Reflective action assessment with a prospective clinical problem solving tool in the context of rehabilitation medicine: an illustrative case study

Abstract

Purpose: This study describes a case formulation approach applying a prospective ICF derived clinical tool to assess rehabilitation needs for a community dwelling stroke survivor with care from an outpatient rehabilitation medicine clinic. Method: Case history data on the person were assessed for rehabilitation management planning using a prospective tool to interlink current with projected future functional status in everyday settings. Implicit assessment with reflective action informed decision points at each stage of the rehabilitation process. Results: As a result of reflective action using the prospective tool, rehabilitation management led to significant changes in client participation after limitations to mobility and self care were mapped to the living conditions of the stroke survivor. The context sensitive rehabilitative plan resulted in higher subjective health-related quality of life in the stroke survivor and significant other and enhanced their capacity for participation. Conclusions: Reflective action informed assessment applying ICF concepts to clinical problem solving resulted in positive gains in health-related quality of life in a stroke survivor.

Implications for Rehabilitation

• Reflective inquiry about the use of The International Classification of Disability, Functioning and Health (ICF) enables extension of its applicability in clinical practice settings.

• An ICF-based tool is proposed to interlink the ICF and ICD in rehabilitation case management.

• A case study is used to highlight the use of an ICF-based tool in the context of rehabilitation medicine.

Keywords::

• Clinical rehabilitation
• International Classification of Functioning
• Disability and Health (ICF)
• medicine
• problem solving
• reflective practice

Acknowledgements

This paper was presented under the title ‘Thinking as you measure: ICF as the model for daily rehabilitation practice’ as part of the Symposium ‘Think Before You Measure’. University of Sydney, June 29, 2011. The author would like to thank ‘Sue’ and her husband for agreeing for their story to be shared.

Declarations of Interest: The authors report no declarations of interest.