Implementation of ICF as a Tool for Clinical Reasoning in Physiotherapy - Report Example

Implementation of ICF as a Tool for Clinical Reasoning in Physiotherapy: A Systematic Review of [Date] Implementation of ICF as a Tool for Clinical Reasoning in Physiotherapy: A Systematic Review Keywords: Clinical reasoning, decision-making, ICF, biomedical model Introduction: Clinical reasoning is considered as a model of gathering data from different clinical situations. In simpler words, it can be said that clinical reasoning allows healthcare practitioners to come up with assessment through different areas or aspects of patient (Rogers, 1983). The main purpose behind undertaking clinical reasoning is to skim enough possibilities or options for effective decision-making process regarding treatment for patients (Norman et al., 1999). In order to provide top-notch healthcare facilities to patients coming from different situations of disability, clinicians would conduct physical exam, prescribe various medical tests, undergo diagnostic process, pointing out effective regime for treatment purpose and finally reaching to the level of counseling where patients are made to believe the body needs that have been ignored previously from the patient’s hand (McGaghie, 1980). In all fields of clinical practices, healthcare professionals make use of clinical reasoning in order to come up with better treatment strategy for their clients. The diagnostic models or strategies are all based upon effective biomedical model of clinical research. The fact remains that healthcare practitioners are made liable to have information gathering skills and decision-making techniques as well. Intellectual standards in medicine have come up with different symptoms that a patient may show (Milofsky, 1979). The clarity which makes the clinicians to differ all these disability situations would be the effective gathering of information. Sometimes the social participation of patients in different social activities all allow healthcare practitioners to come up with better understanding about patient’s disability. Moreover, advancement in medical research has also made it quiet mandatory for the clinicians to run tests for all sorts of social aspects as well as psychological testing of patients that may tell enough about client’s disability (Elstein & Schwarz, 2002). Most recently, another most effective model of clinical reasoning has been framed by World Health Organization (WTO) entitled International Classification of Functioning, Disability and Health (ICF) model (Bickenbach et al., 2003). As a matter of fact, this model is effective for clinicians to be aware of the cause and effect of different illness conditions in which respective clients are found. This model goes beyond collecting respective information about the client’s structure and involvement in social activities. In this way, clinicians can actually get aware regarding the environment in which the client has been living and ultimately got affected by it. This often tells as to what activities have made the client into the illness situation (Cieza et al., 2007). Herein, the research focuses on the relationship that is between the implication of ICF and physiotherapy. Research has proven that physiotherapy is one effective way to get effective treatment. Body functions are more likely to be regained with the help of physiotherapy. Also to note is the fact that physiotherapy is effective because it does not make patients daily activities affected by any chance (Atkinson & Nixon-Cave, 2011). But the limitations of physiotherapy are noted to be its inclusion of social participations of patient within different communities (Matney et al., 2011). This systematic review is aimed to assess the workability of ICF as a clinical reasoning tool. Furthermore, the research finds out ways in which ICF can be best used for undertaking clinical reasoning for cases of rehabilitation and physiotherapy. The research aims to provide discussion regarding aforementioned subjects and aspects by answering the following research questions: • Do rehabilitation therapists and physiotherapists use the ICF model as a clinical reasoning tool? • Does the ICF model facilitate the clinical reasoning skills of health rehabilitation staff and PTs? • How does the ICF model facilitate the clinical reasoning of therapists? Data Collection and Pre-Analysis: It is significant to address research questions or inquiries by undertaking past literature research. A number of databases were skimmed for undertaking a thorough research. This research was divided into two different sections while a hand research was also undertaken for four important and relevant journals listed in the references section (Lundy & Janes, 2009). Within the first section of research, 1600 citations were listed down where the age factor was not put into a respective constraint. These citations included adults as well as infants’ cases because clinicians from different fields of rehabilitation make use of different techniques to undergo clinical reasoning. Most recently, healthcare practitioners make use of different ICF readings under observation while prescribing rehabilitation and physiotherapy. The second round of the research, an abstract along with 1600 citations was skimmed in order to assess the research studies which were only published during past years. In this, it was found out that whether different clinical researches have been able to discuss regarding clinicians undertaking of clinical reasoning (Pedro-Go´mez et al., 2011). The skimming of citations was undertaken by filtering the researches that noted ICF implications. In total, these citations included 32 case report studies, 110 studies mapped the usage and effective application of ICF clinical tool. It should be noted that there were 25 roughly marked text articles that were used as per criteria eligibility for two reviewers. Experimental Results: The skimming of different researches marked the evident that ICF implied clinical reasoning within the field of physiotherapy remains in the developing stage. There are enough gaps being noted in the literature submission regarding reasoning by clinicians using ICF in different patient situations. One of the most effective studies that have been published regarding mapping of ICF for evidence-based basic physiotherapy techniques was by Franki et al. (2012). There were a range of techniques implemented by physiotherapists’ among children with cerebral palsy. The research implemented around 58 articles that were majorly discussing various forms of physiotherapy that were allowing effective understanding of involvement of patients in social activities and the impact of environment on them (Skelton, 2008). The review encompassed 58 articles on a range of standard physiotherapy techniques. While, this present systematic review included prospective studies mapped the ICF to health professional clinical reasoning process to understand how the health professionals use the ICF in clinical practice as clinical reasoning tool (Goldeberg & Jenkins, 2013). The outcomes of implication of ICF as a reasoning tool remain uninformed. Therefore, there needs to be an in-depth assessment for the research regarding clinical reasoning. As far as the results of implication of ICF on clinical practices are concerned, it is suggested that more and more research is conducted in order to assess its implication in a correct manner. There may be some limitations underlying its implication in reality (Bickenbach et al., 2003). Figure 1 (Elstein & Schwarz, 2002) In addition, there needs to be assessment of different working definitions of ICF. This is much needed because the concept has been implied in respective fields of medicine. This makes a limitation for clinicians of all the medicinal fields to apply ICF as a clinical reasoning. Therefore, it is recommended that more and more assessment is undertaken with different conditions of patients from different aspects of illnesses (Brunero & Lamont, 2011). Once there is an evident implication of ICF in clinical reasoning as a tool then it is expected that much more advancement can be undertaken to inset clauses within the model. Most of the studies that have been found over the years are presentation of patient cases and decision making that was undertaken by clinicians. The hierarchy of evident related to the strength of literature has been stimulated in the research articles found out so far in different databases. Another important factor to be noted here is the research methodology. There can be different methods that can be applied in order to effectively find situations of patients that have not been assessed as yet because of lack of understanding ICF implied cases. The aspect of bias is another factor that may affect our overall understanding of ICF implication. Therefore, it is suggested that report cases and real life situations are made use of after evaluating the intensity of bias in overall results (World Health Organization, 2013). Patient and Therapist Expectations: Since the implication of ICF model has been done by world health organization, it is expected that a great of research has been done in order to come up with such a model. Thus, there are many expectations of patients and therapists with ICF model. Also, the utilization of this model as a tool of clinical reasoning is surely going to help the modern advanced infrastructure of healthcare sector (Adams, 2010). There are some limitations associated with the model but they can surely be addressed well depending on its implication in different fields of medicines. It should be clear by now that this model is needed so that different aspects of patients can be well understood because more and more advancement is needed to undertake decision making. Often clinicians have maintained an argument about diagnosis. There are increased situations and divergent symptoms of illness and diseases. These can only be well understood or judged by the healthcare practitioners when they can find out the context and background of issues. Thus, necessary research as suggested in above should be carried out soon. This extended abstract has penned down all relevant suggestion in the light of past research and argument posed by clinicians in different decision making experiences. In a nutshell it can be said that ICF can bring a boom in the field of clinical reasoning which will develop horizons for effective healthcare. List of References Adams, J.S., 2010. Utilizing evidence-based research and practice to support the infussion alliance. Journal of Infusion Nursing, 33(5), pp.273-77. Atkinson, H. & Nixon-Cave, K., 2011. A tool for clinical reasoning and reflection using the international classification of functioning, disability and health (ICF) framework and patient management model. Physical Therapy, 91(3), pp.416-30. Bickenbach, J., Chatterji, S., Kostanjsek, N. & Üstün, B., 2003. Ageing, Disability and the WHOs International Classification of Functioning, Disability and Health (ICF). The Geneva Papers on Risk and Insurance. Issues and Practice, 28(2), pp.294-303. Brunero, S. & Lamont, S., 2011. The Process, Logistics and Challenges of Implementing Clinical Supervision in a Generalist Tertiary Referral Hospital. Scandinavian Journal of Caring Sciences, 26(1), pp.186-93. Cieza, S., Kollerits, B., Grimby, G. & Stucki, G., 2007. Content Comparison of Health-Related Quality of Life Measures Used in Stroke Based on the International Classification of Functioning, Disability and Health (ICF): A Systematic Review. Quality of Life Research, 16(5), pp.833-51. Elstein, A. & Schwarz, A., 2002. Evidence Base Of Clinical Diagnosis: Clinical Problem Solving And Diagnostic Decision Making: Selective Review Of The Cognitive Literature. BMJ: British Medical Journal, 324(7339), pp.729-32. Goldeberg, P. & Jenkins, J., 2013. Genetics: Part of Nursing Practice. [http://ce.nurse.com/PrintTopic.aspx?TopicId=1188] [Accessed 11 November 2013]. Lundy, K. & Janes, S., 2009. Community Health Nursing: Caring for the Publics Health. New York: Jones & Bartlett Learning. Matney, S., Brewster, P. & Sward, K., 2011. Philosophical Approaches to the Nursing Informatics Data-Information-Knowledge-Wisdom Framework. Advances in Nursing Science, 34(1), pp.6-18. McGaghie, W., 1980. Medical Problem Solving: An Analysis of Clinical Reasoning by Arthur S. Elstein; Lee S. Shulman; Sarah A. Sprafka. Journal of Religion and Health, 19(2), pp.159-60. Milofsky, C., 1979. Medical Problem Solving: An Analysis of Clinical Reasoning. by Arthur S. Elstein; Lee S. Shulman; Sarah A. Sprafka. American Journal of Sociology, 85(3), pp.703-05. Norman, G., Brooks, L., Colle, C. & Hatala, R., 1999. The Benefit of Diagnostic Hypotheses in Clinical Reasoning: Experimental Study of an Instructional Intervention for Forward and Backward Reasoning. Cognition and Instruction, 17(4), pp.433-48. Pedro-Go´mez, J., Morales-Asencio, J., Veny, M. & Vives, G., 2011. Determining factors in evidence-based clinical practice among hospital. Journal of Avanced Learning, 68(2), pp.452-59. Rogers, C., 1983. Clinical reasoning: The ethics, science, and art. American Journal of Occupational Therapy, 37(1), p.601–616. Skelton, J., 2008. Language and Clinical Communication: This Bright Babylon. [Print] New York: Radcliffe Publishing. World Health Organization, 2013. Promoting Access to Medical. Washington DC.: World Health Organization. Read More