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Conceptual challenges of the construct ‘functioning and disabilities’ in the person-centered framework

Luis Salvador-Carulla, Javier E. Saavedra, Mencia Ruiz

Abstract


The publication of the International Classification of Functioning (ICF), the approval of the UN Convention on the Rights of Persons with Disabilities and the release of the 2011 World Report on Disability are cornerstones in the process of developing a functioning and disability (F&D) perspective in the care systems in the World. However, the significant advances on the conceptualisation of functioning and disabilities -mainly derived from the ICF model- have not produced an international consensus on the definition of this construct and different approaches persist even within the ICF framework. Reasons for dissent are, among others, holistic versus practical approaches to human functioning, universal versus health-related perspectives and assessment of individuals versus assessment of target groups (e.g. specific diseases or age groups). Different models of F&D are described as well as their related assessment instruments. In order to improve the definition of F&D, a clear distinction between the supra-domains ‘activity/participation’ and ‘inclusion/citizenship’ may be needed. Within this context, person-centered medicine and the related Person-centered Integrated Diagnosis (PID) model may provide a new perspective on this topic as it incorporates F&D into a broader frame where F&D domains can be differentiated from the health condition, the experiences of health and the determinants of health.


Keywords


Assessment instruments, disability, functioning, ICF, person-centered care, person-centered integrative diagnosis

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References


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DOI: https://doi.org/10.5750/ijpcm.v2i2.218

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