Use of the International Classification of Functioning, Disability and Health (ICF) to expand and standardize the assessment of quality-of-life following a stroke: proposal for the use of codes and qualifiers

Abstract

Purpose

Propose a way of coding and qualifying HRQoL following a stroke using the codes and qualifiers of the International Classification of Functioning, Disability and Health (ICF).

Methods

An observational, cross-sectional study was conducted involving 51 individuals with hemiparesis resulting from a stroke. ICF codes related to the Stroke Specific Quality of Life (SS-QOL) scale were listed and subsequently classified using the generic ICF qualifiers, which range from .0 – no impairment to .4 – complete impairment. A simple mathematic calculation was proposed to convert the SS-QOL scores into ICF qualifiers.

Results

The use of the ICF qualifiers revealed that the individuals exhibited a moderate level (.2) of quality of life, with mild impairment (.1) regarding upper limb function, language, self-care, and vision as well as severe impairment (.3) regarding social relations.

Conclusions

The proposal presented in this study allowed qualifying 43 ICF codes related to quality of life after a stroke in a simple, standardized manner, enabling the identification of different levels of impairment on each of the domains of the SS-QOL scale. This coding standardizes the evaluation, facilitates communication between healthcare providers, and systematizes the collection of data and information on health.

Implications for rehabilitation

• Proposal for qualifying concepts related to body functions, activity & participation, and environmental factors in a simple, standardized manner.

• The proposed mathematic calculation is simple and easy to understand, which minimizes the occurrence of errors.

• Possibility to identify different levels of impairment in each of the domains of the Stroke Specific Quality of Life scale, facilitating the establishment of individualized, longitudinal care.

• The ICF codes standardize the evaluation, facilitate communication between healthcare providers, and systematize the collection of data and information on health and functioning.

Keywords:

• Stroke
• quality of life
• International Classification of Functioning
• Disability and Health
• ICF qualifiers
• ICF codes

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was conducted during a scholarship supported by the CAPES/PROSUP – Brazilian Federal Agency for Support and Evaluation of Graduate Education within the Ministry of Education of Brazil.