Functioning, Disability, And Health

The World Health Organization’s International Classification of Functioning, Disability, and Health (WHO-ICF) helps professionals understand the impact that aphasia has on the individual’s life and helps define it. Further, it considers how the health condition impacts their lives in terms of functioning, disability and context factors. “Functioning refers to the body functions.., activities, and participation in life events; disability refers to impairments, activity limitations, and participation restrictions that prevent an individual from participating fully in his or her desired life activities” (Chapey, 2008. p 65-66). Functioning involves what the client does and engages in. Disability includes what the client cannot do to a full extent

The activity and participation level allows us to know the level of function and independence for the person with the health condition. How independent can this person be in everyday situations? How much functional communication do they have? That is, how has aphasia impacted their lives and what is the damage and extent of the damage to the language areas. The other part of the WHO-ICF framework includes the contextual factors such as environmental and personal factors. Environmental factors talk about the things that are out of the person’s control and personal factors are the describing characteristics of the individual (Hung, 2015). The model tells us to take a comprehensive approach to viewing a health condition. A clinician should ask: What is the health condition of the individual? What body functions and structures has it damaged? How have these conditions limited their participation and activity level? What are the contributing environmental and personal factors? The purpose of this model is to “heighten the awareness of the holistic components of functioning and participation in life activities, and the very complex interaction of conditions between an individual and his or her environment that affects functioning” (Chapey, 2008, p

Clinicians will want to ensure the “continued participation in the face of threat or frustration” (Chapey, 2008, p 80). Typically, this area can be assessed and appears with most activity assessment tools. However, this area will measure their capacity and performance in regards to the participation level in their environment. Tools that can be used include the WHO Quality of Life (WHOQOL-BREF) assessment tool. The WHOQOL-BREF attempts to understand how the individual feels about their status in regards to physical health, psychological health, social relationships, and environment (Chapey, 2008, p 120). It is subjective to the person’s beliefs. Another assessment tool that can be used to assess participation is the Community Integration Questionnaire (CIQ). It attempts to understand their community participation after their accident (Hung, 2015). An effective assessment tool that attempts to understand quality of life needs to consider the person’s beliefs of their own life and not what the caregivers, family members, and spouses, etc. may think. Only that individual would know how the health condition has impacted their