Using the ICF to Facilitate Clinical Reasoning in Physiotherapy Practice – Health System Example

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"Using the ICF to Facilitate Clinical Reasoning in Physiotherapy Practice"  is an inspiring example of a paper on the health system. Clinical reasoning is a road map of gathering relevant clinical data from different clinical situations. Such practice depends on healthcare practitioners’ knowledge, thinking, reflective and self-awareness skills. The main purpose of clinical reasoning is to identify sufficient possibilities or options for effective decision-making processes regarding the treatment of patients (Norman et al. , 1999, Higges and Jones 2008). In all fields of clinical practice, healthcare professionals use different clinical reasoning models in order to come up with better treatment strategies for their clients.

The biomedical model assumes that clinical reasoning can be explained in terms of physiological processes (Boshuzen & Schmidt 1992). However, advancements in medical research have also made it mandatory for clinicians to run tests relating to all kinds of social aspects as well as the psychological testing of patients to describe the client’ s health conditions (Elstein & Schwarz, 2002). The International Classification of Functioning, Disability, and Health (ICF) model is a road map that has a potential to organize health professionals thinking and action; It also goes beyond collecting information about the client’ s body structure, function, and involvement in social activities, so that clinicians can actually become aware of the environment in which the client has been living and which, ultimately, has affected them.

This process will elaborate on the patient’ s overall situation and the underlying causes that have led to their disability (Cieza et al. , 2007). The ICF was subsequently described as a tool that facilitates patient management by serving as a reference for the documentation of physiotherapeutic examination, evaluation, diagnosis, prognosis and intervention(Huber and Ceiza 2007), the ICF encompasses all aspects of a patient’ s functioning, disability, and health; it is an interactive component of the functional, environmental, and personal factors  (WHO, 2001). The ICF framework suggests and evaluates the functionality of the person at work that makes clear descriptions about the interactions of the ICF domains and the performance statics of an individual.

The knowledge attained in this manner allows structuring the information in an organized manner that can easily be transformed to be utilized extensively (Hollenweger, 2013).

The attained knowledge can, therefore, be used to assist clinical thinking and information sharing (Rosenbaum and Stewart, 2004). The knowledge of the clinical professional influences the clinical procedures with respective application ICF. The knowledge attained with the respective ICF model helps produce information systems and offers a framework for information compilation in case of clinical analysis procedure (define problems, set goals, plan intervention and re-assess intervention). On the other hand, the ICF framework acts as a link between the collection of information through various clinical resources and knowledge sharing by utilizing the collected knowledge.

The framework immensely helps the health professional to solve the clinical problems and refine the decision-making process (Hollenweger, 2013). Published reviews of ICF-related literature The literature regarding ICF has been reviewed three times since it was first published. Allen et al in 2008 in which 21 articles were specifically related to the physiotherapy critically examined One hundred and fifty-four articles that are related to the ICF. In these articles, different authors described the practices of the ICF on a daily basis. Some particular articles described the importance of the ICF to improve clinical care and enhance the knowledge to support interdisciplinary discussions.

The articles depict that ICF has the capability to enhance the evaluation procedures and improve the intrusion of the knowledge. The articles show the importance of ICF in improving the decision making process and communication. It also plays a major role in developing a guideline for the various clinical processes. On the other hand, the research regarding ICF remains reliant on interior reliability (Jette et al 2006). The review stated that in order to use the ICF efficiently, the physiotherapist must have proper knowledge of the tools, structures, and terminologies of the ICF.

On the other hand, it is equally important to have explicit knowledge of clinical situations. Moreover, the review was unable to find particular researches regarding the ICF in association with physiotherapy education for students and clinical staff. The review was also unable to explain what kind of information will be required by the physiotherapists. The second review by Constand and MacDermid in 2014, analyzed the use of ICF in achieving aims in healthcare practices.

The review revealed that healthcare professional has integrated the ICF for achieving aims in healthcare practices. With the integration of the ICF into a goal-setting approach helps the clinical practitioners and patients to organize the goals. The ICF framework depicts the importance of the needs of patients and depicts the importance of the goal-setting approach to meet the patients’ needs in an appropriate manner.   The review depicts the benefits of the ICF in association with the goal-setting approach. The benefits make the goal-setting approach mutual as well as help the integration of the ICF for achieving goals in the clinical practices.

The review suggests the two restrictions while integrating the ICF into the healthcare goal-setting practices. It should be noted that only eight out of nineteen articles conferred the restrictions. The fact is that integrating the goal-setting approach in the clinical procedures would consume valuable time and is a difficult job, particularly for clinical practitioners. As eight of the nineteen articles have depicted the limitations, there is a need to evaluate the benefits of the ICF integration into the health care facilities particularly in goal-setting practices of the ICF.   However, the goal-setting approach has an encouraging impact and contribution to patient care units. The proposed modal of ICF requires further research to be more sophisticated.

On the other hand, the modal should be such facilitating to assist the change in the clinical procedures. However, the practical consideration of the modal will help in determining will the theoretical modal work appropriately. On the other hand, it is important to spread the knowledge intended by the ICF and the integration of the ICF in the clinical procedures.

Enhanced knowledge of the ICF is helping in delivering the increased use of the ICF tools in rehabilitation processes. The goal-setting application of the ICF is viable for the patient care centers, health practitioners and patients. The goal-setting practices of the ICF should be integrated with the entry-level education and postgraduate education regarding clinical practices. The knowledge should be delivered in an appropriate manner to clearly present the evidence, conceptual models of the ICF. In 2015, Birnbaum et al released the publication that depicted the possibilities of ICF modal for use of the examination in health education.

Birnbaum et al have reviewed 18 articles to analyze the tools of the ICF for providing the initiative for the formation of modal for health education. Finally, the collected results of the initiatives were reviewed. On the basis of reports in the literature education and teaching, examining the educational function of the CIF in the teaching of health care appears to be relatively new, but growing phenomenon with almost one half of was tested were published in 2010 or later. In addition, the measures were to point in this magazine whose various ICF may be part of the training of health care professionals or student clinicians in the financial year.

In addition, one-third of the studies included in this study were in the knowledge evaluation. Clinical reasoning is rational to understand the decision-making in clinical practice and ICF constitute clinical reasoning tool and create the knowledge that can play a significant impact on the way the functions and the inability to apply in the health care and health education (Holleway, 2013). In our view, evidence convincing such a change does not found in the articles about the use of CIF in the process of clinical considerations in the education of health care practices.

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