An Italian experience in the ICF implementation in rehabilitation: Preliminary theoretical and practical considerations

Purpose. The International Classification of Functioning, Disability and Health (ICF) in its complete form cannot be adopted in clinical rehabilitative practice due to its complexity and size. Ongoing international research is aimed at validating and verifying the reliability of simplified instruments derived from the ICF (ICF Core Sets). An Italian multicentre study was recently conducted with these aims. The purpose of this article is to present some qualitative considerations on ICF Core Sets implementation. Method. A brief schedule purposely built to assess the difficulties encountered by the health professionals who administered the ICF Core Sets were sent them via e-mail. Due to the small size of the sample, a qualitative analysis was performed. Result. The main difficulties which emerged were: (i) To clearly translate the ICF categories' contents in a language easily understandable especially by patients with low education and concrete cognitive style, (ii) the process of assigning the qualifier to the given category, particularly with the 'Activity and Participation' and 'Environmental factors' components, and (iii) the influence of evaluators' different professional backgrounds on interview performance. Conclusion. Since the classification was designed to uniform language and to promote homogeneous ways of evaluation in extremely different healthcare and social contexts, more studies are necessary to improve reliability and to identify the best methods of using the ICF in daily clinical practice.