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Disability :Current Concepts
 

Disability :Current Concepts

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International Classification of Function, Disability and Impairment

International Classification of Function, Disability and Impairment

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    Disability :Current Concepts Disability :Current Concepts Presentation Transcript

    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat InternationalClassification of Disability Prof. Ahmed-Refat A.G Refat 25/12/2012 1
    • International Classification of DisabilityAhmed-Refat AG Refat www.SlideShare.net/AhmedRefat 2
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat Contents Definition of Impairment, Disability and Handicap Evolutions of the concepts From ICIDH-1980 to ICF2001 Disability Statistics Models of Disability Current Model of Disability 3
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat Impairment, Disabilityand HandicapEvolution of the Concepts From 1980 to 2001 4
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefatThe most commonly cited definitions are those provided by the World Health Organization (1980) in The International Classification of Impairments, Disabilities, and Handicaps: ICIDH- WHO- 1980 Impairment: 5
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat Impairment:Any loss or abnormality ofpsychological, physiologicalor anatomical structure or function. 6
    • International Classification of DisabilityAhmed-Refat AG Refat www.SlideShare.net/AhmedRefat Disability: 7
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat Disability: Any restriction or lack(resulting from an impairment) of abilityto perform an activity in themanner or within the range considered normal for a human being. 8
    • International Classification of DisabilityAhmed-Refat AG Refat www.SlideShare.net/AhmedRefat Handicap 9
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat Handicap: a disadvantage for a given individual that limits orprevents the fulfillment of a role that is normal 11
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefatAs traditionally used, impairment refers toa problem with a structure or organ of the body; disability is a functional limitation with regard to a particular activity; andhandicap refers to a disadvantage in filling a role in life relative to a peer group. 11
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefatExamples to illustrate the differences among the terms "impairment," "disability," and "handicap." 12
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat David is a 4-yr.-old who has a form ofcerebral palsy (CP) called spastic diplegia.Davids CP causes his legs to be stiff, tight, and difficult to move. He cannot stand or walk. 13
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefatImpairment: The inability to move the legs easily at the joints and inability to bear weight on the feet is an impairment. Without orthotics or surgery, Davids levelof impairment may increase as imbalanced muscle contraction over a period of time can cause hip dislocation and deformed bone growth. No treatment may be currently available to lessen Davids impairment. 14
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat Disability: Davids inability to walk is a disability. His level of disability can beimproved with physical therapy and special equipment. For example, if he learns to use a walker, his level of disability will improve considerably. 15
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat Handicap: Davids cerebral palsy ishandicapping to the extent that it preventshim from fulfilling a normal role at home, inpreschool, and in the community. His levelof handicap has been only very mild in theearly years as he has been well-supported to be able to play with other children,interact normally with family members and participate fully in family and community activities. As he gets older, his handicap 16
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefatwill increase where certain sports and physical activities are considered "normal" activities for children of the same age. He has little handicap in his preschoolclassroom, though he needs some assistance to move about the classroom and from one activity to another outside the classroom. Appropriate services and equipment can reduce the extent to which cerebralpalsy prevents David from fulfilling a normal role in the home, school and community as he grows. 17
    • International Classification of DisabilityAhmed-Refat AG Refat www.SlideShare.net/AhmedRefatStatistics 18
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefatPercentage of population estimated to be disabled in different countries. Denmark 10,0- 12,0 % France 5,0- 8,3 % Norway 12,0 % Spain 25,0 % Sweden 12,0 % U.K. 7,3 % 19
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat In June 2011, World Health Organization (WHO) and the WorldBank released the first World Report on Disability. 21
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat(1) Estimates based on the World Health Survey The average prevalence rate of disabilityin the adult population aged 18 years and over was 15.6% (some 650 million people of the estimated 4.2 billion adults aged 18 and older in 2004) ranging from 11.8% in higher income countries to 18.0% in lower income countries. 21
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefatIf the prevalence figures are extrapolatedto cover adults 15 years and older, around 720 million people have difficulties in functioning with around 100 million experiencing very significant difficulties. 22
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat 2- Estimates based on the WHO Global Burden of Disease study The analysis of the Global Burden of Disease 2004 data for this Report estimates that 15.3% of the world population (some 978 million people ofthe estimated 6.4 billion in 2004 (35)) had “moderate or severe disability”, while 2.9% or about 185 million experienced 23
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat“severe disability” . Among those aged 0–14 years, the figures were 5.1% and 0.7%, or 93 million and 13 million children, respectively. Among those 15 years and older, the figures were 19.4% and 3.8%, or 892 million and 175 million, respectively. 24
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefatModels that characterized the history of disability:1. The traditional model,2. the medical/genetic model,3. the social/human-rights model . 25
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat 1- Traditional Model: This modelconsiders disability as a result of some sin or as a punishment from God. 26
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat 2- Medical Model: This model considers that persons with disability have adysfunction or a problem that needs to be corrected. Therefore, medical model promotes activities such as treatment,surgery, appliances, etc. aimed at reducing the disability in the person. 27
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat The medical model views disability as a problem of the person, directly caused bydisease, trauma or other health condition,which requires medical care provided in the form of individual treatment by professionals. 28
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat 3- Social Model: This model considersphysical, social, cultural, environmental and attitudinal barriers that "disable" persons with impairments and that block their participation in different life activities. Therefore, this model promotes a fight against the different barriers. 29
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefatThe social model of disability, on the other hand, sees the issuemainly as a socially created problem, and basically as a matter of the full integration of individuals into society. 31
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat Disability is not an attribute of anindividual, but rather a complex collection of conditions, many of which are created by the social environment. 31
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat Hence the management of the problem requires social action, and it is the collective responsibility of society at large to make the environmental modifications necessary for the full participation ofpeople with disabilities in all areas of social life. The issue is therefore anattitudinal or ideological one requiring social change, which at the political levelbecomes a question of human rights. For this model disability is a political issue. 32
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat In addition, there is the Human rightsmodel, that looks at disability as an issue of human rights.Community-Based Rehabilitation (CBR ) isbased on human rights model of disability. 33
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefatThe social model of disability has considerdisability as arising from the interactionof a person’s functional status with the physical, cultural, and policy environments. 34
    • International Classification of DisabilityAhmed-Refat AG Refat www.SlideShare.net/AhmedRefatICF-WHO-2001 35
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat ICF-WHO-2001International Classification of Functioning, Disability and Health 36
    • International Classification of DisabilityAhmed-Refat AG Refat www.SlideShare.net/AhmedRefat 37
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefatICF belongs to the WHO familyof international classifications, Other Member are: 38
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat1- International Classification of Diseases (ICD) Current ICD-10 (2015) ICD-1122- International Classification of Health Interventions (ICHI) ICD The best known member of which is the ICD-10 (the International Statistical Classification of Diseases and Related Health Problems). 39
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat ICD-10 gives users an etiological framework for the classification, bydiagnosis, of diseases, disorders and other health conditions. 41
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefatBy contrast, ICF classifies functioning anddisability associated with health conditions. The ICD-10 and ICF are thereforecomplementary, and users are encouraged to use them together to create more meaningful picture of the experience of health of individuals and populations. 41
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat Information on mortality (provided by ICD-10) and information about health and health-related outcomes (provided by ICF) can be combined in summary measures of population health. 42
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefatIn short, ICD-10 is mainly used to classify causes of death, but ICF classifies health. 43
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat The overall aim of the ICF classification isto provide a unified and standard languageand framework for the description of health and health-related states. 44
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat ICF is based on an integration of the twoopposing models i.e biomedical and social . In order to capturethe integration of the various perspectives of functioning, a “bio-psycho-social” approach is used. 45
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat “bio-psycho-social” approachin ICF disability and functioning are viewed as outcomes of interactions between health conditions (diseases, disorders and injuries) and contextual factors.The medical model views disability as a feature of the person, directly caused by disease, trauma or otherhealth condition, which requires medical care provided in the form of individual treatment by professionals. 46
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat Disability, on medical model, calls formedical or other treatment or intervention, to correct the problem with the individual. 47
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat The social model of disability, on the other hand, seesdisability as a socially created problem and not at all an attribute of an individual. On the social model, disability demands a political response, since the problem is created by an unaccommodating physical environment brought aboutby attitudes and other features of the social environment 48
    • International Classification of DisabilityAhmed-Refat AG Refat www.SlideShare.net/AhmedRefat 49
    • International Classification of DisabilityAhmed-Refat AG Refat www.SlideShare.net/AhmedRefatComponents of ICF Model 51
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat I - BODY FUNCTIONS Body functions are the physiological functions of body systems (including psychological functions).Impairments are problems in body function or structure as a significant deviation or loss. 51
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat Body functions Mental functions Sensory functions and pain Voice and speech functions Functions of the cardiovascular, haematological, immunological and respiratory systems Functions of the digestive, metabolic and endocrine systems Genitourinary and reproductive functionsNeuromusculoskeletal and movement-related functions Functions of the skin and related structures 52
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat II- BODY STRUCTURES Body structures are anatomical parts of the body such as organs, limbs and their components.Impairments are problems in body function or structure as a significant deviation or loss. 53
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat Body structures Structures of the nervous system The eye, ear and related structures Structures involved in voice and speech Structures of the cardiovascular, immunological and respiratory systemsStructures related to the digestive, metabolic and endocrine systems Structures related to the genitourinary and reproductive systems Structures related to movement 54
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat III-ACTIVITIES AND PARTICIPATIONActivity is the execution of a task or action by an individual. Participation is involvement in a life situation. 55
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat Activity limitations are difficulties an individual may have in executing activities. Participation restrictionsare problems an individual may experience in involvement in life situations. 56
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat Activities and participation Learning and applying knowledge General tasks and demands Communication Mobility Self-care Domestic lifeInterpersonal interactions and relationships Major life areas Community, social and civic life 57
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat IV- ENVIRONMENTAL FACTORS Environmental factors make up the physical, social andattitudinal environment in which people live and conduct their lives. 58
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat Environmental factors Products and technologyNatural environment and human-made changes to environment Support and relationships Attitudes Services, systems and policies 59
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat Body Functions and Structures; and Activities and Participation These terms, which replace the formerly used terms “impairment”, “disability” and “handicap” , extend the scope of theclassification to allow positive experiences to be described. 61
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat “Activity limitation” replaces the term “disability” used in the 1980 version of ICIDH.“Participation restriction” replaces the term “handicap” used in the 1980 version of ICIDH 61
    • International Classification of DisabilityAhmed-Refat AG Refat www.SlideShare.net/AhmedRefat Functioning 62
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat Functioning is an umbrella term encompassing allbody functions, activities and participation; Disability 63
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat Disability serves as an umbrella term forimpairments, activity limitations or participation restrictions. 64
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefatFunctioning is an umbrella term for body functions, body structures, activities and participation. It denotes the positive aspects of the interaction between anindividual (with a health condition) and that individuals contextual factors (environmental and personal factors). 65
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat Impairment is a loss or abnormality in body structure or physiological function (including mental functions). Abnormality here is used strictly to refer to a significant variation from established statistical norms (i.e. as a deviation from apopulation mean within measured standard norms) and should be used only in this sense. 66
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat Disability is an umbrella term for impairments, activity limitations and participation restrictions. It denotes the negative aspects of the interaction between an individual (with a healthcondition) and that individuals contextual factors (environmental and personal factors). 67
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefatImpairments are problems in body function or structure such as a significant deviation or loss.Activity is the execution of a task or action by an individual. Participation is involvement in a life situation. 68
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat Activity limitations are difficulties an individual may have in executing activities.Participation restrictions are problems an individual may experience in involvement in life situations. 69
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefatEnvironmental factors make up the physical, social and attitudinalenvironment in which people live and conduct their lives. 71
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat Exercises Identify the Impairment,Function and Activity Associated with the following conditionsLeprosy - Panic Disorder-Spinal Injury- Juvenile diabetes 71
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat Leprosy Loss of sensation of extremities = ? Difficulties in grasping objects =?Stigma of leprosy leads to unemployment =? 72
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat Panic Disorder AnxietyNot capable of going out alone Peoples reactions leads to no social relationships 73
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat Spinal Injury ParalysisIncapable of using public transportation Lack of accommodations in public transportation no participation in religious activities 74
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat Juvenile diabetes Pancreatic dysfunction None (impairment controlled by Medication)Does not go to school because of stereotypes about disease 75
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat Vitiligo Facial disfigurement NoneNo participation in social relations owing to fear of contagion 76
    • International Classification of DisabilityAhmed-Refat AG Refat www.SlideShare.net/AhmedRefat 77
    • International Classification of DisabilityAhmed-Refat AG Refat www.SlideShare.net/AhmedRefat 78
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat Cited ReferencesInternational Classification of Functioning, Disability andHealth: ICF. World Health Organization 2001.Towards a Common Language for Functioning, Disabilityand Health: ICF The International Classification ofFunctioning, Disability and Health. World HealthOrganization 2002.http://www.who.int/classifications/en/ 79
    • International Classification of Disability Ahmed-Refat AG Refat www.SlideShare.net/AhmedRefat Exercise #1 ( International Classification of Function & Disability) Dr. Ahmed- Refat 25/12/2012Your Name HEALTH IMPAIRMENT ACTIVITY PARTICIPATION CONDITION LIMITATION RESTRICTION 81
    • International Classification of DisabilityAhmed-Refat AG Refat www.SlideShare.net/AhmedRefat 81