Lecture to first year medical students how to use ICF in taking a history (Introduction to Clinical Medicine)

1. Fakulteit Geneeskunde en Gesondheidswetenskappe  Faculty of Medicine and Health Sciences
The F-Words in history taking
26 September 2017
Dr Stefanus Snyman

2. Write down and discuss
1. 5 months later: What do you remember of the
ICF?
2. Why do you think it is of value to revisit the
ICF when we talk about taking a medical
history?

3. Outcomes
• Demonstrate how to take a patient’s history by
using the International Classification of
Functioning, Disability and Health (ICF).

4. Outline of this session
• Recap the ICF
• The ICF as framework to think about your
patient
• Taking a spiritual history

5. Resources
• Prescribed:
• Notes: Health in Context notes / podcast (ICF
and Worldview).
• Notes: Taking a spiritual history (pdf & mp3)
(SUNLearn)
• Recommended:
• Overview: ICF Practical Manual (see
SUNLearn).
(Read Chapter 1-2)
• ICF Checklist (scan to give you the bigger
picture) (See SUNLearn)

6. Resources
• Background resources
• Want to know something specific to describe
the various ICF domains:
http://apps.who.int/classifications/icfbrowser/
• Now each chapter up to level 3

9. Patient-centred
By using ICF, patient outcomes are highlighted
through interprofessional activity that
conceptualises the complex interrelatedness of
functioning as a ‘dynamic interaction between a
person’s health condition, environmental factors
and personal factors.

12. Body function and structure domains:
Impairment
1. Mental status
2. Sensory functions (vision, hearing, vestibular,
pain)
3. Voice and speech
4. Vascular and circulatory system
5. Respiratory system
6. Endocrine, digestive and metabolic
7. Genito-urinary and reproductive systems
8. Skin and related structures

14. Activity & Participation domain:
Life areas (tasks and actions)
1. Learning and applying knowledge
2. General tasks and demands
3. Communication
4. Mobility
5. Self care
6. Domestic life
7. Interpersonal interactions
8. Major life
9. Community, social and civic life
Want to know something specific to
describe the various ICF domains:
http://apps.who.int/classifications/icfbrows
er/

16. Personal factors [Positive / Negative]
• Age
• Gender
• Race
• Education
• Worldview
• Experiences
• Personality
• Aptitude
• Coping styles
• Lifestyle
• Fitness, etc.

18. Environmental factors
[Barriers or Facilitators]
1. Products and technology
2. Natural environment and man
made changes
3. Support & relationships
4. Attitudes
5. Services, systems & policies

19. Taking a spiritual history
• Why would you take a spiritual history?
• When would you take a spiritual history?
• Resources:
• Notes on SUNLearn
• Review worldview notes from health in context
• Simply Ask booklet for future reference about
religions

20. Good opportunity to take a spiritual
history:
• When someone is suffering from major illness,
terminal disease or dying
• In the peri-operative period
• At registration or health maintenance check
• In a social crisis or time of loss

21. Belief, Practice and Faith Community.
• Belief:
• ‘Do you have a faith which helps you (in a time
like this)?’
• ‘Do you have a personal faith?’
• ‘What is important to you (in life)?’

22. Belief, Practice and Faith Community.
• Practice:
• ‘How does it affect your life?’
• ‘Have you ever prayed about your situation?’

23. Belief, Practice and Faith Community.
• Faith Community:
• ‘Do you belong to a faith community?’
• ‘Who gives you support?’
• ‘What keeps you going?’