title: Comparing the content of instruments assessing environmental factors using the International Classification of Functioning, Disability and Health.
abstract: OBJECTIVE
  To describe and compare the content of instruments that assess environmental factors using the International Classification of Functioning, Disability and Health (ICF).
  
  
  METHODS
  A systematic search of PubMed, CINAHL and PEDro databases was conducted using a pre-determined search strategy. The identified instruments were screened independently by two investigators, and meaningful concepts were linked to the most precise ICF category according to published linking rules.
  
  
  RESULTS
  Six instruments were included, containing 526 meaningful concepts. Instruments had between 20% and 98% of items linked to categories in Chapter 1. The highest percentage of items from one instrument linked to categories in Chapters 2-5 varied between 9% and 50%. The presence or absence of environmental factors in a specific context is assessed in 3 instruments, while the other 3 assess the intensity of the impact of environmental factors.
  
  
  CONCLUSIONS
  Instruments differ in their content, type of assessment, and have several items linked to the same ICF category. Most instruments primarily assess products and technology (Chapter 1), highlighting the need to deepen the discussion on the theory that supports the measurement of environmental factors. This discussion should be thorough and lead to the development of methodologies and new tools that capture the underlying concepts of the ICF. :
authors.affiliation: School of Health Sciences ESSUA, Aveiro University, Aveiro, Portugal. jalvarelhao@ua.pt
authors.forename: José
authors.initials: J
authors.lastname: Alvarelhão
authors.forename: Anabela
authors.initials: A
authors.lastname: Silva
authors.forename: Ana
authors.initials: A
authors.lastname: Martins
authors.forename: Alexandra
authors.initials: A
authors.lastname: Queirós
authors.forename: António
authors.initials: A
authors.lastname: Amaro
authors.forename: Nelson
authors.initials: N
authors.lastname: Rocha
authors.forename: Jorge
authors.initials: J
authors.lastname: Lains
mesh_terms: D000203:Activities of Daily Living / Q000145:classification*; D004185:Disability Evaluation; D004777:Environment; D006262:Health / Q000145:classification*; D006801:Humans; D011795:Surveys and Questionnaires