheng-Jean Huang, Ming-Cheng Tsai, Shih-Hsun Kuo, Jwu-wen Kuo, Shih-Ching Chen, Hsin-Chi Wu, Yue-Nan Jenp, Rei-Ying Huang, Ker-Neng Lin, Ben-Sheng Chang, Kwan-Hwa Lin, Hua-Fang Liao, Shwn-Jen Lee, Ting-Fang Wu, Shu-Jen Lu, Shu-Chen Wang, Chi-Fen Chang, Shu-Er Lee, Hong-Jer Chang, and Peishan Yang.

Declaration of Interest: This study was supported by grant DOH 99M4080 from the Department of Health, Executive Yuan, Taiwan. The authors report no conflicts of interest.