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ICF and Transition Services

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Given the universal concepts and language of the ICF, it is timely for clinicians, educators, researchers and everyone working with youth and adolescents with disabilities and chronic health conditions to incorporate its framework in transition practice and research. The ICF has potential to improve communication and collaboration among health professionals working within multidisciplinary teams to impact adult health outcomes that are meaningful to youth and families. The ICF also encourages a holistic approach to care by focusing on personal and environmental factors beyond health, thus professionals should embrace its theory, framework and applications in practice and research. We present the YouthKIT, a tool that uses concepts of the ICF to address transition needs of adolescents with chronic health conditions.

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ICF and Transition Services

  1. 1. Research Making a Difference www.canchild.ca How Can We Use the ICF to Enhance Transition Services for Youth with Disabilities May 18, 2015 Tram Nguyen MSc. PhD Candidate & Dr. Olaf Kraus de Camargo School of Rehabilitation Science
  2. 2. Objectives 1. The objective of this workshop is to introduce the World Health Organization’s (WHO) International Classification of Functioning, Disability and Health (ICF), and demonstrate how a transition intervention (YouthKIT™) can be a tool for implementation of the ICF to enhance transition services and delivery of care.
  3. 3. What elements were important for the transition of Martin? https://youtu.be/BxAY1lc-prM
  4. 4. Transition Facilitators for Martin
  5. 5. What is the ICF? Health Condition Body Functions & Structures Activities Participation Environmental Factors Personal Factors
  6. 6. Traditional Reading of the ICF
  7. 7. Person-centred Reading of the ICF
  8. 8. Getting to know the person Who are you? What do/would you like to do?
  9. 9. Where and how do you live?
  10. 10. Now, let’s focus on what you want!
  11. 11. Transition in the Systems of Care Health Condition Body Functions & Structures: continue care to maintain function and structure where possible, emotional wellbeing Activities: enable to perform usual activities Participation: focus on the participation goals of the individual Environmental Factors: promote independent living, access to healthcare, education, justice system. Relationships & Supports Personal Factors: Personal preferences and characteristics of the individual should be respected Freedom of Choice Kraus de Camargo, O. (2011). Systems of care: transition from the bio-psycho- social perspective of the International Classification of Functioning, Disability and Health. Child Care Health Dev, 37(6), 792–799. doi:10.1111/j.1365- 2214.2011.01323.x
  12. 12. Falling off a cliff!
  13. 13. Transition Phase I: preparation Phase II: the journey Phase III: the landing Stewart, D. (2009). Transition to adult services for young people with disabilities: current evidence to guide future research. Dev Med Child Neurol, 51 Suppl 4, 169–173. doi:10.1111/j.1469-8749.2009.03419.x
  14. 14. Transition Phase I: preparation The ‘preparation’ phase takes place during a youth’s late childhood and early adolescence as they begin to look ahead and prepare for adult life (Stewart et al. 2009).
  15. 15. Transition Phase II: the journey The ‘journey’ phase takes place during the transition itself, and represents a period in which the adolescent is experiencing changes from one developmental stage, environment or role to another (Stewart et al. 2009).
  16. 16. Transition Phase III: the landing The phase of ‘landing’ in the adult world recognizes that adolescents will reach a destination, with outcomes and goals being met, and time taken to ‘refuel’ before starting on another journey along their life course (Stewart et al. 2009).
  17. 17. Approach • Demonstration of how the YouthKIT can be used as a tool to facilitate transition within the biopsychosocial framework of the ICF
  18. 18. Youth KIT™ An organizational tool consisting of 10 modules designed to promote self-management (Stewart et al.,2009).  Personal Information  Social Information  Social Activities  School Information  Work Information  Budget Information  Personal Care and Life Skills  Medical and Health Information  Obtaining Information  Sharing Information
  19. 19. YouthKIT™ Video www.keepingittogether.ca
  20. 20. YouthKIT™ & ICF YouthKIT ICF Personal Information Personal Factors Information About Me Activities & Participation Social Information Environmental Factors (Family & Friends) School Information Environmental Factors (School) Work Information Environmental Factors (Work) Budget Information Environmental Factors (Finances) Personal Care and Life Skills Activities & Participation, Environmental Factors Health Condition/Disability Information Health Condition, Environmental Factors (Health Professionals, Medications)
  21. 21. Implementation & Evaluation • Youth KIT™ was used as an intervention in a four-year longitudinal transition study. • Surveys on utilization of the Youth KIT™ at 2 pre- and 2 post-transfer study visits; post- transfer qualitative interviews with youth.
  22. 22. Key Findings Highest ranked modules: • Personal Information(90%) • Social information (86%) and • Medical and Health information (86%) Gorter, J. W., Stewart, D., Cohen, E., Hlyva, O., Morrison, a., Galuppi, B., Nguyen, T … Weiser, N. (2015). Are two youth-focused interventions sufficient to empower youth with chronic health conditions in their transition to adult healthcare: a mixed- methods longitudinal prospective cohort study. BMJ Open, 5(5), e007553– e007553. doi:10.1136/bmjopen-2014-007553
  23. 23. Feedback • Bursary: Definition? (Canadian lingo) • Personal Care/Life Skills: Complicated words, should be more youth friendly, take into account literacy level, assistive devices in home and community • Different modules for different types of disabilities • Youth with Dyslexia? Youth with Autism? • Add the mentor information or who would be a good mentor for the different modules, offer options of mentors. • Use faces instead of yes/no
  24. 24. A successful transition
  25. 25. Thank-you & Acknowledgements • CanChild Team • TRACE Team http://bmjopen.bmj.com/cgi/doi/10.1136/bmjopen-2014-007553

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