Abstract
Internationally accepted approaches to the study of functioning and disability can
inform critical care practitioners and scholars in their study of functional limitations,
disability, and quality of life after critical illness and intensive care. Therefore
this article provides an introduction to the World Health Organization's International
Classification of Functioning, Disability and Health (ICF). The Institute of Medicine
has also recommended this approach for the study of disability. This conceptual framework
divides potential problems as follows: problems in body structure and tissue, limitations
in activity (i.e., functional limitations as assessed in standardized environments),
and restrictions in participation (i.e., the inability to fulfill a social role).
The ICF draws attention to effect modifiers that can prevent problems at one level
from progressing (or conversely can hasten their progression) to profound decrements
in a patient's quality of life. It is particularly relevant for studies of long-term
outcomes after critical illness and post–intensive care syndrome (PICS). This article
provides a discussion of the ICF specific to the intensive care unit and the disablement
process, with particular attention to new opportunities for intervention and their
implications for cost and quality of life.
Keywords
critical illness - post–intensive care syndrome (PICS) - survivorship - disability
- quality of life
