Identification of the most common problems by patients with ankylosing spondylitis using the international classification of functioning, disability and health
Objective:
The International Classification of Functioning, Disability and Health (
ICF) aims to classify functioning and health by a number of categories divided over 3 components: body functions and body structures, participation and activities, and environmental factors. We identified the common health problems of patients with ankylosing spondylitis (AS) based on the
ICF from the perspective of the patient.
Methods:
During structured interviews with the extended
ICF checklist, trained assessors collected data from 111 patients with AS.
ICF categories identified by more than 5 percent of the patients as at least mildly impaired or restricted were selected. Categories identified by less than 5 percent were removed. Additional impairments/restrictions reported by more than 5 percent of the patients, after the structured interviews and not yet included in the checklist, were added.
Results:
One hundred nineteen (72 percent) out of 165 categories of the extended
ICF checklist were identified to be at least mildly impaired or restricted. Within each of the 4 components of the
ICF, at least one-third of the categories were impaired or restricted for more than 50 percent of the patients. Thirty-nine (33 percent) categories were related to movement and mobility. Within the component "environmental factors" the categories "support of immediate family" and "health professionals" were the most important facilitators, "climate" was the most important barrier. Eight impairments were additionally mentioned as relevant. These were hierarchically lower levels of
ICF categories previously included and they were added.
Conclusion:
One hundred twenty-seven
ICF categories represent the comprehensive classification of functioning in AS from the patients' perspective. The results underscore the need to address the 4
ICF components when classifying functioning and to emphasize that functioning implies more than physical functioning.
