Presentation on theme: "Dr. José Luis Ayuso-Mateos Professor of Psychiatry Universidad Autónoma de Madrid, Spain WP4 Leader."— Presentation transcript:
Dr. José Luis Ayuso-Mateos Professor of Psychiatry Universidad Autónoma de Madrid, Spain WP4 Leader
1. Use the functioning and disability model of the ICF to analyze health surveys in the general population and existing statistics about education. General Objetives 2.Demonstrate how the ICF model is appropriate for describing disability patterns in the clinical population. 3.Demonstrate ICF validity and usefulness in compiling educational databases. 4.Formulate recommendations for the development of health and social policies in the UE.
Need for instruments that use the biopsychosocial model in the assesment of functioning and disability
Full Version of ICF ICF Checklist WHO-DAS II ICF Core Sets
ICF Checklist Selection of the most relevant ICF categories (169 from 1494): - Alterations in: - body functions - body structures - Activities and participation - Environmental factors - Other information about environment - Used by: - clinical - patients / relatives - researchers
WHO-DAS II Assesses 6 domains: 1.Understanding and communication 2.Getting around 3.Self-care 4.Interpersonal interactions and relationships 5.Daily activities 6.Participation
Objectives To demonstrate the applicability of ICF-linked measurement instruments, the ICF Checklist and the WHODAS II in a variety of clinical settings and by different professionals To evaluate the quality of care in patient clinical settings by using functioning levels as outcome indicators in a range of clinical conditions To evaluate disability profiles obtained from ICF-linked assessment instruments
Clinical and rehabilitation centres UAM Instituto Nazionale Neurologico Ludwig-Maximilians Uni Charles Uni. Rehabilitation Institute Slovenia Malarden University Statistical centres IMIM ARS WHO AA A total of 74 researchers
METHOLOGY Dependent Variable: Functioning and disability (defined by the ICF model) Common Instruments for evaluation: Sociodemografic characteristics ICF-Checklist WHODAS-II SF-36 Disease-specific instruments for evaluation Time points of assessment: Baseline assessment 6 weeks 3 months Design: multicentre, transversal and longitudinal study
ICF Checklist and WHODAS II have good psychometric properties Structural validity indicates that they are closely related to the underlying conceptual model (ICF) They have sensibility to change
Evolution of symptomatology after 6 weeks and 3 months: Clinical remission: 53.8% at 6 weeks and 71.8% at 3 months RESULTS:Depression sample treated in Primary Care
Overall and Individual Fitted Regression Lines For the Whole Sample (unipolar depression N=97)
DEPRESSION NORMAL MOOD MANIA HYPOMANIA MIXED EPISODE More than 6 months
facilitatorsbarriers health professional support of family members and friends attitudes of immediate family members and friends social norms practices and ideologies health services, systems and policies
Identifying g aps between Capacity and Performance Performance Capacity = positive effect of environment Uses of disability profiles
Identifying g aps between Capacity and Performance Performance Capacity = negative effect of environment Uses of disability profiles
Diagnoses alone are not sufficient in clinical settings to guide care and management. MHADIE researchers recommend that the ICF model and its related instruments be used as complementary tools for: 1. define persons functioning 2. identifying patients needs 3. planning interventions, and evaluating clinical outcomes
Since MHADIE data have shown that the ICF notions of the patients capacity and performance play a crucial role in explaining the impact of a health condition on the persons life, in a reliable and valid manner, MHADIE researchers recommend that ICF-based clinical instruments be developed for routine clinical use in order to assess both capacity and performance.
MHADIE research shows that environmental factors have an influence on patients performance independent of their capacity, MHADIE researchers therefore recommend that these factors be taken in account when assessing and planning clinical as well as social interventions. environmental factors should be taken into account when assessing and planning all interventions, both medical and social
MHADIE researchers recommend that the impact of disability must be assessed, not merely at the clinical level, but also at the level of the persons social and economic participation. MHADIE project proves that information about interpersonal interactions, major life areas and community and social life, can be successfully collected and evaluated.
MHADIE researchers recommend that, in the clinical setting, the ICF model be used as a common language across levels of care and for different intervention purposes (prevention, treatment, rehabilitation, public health); ICF is useful as a common language across professions and for collecting information for multidisciplinary treatment.