Application of the Brief International Classification of Functioning, Disability, and Health Core Set as a Conceptual Model in Distal Radius Fractures

作者：Squitieri Lee; Reichert Heidi; Kim H Myra; Chung Kevin C^*

来源：Journal of Hand Surgery-American Volume, 2010, 35A(11): 1795-1805.

DOI：10.1016/j.jhsa.2010.07.013

• International Classification of Functioning, Disability, and Health
• outcomes
• distal radius fractures
• MHQ

Purpose In 2009, the World Health Organization published a conceptual outcome framework for evaluating upper extremity injury and disease, known as the Brief International Classification of Functioning, Disability, and Health (ICF) Core Set for Hand Conditions. The purpose of this study was to apply the ICF conceptual model to outcomes for distal radius fractures (DRFs) and determine the contribution of each ICF domain to patient satisfaction.
Methods Patient-rated and objective functional outcome data were collected at 6 weeks, 3 months, and 6 months after surgery. We measured satisfaction using a subsection of the Michigan Hand Outcomes Questionnaire (MHQ) satisfaction score. Measured study variables were linked to their corresponding ICF domain (personal factors, environmental factors, activity and participation, and body function). We then used hierarchical regression to assess the contribution of each ICF domain to variation in overall patient satisfaction at each time point.
Results We enrolled 53 patients with unilateral DRFs treated with the volar locking plating system. Regression analysis indicated that measured study variables explain 93% (6 weeks), 98% (3 months), and 97% (6 months) of variation in patient satisfaction. For all 3 study assessment dates, activity and participation variables (MHQ-Activities of Daily Living, MHQ-Work, and Jebsen-Taylor Score) contributed the most to variation in patient satisfaction, whereas personal and environmental factors had a considerably smaller role in predicting changes in patient satisfaction.
Conclusions The results demonstrated that it is possible to reliably model the relative contributions of each ICF domain to patient satisfaction over time, and the findings are consistent with previous research (ie, that most outcome variation is due to physical or functional factors). These results are strong enough to support continued use and further research using the ICF model for upper extremity outcomes. (J Hand Surg 2010;35A:1795-1805.

• 出版日期2010-11