ICF Core Set for vocational rehabilitation: results of an international consensus conference

Abstract

Purpose: Vocational rehabilitation (VR) programs aim to facilitate work participation. However, there is no universal framework to describe the functioning of individuals who participate in VR. The objective of this paper is to report on the Core Set for VR based on the International Classification of Functioning, Disability and Health (ICF) by the World Health Organization (WHO). Methods: A formal decision-making and consensus-based process was conducted based on the evidence from four preparatory studies. Twenty-three international experts chosen by WHO Region and expertise in VR attended the consensus conference. Results: Ninety ICF categories were included in the comprehensive Core Set (activities and participation = 40, environmental factors = 33, body functions =  17), while the brief Core Set included 13 second-level categories (activities and participation = 6, environmental factors = 4, body functions =  3). Conclusions: The expert opinion and evidence-based Core Set could serve as an international standard for what to measure and report concerning functioning of individuals in VR. The Core Set could also provide a common language among clinicians, researchers, insurers, and policymakers in the implementation of successful VR. Further testing and validation studies are encouraged.

Implications for Rehabilitation

• Vocational rehabilitation is a multidisciplinary and multi-stakeholder process, which aims to reduce or eliminate the burden of work disability and facilitate work participation.

• The International Classification of Functioning, Disability and Health (ICF) provides a framework to describe and measure the functioning of individuals who are in a vocational rehabilitation program.

• The ICF Core Set for vocational rehabilitation provides us with a list of functioning domains in our effort to examine vocational rehabilitation or return-to-work outcomes and the multiple factors associated with vocational rehabilitation.

• The ICF Core Set for vocational rehabilitation can be used in clinical rehabilitation setting and rehabilitation research, and further steps to ensure the robust measurement, documentation, and reporting of the Core Set in rehabilitation are being planned.

Keywords::

• ICF
• ICF Core Set
• vocational rehabilitation
• employment
• classification
• return-to-work

Acknowledgements

We are most grateful for the contributions from the following experts who attended the consensus conference: Alex Burdorf, Tania Buys, Chetwytn Chan, Julie Fritz, Jain Holmes, Debra B. Homa, Stefan Koch, Jan Kool, Terry Krupa, Sven-Uno Marnetoft, Claude Maroun, Dennis Nowak, Rahel Oertli, Soo-Kyung Park, Robin Pickard, Michiel Reneman, Julietta Rodriguez Guzman, Eva Schonstein, Stefan Staubli, Frank Staudenmann, Urban Studer, Yoshiko Suzuki, and Jos Verbeek. Special thanks to collaborating organizations in the International Steering Committee and their representatives: World Health Organization, Classification, Terminology and Standards (WHO CTS), International Labour Organization (ILO), World Confederation for Physical Therapy (WCPT), World Federation of Occupational Therapists (WFOT), and the International Society of Physical and Rehabilitation Medicine (ISPRM).

We would also like to thank the moderator Alarcos Cieza, the coordinator of the ICF Research branch Melissa Selb, the working group assistants Nandini Devi, Nicole Emmenegger, Fary Khan, and Felix Gradinger who also helped in the writing of the protocol in the plenary sessions. Special thanks to Jerome Bickenbach, Heinrich Gall, Christian Geyh, Cornelia Oberhauser, Urban Schwegler, Wolfgang Segerer, Katharina Strasky, and Niklas Wiegand for their invaluable support during the conference.

Declaration of interest: This project was funded by the Swiss Accident Insurance Company (SUVA) in Switzerland.