A critical exploration of the International Classification of Functioning, Disability, and Health (ICF) framework from the perspective of oncology: recommendations for revision

Background: In 2001, the World Health Organization developed the International Classification of Functioning, Disability, and Health (ICF) framework in an effort to attend to the multidimensional health-related concerns of individuals. Historically, although the ICF has frequently been used in a rehabilitation-based context, the World Health Organization has positioned it as a universal framework of health and its related states. Consequently, the ICF has been utilized for a diverse array of purposes in the field of oncology, including: evaluating functioning in individuals with cancer, guiding assessment in oncology rehabilitation, assessing the comprehensiveness of outcome measures utilized in oncology research, assisting in health-related quality of life instrument selection, and comparing the primary concerns of health professionals with those of their patients. Discussion: Examination of the ICF through the lens of cancer care highlights the fact that this framework can be a valuable tool to facilitate comprehensive care in oncology, but it currently possesses some areas of limitation that require conceptual revision; to this end, several recommendations have been proposed. Specifically, these proposed recommendations center on the following three areas of the ICF framework: (1) the replacement of the term “health condition” with the more inclusive and dynamic term “health state;” (2) the continuing development and refinement of the personal factors component to ensure issues such as comorbidities can be accounted for appropriately; and (3) the inclusion of a mechanism to account for the subjective dimension of health and functioning (eg, quality of life). Summary: It is through the expansion of these conceptual parameters that the ICF may become more relevant and applicable to the field of oncology. With these important revisions, the ICF has the potential to provide a broader biopsychosocial perspective of care that captures the diverse range of concerns that arise throughout the continuum of care in oncology.

[1]  Julie Pryor,et al.  The International Classification of Functioning, Disability and Health (ICF) and nursing. , 2004, Journal of advanced nursing.

[2]  C. Dolea,et al.  World Health Organization , 1949, International Organization.

[3]  Ali Montazeri,et al.  Health-related quality of life in breast cancer patients: A bibliographic review of the literature from 1974 to 2007 , 2008, Journal of experimental & clinical cancer research : CR.

[4]  Eva Kahana,et al.  Cancer in the elderly. , 2006, Transactions of the American Clinical and Climatological Association.

[5]  P. Ganz.  Monitoring the physical health of cancer survivors: a survivorship-focused medical history. , 2006, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[6]  Edward L Spitznagel,et al.  Prognostic importance of comorbidity in a hospital-based cancer registry. , 2004, JAMA.

[7]  C. Gutenbrunner,et al.  Hannover model for the implementation of physical and rehabilitation medicine teaching in undergraduate medical training. , 2010, Journal of rehabilitation medicine.

[8]  Steven E Schild,et al.  Non-small cell lung cancer: epidemiology, risk factors, treatment, and survivorship. , 2008, Mayo Clinic proceedings.

[9]  M. Zwahlen,et al.  Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies , 2008, The Lancet.

[10]  P. Bower,et al.  Patient-centredness: a conceptual framework and review of the empirical literature. , 2000, Social science & medicine.

[11]  M. Wright.  Children receiving treatment for cancer and their caregivers: A mixed methods study of their sleep characteristics , 2011, Pediatric blood & cancer.

[12]  K. Syrjala,et al.  Physical and psychological long‐term and late effects of cancer , 2008, Cancer.

[13]  T. Eadie.  Application of the ICF in communication after total laryngectomy. , 2007, Seminars in speech and language.

[14]  S. McCann,et al.  Methodological issues related to assessing and measuring quality of life in patients with cancer: implications for patient care. , 2007, European journal of cancer care.

[15]  T. Kershaw,et al.  Coping strategies and quality of life in women with advanced breast cancer and their family caregivers , 2004 .

[16]  A. Schwartz,et al.  Reproductive factors, hormone use, estrogen receptor expression and risk of non small-cell lung cancer in women. , 2007, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[17]  Alarcos Cieza,et al.  Does the Comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for Breast Cancer capture the problems in functioning treated by physiotherapists in women with breast cancer? , 2011, Physiotherapy.

[18]  Rodolfo Saracci,et al.  The world health organisation needs to reconsider its definition of health , 1997, BMJ.

[19]  Angela Conti-Becker.  Between the ideal and the real: Reconsidering the International Classification of Functioning, Disability and Health , 2009, Disability and rehabilitation.

[20]  P. Doyle,et al.  Enhancing the conceptual clarity and utility of the international classification of functioning, disability & health: the potential of a new graphic representation , 2013, Disability and rehabilitation.

[21]  A. Bottomley.  The cancer patient and quality of life. , 2002, The oncologist.

[22]  T. Badger,et al.  Body image perceptions in men with prostate cancer. , 2009, Oncology nursing forum.

[23]  K. Ness,et al.  Limitations on Physical Performance and Daily Activities among Long-Term Survivors of Childhood Cancer , 2005, Annals of Internal Medicine.

[24]  A. Cieza,et al.  Content comparison of health-related quality of life (HRQOL) instruments based on the international classification of functioning, disability and health (ICF) , 2005, Quality of Life Research.

[25]  Validity, reliability and responsiveness of the "Schedule for the Evaluation of Individual Quality of Life – Direct Weighting" (SEIQoL-DW) in congenital heart disease , 2004, Health and quality of life outcomes.

[26]  Tami Howe,et al.  The ICF Contextual Factors related to speech-language pathology , 2008 .

[27]  W. Westra,et al.  Molecular pathology of head and neck cancer: implications for diagnosis, prognosis, and treatment. , 2009, Annual review of pathology.

[28]  S. Geyh,et al.  Identifying the concepts contained in outcome measures of clinical trials on breast cancer using the International Classification of Functioning, Disability and Health as a reference. , 2004, Journal of rehabilitation medicine.

[29]  M. Hudson,et al.  A model for care across the cancer continuum , 2005, Cancer.

[30]  K. Ness,et al.  A Framework for Assessment in Oncology Rehabilitation , 2009, Physical Therapy.

[31]  J. Wardle,et al.  Do stress-related psychosocial factors contribute to cancer incidence and survival? , 2008, Nature Clinical Practice Oncology.

[32]  A. Cieza,et al.  Content comparison of health-related quality of life measures used in stroke based on the international classification of functioning, disability and health (ICF): a systematic review , 2007, Quality of Life Research.

[33]  B. Kirsh,et al.  Educating Tomorrow’s Practitioners: Influences on Community Mental Health Occupational Therapy Education , 2005 .

[34]  G. L. Engel.  The need for a new medical model: a challenge for biomedicine. , 2012, Psychodynamic psychiatry.

[35]  Renee Twombly,et al.  What's in a name: who is a cancer survivor? , 2004, Journal of the National Cancer Institute.

[36]  H. Brenner,et al.  Quality of life among long-term (≥5 years) colorectal cancer survivors--systematic review. , 2010, European journal of cancer.

[37]  A. Cieza,et al.  The Personal Factors of the International Classification of Functioning, Disability and Health in the literature – a systematic review and content analysis , 2011, Disability and rehabilitation.

[38]  S. Lucy,et al.  Situating Primary Health Care within the International Classification of Functioning, Disability and Health: Enabling the Canadian Family Health Team Initiative , 2010, Journal of interprofessional care.

[39]  W. Kernohan,et al.  Psychosocial interventions for patients with head and neckcancer (Protocol) , 2011 .

[40]  A. Cieza,et al.  Health professional perspective on disability in head and neck cancer. , 2010, Archives of otolaryngology--head & neck surgery.

[41]  S. Gentile,et al.  Use of ICF to describe functioning and disability in children with brain tumours , 2009, Disability and rehabilitation.

[42]  I. Byock.  Completing the continuum of cancer care: Integrating life‐prolongation and palliation , 2000, CA: a cancer journal for clinicians.

[43]  Cathy J Bradley,et al.  Race, socioeconomic status, and breast cancer treatment and survival. , 2002, Journal of the National Cancer Institute.

[44]  Stephen W Duffy,et al.  A breast cancer prediction model incorporating familial and personal risk factors , 2004, Hereditary Cancer in Clinical Practice.

[45]  Howard Seltman,et al.  Psychological and physical adjustment to breast cancer over 4 years: identifying distinct trajectories of change. , 2004, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[46]  T. Eadie.  The ICF: a proposed framework for comprehensive rehabilitation of individuals who use alaryngeal speech. , 2003, American journal of speech-language pathology.

[47]  R. Morton,et al.  Deterioration in quality‐of‐life of late (10‐year) survivors of head and neck cancer , 2006, Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery.

[48]  S. Ueda,et al.  The subjective dimension of functioning and disability: what is it and what is it for? , 2003, Disability and rehabilitation.

[49]  E. Skarakis-Doyle,et al.  Personal perception and personal factors: incorporating health-related quality of life into the International Classification of Functioning, Disability and Health , 2010, Disability and rehabilitation.

[50]  Donna L Berry,et al.  Treatment decision-making by men with localized prostate cancer: the influence of personal factors. , 2003, Urologic oncology.

[51]  M. Stewart.  Towards a global definition of patient centred care , 2001, BMJ : British Medical Journal.

[52]  M. McGurk,et al.  Are psycho-social and behavioural factors related to health related-quality of life in patients with head and neck cancer? A systematic review. , 2005, Oral oncology.

[53]  李耀华,et al.  Continuum：越多元，越精彩 , 2011 .

[54]  I. Bumeder,et al.  Individual quality of life of patients undergoing autologous peripheral blood stem cell transplantation , 2004, Psycho-oncology.

[55]  A. Cieza,et al.  Content validation of the Comprehensive ICF Core Set for Head and Neck Cancer (HNC): the perspective of psychologists , 2010, Psycho-oncology.

[56]  A. Cieza,et al.  The International Classification of Functioning Disability and Health: its development process and content validity. , 2008, European journal of physical and rehabilitation medicine.

[57]  R. Morton,et al.  The association of psycho‐social factors and survival in head and neck cancer , 2008, Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery.

[58]  A. Cieza,et al.  Assessment of functioning in patients with head and neck cancer according to the International Classification of Functioning, Disability, and Health (ICF): A multicenter study , 2009, The Laryngoscope.

[59]  Madeline Cruice,et al.  The contribution and impact of the International Classification of Functioning, Disability and Health on quality of life in communication disorders , 2008 .

[60]  W. Lawrence,et al.  Burden of illness in cancer survivors: findings from a population-based national sample. , 2004, Journal of the National Cancer Institute.

[61]  U. Koch.  IPOS Sutherland Memorial Lecture: psycho‐oncology and health care research , 2008, Psycho-oncology.

[62]  A. Jemal,et al.  Global cancer statistics , 2011, CA: a cancer journal for clinicians.

[63]  Lesley Seymour,et al.  Age and comorbidity as independent prognostic factors in the treatment of non small-cell lung cancer: a review of National Cancer Institute of Canada Clinical Trials Group trials. , 2008, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[64]  S. Rogers,et al.  Content comparison of quality of life questionnaires used in head and neck cancer based on the international classification of functioning, disability and health: a systematic review , 2008, European Archives of Oto-Rhino-Laryngology.

[65]  B. Kahana,et al.  Functioning and Activity Participation Restrictions among Older Adult, Long-Term Cancer Survivors , 2007, Cancer investigation.

[66]  A. Jemal,et al.  Global Cancer Statistics , 2011 .

[67]  A. Cieza,et al.  Health status and QOL instruments used in childhood cancer research: deciphering conceptual content using World Health Organization definitions , 2011, Quality of Life Research.

[68]  H. Prigerson,et al.  Religious coping is associated with the quality of life of patients with advanced cancer. , 2006, Journal of palliative medicine.

[69]  Identifying the concepts contained in outcome measures of clinical trials on four internal disorders using the International Classification of Functioning, Disability and Health as a reference. , 2004 .

[70]  Virginia Wright,et al.  The ICF model of functioning and disability: Incorporating quality of life and human development , 2010, Developmental neurorehabilitation.

[71]  M. Scherer,et al.  Three model curricula for teaching clinicians to use the ICF , 2008, Disability and rehabilitation.