ICF-Based Interdisciplinary Case Management for Individuals With Disabilities (ICF)
Application of the International Classification of Functioning, Disability, and Health (ICF) on Interdisciplinary Case Management for Healthcare Service Delivery for Individuals With Disabilities
This study evaluates whether an interdisciplinary case management approach based on the International Classification of Functioning, Disability and Health (ICF) and the Rehab-Cycle® framework can improve rehabilitation outcomes for adults with intellectual disabilities receiving community-based rehabilitation services.
A total of 120 adults with mild to moderate intellectual disabilities will be recruited from community rehabilitation services and randomly assigned to either an ICF-based interdisciplinary case management group or a conventional care management group. Participants in the ICF-based group will receive coordinated assessments, goal-setting, intervention planning, and outcome evaluation conducted by an interdisciplinary rehabilitation team. Participants in the control group will continue to receive standard services delivered through conventional care management practices.
The study will assess changes in functioning, activity participation, quality of life, life satisfaction, and rehabilitation team effectiveness. The findings will help determine whether ICF-based interdisciplinary case management can provide more personalized, coordinated, and effective community rehabilitation services for individuals with intellectual disabilities.
Studieoversikt
Status
Detaljert beskrivelse
The International Classification of Functioning, Disability and Health (ICF), developed by the World Health Organization, provides a biopsychosocial framework for understanding functioning and disability by integrating body functions, activities, participation, environmental factors, and personal factors. Although the ICF framework has been increasingly promoted for rehabilitation and social service planning, its application in community-based disability services remains limited. This study aims to evaluate the effectiveness of implementing an ICF-based interdisciplinary case management model inspired by the Rehab-Cycle® framework in community rehabilitation services for individuals with intellectual disabilities.
The study will employ a randomized controlled trial with pre-intervention and post-intervention assessments. One hundred and twenty adults aged 18 to 60 years with medically confirmed mild or moderate intellectual disabilities will be recruited from community-based rehabilitation facilities operated by participating non-governmental organizations. Participants will be randomly allocated to either an ICF-based interdisciplinary case management group (n=60) or a conventional care management group (n=60). In addition, approximately fifteen rehabilitation professionals, including social workers, occupational therapists, physiotherapists, speech therapists, nurses, and clinical psychologists, will participate in the interdisciplinary service delivery process.
The intervention will be developed according to the Rehab-Cycle® process. First, a Neurodevelopment Core Set for Intellectual Condition will be established through an expert consensus process using relevant ICF core sets and the Delphi method. The selected ICF categories will guide interdisciplinary assessment and rehabilitation planning. Participants in the intervention group will undergo ICF-based assessment, development of individualized functioning profiles, interdisciplinary goal setting, coordinated intervention planning, and ongoing case review. Participants in the control group will receive conventional rehabilitation services, with assessments and interventions provided independently by different professionals without formal interdisciplinary ICF-based planning.
The primary purpose of the intervention is to improve functioning and participation through coordinated interdisciplinary rehabilitation management. By identifying participants' strengths, limitations, environmental barriers, and facilitators, the interdisciplinary team will establish mutually agreed rehabilitation goals and implement individualized interventions tailored to each participant's needs. Regular interdisciplinary meetings will be conducted to review progress and modify intervention plans as needed.
Outcome measures will evaluate functioning using selected ICF Core Set items covering body functions, activities and participation, and environmental factors. Additional outcomes will include life satisfaction as measured by the Satisfaction With Life Scale (SWLS), quality of life as measured by the World Health Organization Quality of Life-BREF (WHOQOL-BREF), and interdisciplinary team effectiveness as measured by the Provider-Perceptions of Team Effectiveness (Provider-PTE) scale. Outcomes will be assessed before and after the intervention period.
The study hypothesizes that participants receiving ICF-based interdisciplinary case management will demonstrate greater improvements in functioning, participation, life satisfaction, and quality of life than those receiving conventional care management. It is also expected that healthcare professionals implementing the ICF-based approach will report enhanced interdisciplinary team effectiveness. The results will contribute evidence regarding the feasibility and effectiveness of integrating the ICF and Rehab-Cycle® frameworks into community-based rehabilitation services and may inform future disability and rehabilitation service planning in Hong Kong and other settings.
Studietype
Registrering (Antatt)
Fase
- Ikke aktuelt
Kontakter og plasseringer
Studiekontakt
- Navn: Sam Chi Chung Chan, PhD
- Telefonnummer: 27664310
- E-post: samcc.chan@polyu.edu.hk
Studer Kontakt Backup
- Navn: Sam Chi Chung Chan
- Telefonnummer: +85227664310
- E-post: samcc.chan@polyu.edu.hk
Studiesteder
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Hong Kong, Hong Kong
- Rekruttering
- The Hong Kong Polytechnic University
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Ta kontakt med:
- Sam Chi Chung Chan, PhD
- Telefonnummer: 27664310
- E-post: samcc.chan@polyu.edu.hk
-
Ta kontakt med:
- Sam Chi Chung Chan, PhD
- E-post: samcc.chan@polyu.edu.hk
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Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
- Voksen
Tar imot friske frivillige
Beskrivelse
Inclusion Criteria:
- between the age of 18 and 60 years old,
- intellectual disability with mild grade (IQ 50-69) or moderate grade (IQ 35-49) as confirmed by medical doctors,
- ability to communicate verbally in Cantonese or English.
Exclusion Criteria:
- acute and unstable medical conditions (such as seizures),
- Current or recent diagnosis of severe psychiatric disorders (e.g., active psychosis, major depressive episode within the past 12 months, or other conditions that significantly impair participation)
Their caregivers will provide proxy consent if the participants with intellectual disability were unable to give the informed consent.
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Helsetjenesteforskning
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Dobbelt
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
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Eksperimentell: ICF-based care management group with interdisciplinary Rehab-Cycle® process
Participants will receive an interdisciplinary case management program based on the International Classification of Functioning, Disability and Health (ICF) framework and the Rehab-Cycle® model.
The intervention includes ICF-based assessment, development of individualized functioning profiles, client-centered goal setting, interdisciplinary care planning, coordinated rehabilitation interventions, and regular team reviews.
Healthcare professionals collaboratively identify participant needs, establish rehabilitation goals, implement interventions, and monitor outcomes related to functioning, activity, participation, and environmental factors within routine community rehabilitation services.
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Participants will receive interdisciplinary case management based on the International Classification of Functioning, Disability and Health (ICF) framework and the Rehab-Cycle® process.
The intervention includes ICF-based assessment, development of individualized functioning profiles, collaborative goal setting involving participants and healthcare professionals, interdisciplinary care planning, coordinated rehabilitation interventions, and regular interdisciplinary review meetings.
Interventions are designed to address body functions, activities, participation, and environmental factors according to each participant's needs within community-based rehabilitation services.
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Aktiv komparator: Conventional care management group without interdisciplinary Rehab-Cycle® process
Participants will receive standard community rehabilitation services routinely provided by participating organizations.
Assessments, goal setting, intervention planning, and service delivery will be conducted independently by individual healthcare professionals according to existing practice.
No ICF-based functioning profile, structured interdisciplinary case conference, coordinated Rehab-Cycle® process, or formal interdisciplinary intervention planning will be implemented.
Participants will continue to receive usual rehabilitation and support services throughout the study period.
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Participants will receive standard community rehabilitation services routinely provided by participating non-governmental organizations.
Assessments, goal setting, intervention planning, and treatment implementation will be conducted independently by individual healthcare professionals according to usual practice.
No ICF-based functioning profile, structured Rehab-Cycle® process, formal interdisciplinary case conference, or coordinated interdisciplinary intervention planning will be used.
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Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
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ICF-based assessments of the core set items
Tidsramme: before and after the experimental and control interventions in a 6-month period
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The selected core set items will be used to assess (a) body functions (b117 intellectual function), (b) activity capacity and participation performance in daily living (e.g.
basic interpersonal interactions) and (c) environmental and personal influence (e.g.
e310 immediate family).
The ICF 5-point qualifier will be used based on the converted results of the corresponding assessments with a scale from 0 (no problem) to 4 (complete problem).
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before and after the experimental and control interventions in a 6-month period
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Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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Satisfaction with Life Scale (SWLS)
Tidsramme: before and after the experimental and control interventions in a 6-month period
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The SWLS a brief 5-item self-report measure assessing global cognitive judgments of life satisfaction (Diener et al., 1985).
Each item is rated on a 7-point Likert scale from 1 ("strongly disagree") to 7 ("strongly agree"), producing a total score between 5 and 35, with higher scores reflecting greater satisfaction.
The scale captures cognitive judgments rather than emotional states, making it suitable for diverse populations.
Research consistently demonstrates strong psychometric properties, including high internal consistency, good test-retest reliability, and solid construct validity across cultures and age groups.
With its robust measurement performance, the SWLS is a widely used tool in health, rehabilitation, and social science research
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before and after the experimental and control interventions in a 6-month period
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Provider-Perceptions of Team Effectiveness (Provider-PTE)
Tidsramme: before and after the experimental and control interventions in a 6-month period
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A brief self-report questionnaire that evaluates healthcare providers' perceptions of interdisciplinary team effectiveness in delivering coordinated care.
The instrument assesses key domains including communication, role clarity, shared goals, collaboration, and overall team functioning using Likert-type response scales.
Higher scores indicate more positive perceptions of team effectiveness.
The Provider-PTE has demonstrated good reliability and validity and is sensitive to differences in interprofessional team performance across healthcare settings.
The measure will be used to assess changes in interdisciplinary team functioning associated with implementation of the ICF-based case management approach
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before and after the experimental and control interventions in a 6-month period
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Samarbeidspartnere og etterforskere
Samarbeidspartnere
Etterforskere
- Hovedetterforsker: Sam Chi Chung Chan, The Hong Kong Polytechnic University
Publikasjoner og nyttige lenker
Generelle publikasjoner
- Diener E, Emmons RA, Larsen RJ, Griffin S. The Satisfaction With Life Scale. J Pers Assess. 1985 Feb;49(1):71-5. doi: 10.1207/s15327752jpa4901_13.
- Development of the World Health Organization WHOQOL-BREF quality of life assessment. The WHOQOL Group. Psychol Med. 1998 May;28(3):551-8. doi: 10.1017/s0033291798006667.
- First MB. Diagnostic and statistical manual of mental disorders, 5th edition, and clinical utility. J Nerv Ment Dis. 2013 Sep;201(9):727-9. doi: 10.1097/NMD.0b013e3182a2168a. No abstract available.
- Schiariti V, Selb M, Cieza A, O'Donnell M. International Classification of Functioning, Disability and Health Core Sets for children and youth with cerebral palsy: a consensus meeting. Dev Med Child Neurol. 2015 Feb;57(2):149-58. doi: 10.1111/dmcn.12551. Epub 2014 Aug 6.
- Rauch A, Cieza A, Stucki G. How to apply the International Classification of Functioning, Disability and Health (ICF) for rehabilitation management in clinical practice. Eur J Phys Rehabil Med. 2008 Sep;44(3):329-42.
- International Classification of Functioning, Disability and Health (ICF), Geneva, CH: WHO.
- Verkerk G, van der Molen-Meulmeester L, van Hartingsveldt M, Alsem M. Instructions for Administering the Canadian Occupational Performance Measure with Children Themselves. Phys Occup Ther Pediatr. 2023;43(1):58-73. doi: 10.1080/01942638.2022.2079392. Epub 2022 Jun 8.
- Van Naarden Braun K, Christensen D, Doernberg N, Schieve L, Rice C, Wiggins L, Schendel D, Yeargin-Allsopp M. Trends in the prevalence of autism spectrum disorder, cerebral palsy, hearing loss, intellectual disability, and vision impairment, metropolitan atlanta, 1991-2010. PLoS One. 2015 Apr 29;10(4):e0124120. doi: 10.1371/journal.pone.0124120. eCollection 2015.
- Thyson S, Werminghaus M, Volpert S, Althaus L, Buscher L, Schatton D, van Treeck W, Klenzner T. Assessment of Cochlear Implant Rehabilitation Success by Speech-Language Therapists Using International Classification of Functioning, Disability and Health Criteria. J Speech Lang Hear Res. 2024 Oct 8;67(10):3826-3840. doi: 10.1044/2024_JSLHR-23-00534. Epub 2024 Oct 4.
- Steiner WA, Ryser L, Huber E, Uebelhart D, Aeschlimann A, Stucki G. Use of the ICF model as a clinical problem-solving tool in physical therapy and rehabilitation medicine. Phys Ther. 2002 Nov;82(11):1098-107.
- Stucki G, Ewert T, Cieza A. Value and application of the ICF in rehabilitation medicine. Disabil Rehabil. 2002 Nov 20;24(17):932-8. doi: 10.1080/09638280210148594.
- Schraner I, De Jonge D, Layton N, Bringolf J, Molenda A. Using the ICF in economic analyses of Assistive Technology systems: methodological implications of a user standpoint. Disabil Rehabil. 2008;30(12-13):916-26. doi: 10.1080/09638280701800293.
- Stucki G, Stier-Jarmer M, Grill E, Melvin J. Rationale and principles of early rehabilitation care after an acute injury or illness. Disabil Rehabil. 2005 Apr 8-22;27(7-8):353-9. doi: 10.1080/09638280400014105.
- Scherer MJ, DiCowden MA. Organizing future research and intervention efforts on the impact and effects of gender differences on disability and rehabilitation: the usefulness of the International Classification of functioning, Disability and Health (ICF). Disabil Rehabil. 2008;30(3):161-5. doi: 10.1080/09638280701532292.
- Reddihough D, Leonard H, Jacoby P, Kim R, Epstein A, Murphy N, Reid S, Whitehouse A, Williams K, Downs J. Comorbidities and quality of life in children with intellectual disability. Child Care Health Dev. 2021 Sep;47(5):654-666. doi: 10.1111/cch.12873. Epub 2021 May 4.
- Reinhardt JD, Fellinghauer BA, Strobl R, Stucki G. Dimension reduction in human functioning and disability outcomes research: graphical models versus principal components analysis. Disabil Rehabil. 2010;32(12):1000-10. doi: 10.3109/09638281003775410.
- Leonard H, Montgomery A, Wolff B, Strumpher E, Masi A, Woolfenden S, Williams K, Eapen V, Finlay-Jones A, Whitehouse A, Symons M, Licari M, Varcin K, Alvares G, Evans K, Downs J, Glasson E. A systematic review of the biological, social, and environmental determinants of intellectual disability in children and adolescents. Front Psychiatry. 2022 Aug 25;13:926681. doi: 10.3389/fpsyt.2022.926681. eCollection 2022.
- Enemark Larsen A, Wehberg S, Christensen JR. Looking into the Content of the Canadian Occupational Performance Measure (COPM): A Danish Cross-Sectional Study. Occup Ther Int. 2020 May 14;2020:9573950. doi: 10.1155/2020/9573950. eCollection 2020.
- Kilpatrick K, Paquette L, Bird M, Jabbour M, Carter N, Tchouaket E. Team Functioning And Beliefs About Team Effectiveness In Inter-Professional Teams: Questionnaire Development And Validation. J Multidiscip Healthc. 2019 Oct 4;12:827-839. doi: 10.2147/JMDH.S218540. eCollection 2019.
- Hasson F, Keeney S, McKenna H. Revisiting the Delphi technique - Research thinking and practice: A discussion paper. Int J Nurs Stud. 2025 Aug;168:105119. doi: 10.1016/j.ijnurstu.2025.105119. Epub 2025 May 12.
- Chiu WT, Yen CF, Teng SW, Liao HF, Chang KH, Chi WC, Wang YH, Liou TH. Implementing disability evaluation and welfare services based on the framework of the International Classification of Functioning, Disability and Health: experiences in Taiwan. BMC Health Serv Res. 2013 Oct 14;13:416. doi: 10.1186/1472-6963-13-416.
- Bolte S, Lawson WB, Marschik PB, Girdler S. Reconciling the seemingly irreconcilable: The WHO's ICF system integrates biological and psychosocial environmental determinants of autism and ADHD: The International Classification of Functioning (ICF) allows to model opposed biomedical and neurodiverse views of autism and ADHD within one framework. Bioessays. 2021 Sep;43(9):e2000254. doi: 10.1002/bies.202000254. Epub 2021 Apr 1.
- Glasson EJ, Buckley N, Chen W, Leonard H, Epstein A, Skoss R, Jacoby P, Blackmore AM, Bourke J, Downs J. Systematic Review and Meta-analysis: Mental Health in Children With Neurogenetic Disorders Associated With Intellectual Disability. J Am Acad Child Adolesc Psychiatry. 2020 Sep;59(9):1036-1048. doi: 10.1016/j.jaac.2020.01.006. Epub 2020 Jan 13.
- Bickenbach JE, Chatterji S, Badley EM, Ustun TB. Models of disablement, universalism and the international classification of impairments, disabilities and handicaps. Soc Sci Med. 1999 May;48(9):1173-87. doi: 10.1016/s0277-9536(98)00441-9.
- Arnadottir SA, Gunnarsdottir ED, Stenlund H, Lundin-Olsson L. Participation frequency and perceived participation restrictions at older age: applying the International Classification of Functioning, Disability and Health (ICF) framework. Disabil Rehabil. 2011;33(23-24):2208-16. doi: 10.3109/09638288.2011.563818. Epub 2011 Mar 29.
- Alford VM, Ewen S, Webb GR, McGinley J, Brookes A, Remedios LJ. The use of the International Classification of Functioning, Disability and Health to understand the health and functioning experiences of people with chronic conditions from the person perspective: a systematic review. Disabil Rehabil. 2015;37(8):655-66. doi: 10.3109/09638288.2014.935875. Epub 2014 Jul 2.
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