An occupational perspective on the concept of participation in the International Classification of Functioning, Disability and Health--some critical remarks.

The International Classification of Functioning, Disability and Health (ICF; World Health Organization, 2001) provides an international and interprofessional scientific basis for understanding and studying health. The concept of participation plays an important role in the classification and has become a central construct in health care, rehabilitation, and in occupational therapy. The aim of this paper is to provide a critical analysis of the concept of participation in the ICF. As background, the origins and current presentation of the ICF are presented. The use and function of the ICF and the contemporary discussions regarding the classification are reviewed. An occupational perspective on participation in the ICF reveals major shortcomings regarding the subjective experience of meaning and autonomy. Furthermore, the ICF has limitations in capturing different kinds of participation in a single life situation. Following these analyses we discuss the advantages and shortcomings of using the ICF, and how an occupational perspective can contribute to an ongoing discussion about the development of the ICF.

[1]  C. Henriksson,et al.  Concepts in occupational therapy in relation to the ICF. , 2003, Occupational therapy international.

[2]  B. Üstün,et al.  The role of Environment in the International Classification of Functioning, Disability and Health (ICF) , 2003, Disability and rehabilitation.

[3]  R. J. Wolfe,et al.  Occupational science: academic innovation in the service of occupational therapy's future. , 1991, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[4]  A. Brownlea,et al.  Participation: myths, realities and prognosis. , 1987, Social science & medicine.

[5]  L. Nordenfelt.  Action theory, disability and ICF , 2003, Disability and rehabilitation.

[6]  R. Imrie.  Demystifying disability: a review of the International Classification of Functioning, Disability and Health. , 2004, Sociology of health & illness.

[7]  P. Halligan,et al.  New wine in old bottles: the WHO ICF as an explanatory model of human behaviour , 2003, Clinical rehabilitation.

[8]  Y. Heerkens,et al.  Past and future use of the ICF (former ICIDH) by nursing and allied health professionals , 2003, Disability and rehabilitation.

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

[10]  E. Yerxa.  Occupation: the keystone of a curriculum for a self-defined profession. , 1998, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[11]  J. Swain.  Disabling Barriers, Enabling Environments , 2004 .

[12]  Doing and Being in the Atmosphere of the Doing: Environmental Influences on Occupational Performance in a Nursing Home , 2002 .

[13]  G. Whiteford.  Occupational Deprivation: Global Challenge in the New Millennium , 2000 .

[14]  M. Cutchin.  Using Deweyan philosophy to rename and reframe adaptation-to-environment. , 2004, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[15]  Ann A. Wilcock,et al.  An Occupational Perspective of Health , 2000 .

[16]  T. B. Üstün,et al.  Models of disablement, universalism and the international classification of impairments, disabilities and handicaps. , 1999, Social science & medicine.

[17]  Colin Barnes,et al.  Exploring Disability: A Sociological Introduction , 1999 .

[18]  M. Leonardi,et al.  Applying the International Classification of Functioning, Disability and Health (ICF) to measure childhood disability , 2003, Disability and rehabilitation.

[19]  D. Nelson,et al.  Therapeutic occupation: a definition. , 1996, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[20]  M. Law,et al.  Participation in the occupations of everyday life. , 2002, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[21]  N. Pollock,et al.  Client-centered assessment. , 1993, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[22]  D. Nelson,et al.  Occupation: form and performance. , 1988, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[23]  E. Yerxa.  Health and the human spirit for occupation. , 1998, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[24]  M. Law,et al.  1991 Muriel Driver lecture. The environment: a focus for occupational therapy. , 1991, Canadian journal of occupational therapy. Revue canadienne d'ergotherapie.

[25]  J. M. Gray.  Discussion of the ICIDH-2 in Relation to Occupational Therapy and Occupational Science , 2001 .

[26]  T Ewert,et al.  Value and application of the ICF in rehabilitation medicine , 2002, Disability and rehabilitation.

[27]  R. Hurst.  The International Disability Rights Movement and the ICF , 2003, Disability and rehabilitation.

[28]  F. Clark,et al.  Practical contributions of occupational science to the art of successful ageing: How to sculpt a meaningful life in older adulthood , 1998 .

[29]  A. Chorus,et al.  Measuring participation according to the International Classification of Functioning, Disability and Health (ICF) , 2003, Disability and rehabilitation.

[30]  恵子 紀国谷.  国際生活機能分類(International Classification of Functioning, Disability and Health: ICF)にみた福祉・保健・医療の専門職協働における連携に関する貢献と課題 , 2007 .