Applying ICF in nursing practice: classifying elements of nursing diagnoses.
OBJECTIVE
This study explores the relevance of the International Classification of Functioning, Disability and Health (ICF) to nursing diagnoses.


BACKGROUND
As a multidisciplinary classification of human functioning, the ICF (previously known as ICIDH-2) is potentially relevant to nursing care. However, nurses have rarely used the classification during the 23 years of its existence.


METHODS
In part 1 of the study, 51 nursing diagnoses from anonymous patients were deliberately selected for diversity from an existing database. The 427 diagnostic elements from these diagnoses (problem statements, aetiological factors, signs and symptoms) were classified, using the ICF, by a panel of six nurses. In part 2 of the study, the panel classified 223 elements from 30 diagnoses of patients they had actually cared for.


RESULTS
Nearly all diagnostic elements could be classified, most often in the sub-dimensions of body functions and activities. Agreement on appropriate ICF components was 61% for anonymous patients and 75% for familiar patients. Agreement at the more detailed 3-digit level of the classification was 42% for anonymous and 60% for familiar patients.


CONCLUSIONS
The ICF has relevance to nursing care. As a general classification, it was not designed by nurses or specifically for nursing care. This can explain some difficulties in using the classification that were identified in this study, as well as the rather low levels of agreement. To resolve these issues and to further improve the classification, nurses should further explore the use of the ICF and participate in future revision processes.
Heinen
M M
MM
Centre for Quality of Care Research, Nursing Science, University Medical Centre St Raboud, Nijmegen, The Netherlands. m.heinen@kwazo.umcn.nl
van Achterberg
T
T
Roodbol
G
G
Frederiks
C M A
CM
D000046:Academic Medical Centers; D000203:Activities of Daily Living / Q000145:classification*; D003142:Communication; D004185:Disability Evaluation; D006304:Health Status; D006694:Holistic Health; D006801:Humans; D038801:International Classification of Diseases / Q000145:classification*; D007400:Interprofessional Relations; D009426:Netherlands; D009733:Nursing Diagnosis / Q000145:classification*; D015403:Nursing Evaluation Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000523:psychology; D015588:Observer Variation; D010348:Patient Care Team; D010865:Pilot Projects; D012919:Social Behavior; D009626:Terminology as Topic