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ICF Core Set for Hand Conditions

The ICF Core Set development project for hand conditions was a cooperative effort between the German Social Accident Insurance (DGUV), the Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW) (Germany) and the ICF Research Branch. The aim of the project was the development of ICF Core Sets to comprehensively describe functioning and disability of individuals with hand conditions i.e. conditions/health problems located directly at the hand e.g. carpal, tunnel syndrome or injuries of the hand or osteoarthritis of finger joints or amputations or Dupuytren's disease, etc. and conditions/health problems originating external to the hand but affecting the hand e.g. rheumatoid arthritis, stroke, Parkinson's disease or multiple sclerosis, etc. It is envisioned that these ICF Core Sets will stimulate further research as well as form the basis for studying the content validity of already existing instruments or for the development of new instruments to quantify the severity of hand, to measure change over time and the effectiveness of interventions.

In the preparatory phase of the project, a systematic literature review, a qualitative study, an expert survey and a multicentre cross-sectional study were conducted:

  • A systematic literature review was performed to identify parameters and outcomes reported in studies published from 1998-2008 involving individuals with hand conditions as well as to identify and quantify the concepts contained in those parameters and outcomes using the ICF as a reference.
  • A qualitative study (10 focus groups) with 59 individuals with hand conditions was performed at 5 different study centres in Germany to identify the aspects of functioning and health which are important to the participants.
  • An internet-based expert survey was performed to gather the opinion of a pool of 162 experts (physicians, nurses, physiotherapists, occupational therapists, psychologists and social workers) from 55 countries regarding the most relevant and typical areas to be considered in individuals with hand conditions.
  • A multicentre cross-sectional study with 210 individuals was performed at 5 study centres in Germany (BG Trauma Hospital Hamburg, BG Trauma Clinic Tübingen, BG Clinic Bergmannstrost Halle, Trauma Hospital Berlin, Institute for Health and Rehabilitation Sciences Munich) to describe functioning and health of individuals with hand conditions using the ICF.

An international ICF consensus conference took place at the Swiss Paraplegic Research in Nottwil, Switzerland in 7-9 May 2009. The aim of the conference was to establish the first version of the Comprehensive and Brief ICF Core Sets for patients with hand conditions. Twenty-three hand conditions experts from 6 health professions (physicians, physiotherapists, occupational therapists, nurses, psychologists and social workers) and from 22 countries decided which ICF categories are to be included in the ICF Core Sets for hand conditions following a multi-stage, iterative decision-making and consensus process which integrated the results from the 4 preparatory studies.

117 ICF categories were selected for inclusion in the Comprehensive ICF Core for hand conditions. These categories can be taken into account when conducting a comprehensive, multidisciplinary assessment. Out of the 117 Comprehensive ICF Core Set categories, 23 ICF categories were selected as candidate categories for the Brief ICF Core Set for hand conditions. The Brief ICF Core Set can be used in assessing any patient with hand conditions irrespective of the healthcare setting in which the individual is treated and when individual healthcare professionals and not a multidisciplinary team is involved.

For information on the efforts toward implementing the ICF Core Set for hand conditions in Germany, see Leuchtturm Project Hand

The project was supported by the German Social Accident Insurance (DGUV).

For more information, feel free to contact Dr. Michaela Coenen