Measuring Participation as Defined by the International Classification of Functioning, Disability and Health: An Evaluation of Existing Measures

Objectives: The content and theoretic underpinning of measures designed to assess participation, disability, and handicap vary widely,. and few authors have attempted to compare the content of existing measures. The objectives of this study were to use the International Classification of Functioning, Disability and Health (ICF) taxonomy to (1) evaluate the participation content of measures and (2) identify the most comprehensive measures. Design: We searched PubMed, Cumulated Index of Nursing and Allied Health Literature, and Health and Psychosocial Instruments databases to identify appropriate measures. Content analysis was conducted by classifying participation-related items of each measure into I or more of the 9 activities and participation chapters of the ICF taxonomy. Setting: Not applicable. Participants: We evaluated 40 generic and condition-specific self-report measures that met study inclusion criteria. Interventions: Not applicable. Main Outcome Measures: The most comprehensive measures were identified and coded by using second- and third-level ICF codes. Results: Five measures containing participation items linked to all 9 chapters were the Community Living Skills Scale, the Assessment of Life Habits, Mayo-Portland Adaptability Inventory, the participation measure for postacute care, and the Psychosocial Adjustment to Illness Scale. The breadth and coverage of these 5 measures were compared. Conclusions: We identified 5 measures that had items that were linkable to all 9 chapters of activities and participation; however, these measures differed in specifics of coverage and the approach to assessing participation. These findings can be used by clinicians and researchers to select the most comprehensive participation outcome measure for their populations.