International classification of functioning: assessment of life restrictions in disabled with bronchial asthma

Authors:

Ishutina Inna Sergeevna, PhD in Medical sciences, Head of the Department of medical and social examination and medical rehabilitation, Institute for Rehabilitation and Habilitation of the Disabled, Federal State Budgetary Institution “Federal Scientific Center of Rehabilitation of the Disabled named after G. A. Albrecht” of the Ministry of Labour and Social Protection of the Russian Federation, 50 Bestuzhevskaya Street, Saint Petersburg, 195067 Russian Federation, tel. 8-905- 266-83-54, e-mail: in.ishutina@yandex.ru

Kantemirova Raisa Kantemirovna, Grand PhD in Medical sciences, Head of the therapeutic department, chief researcher, Institute for Rehabilitation and Habilitation of the Disabled, Federal State Budgetary Institution “Federal Scientific Center of Rehabilitation of the Disabled named after G. A. Albrecht” of the Ministry of Labour and Social Protection of the Russian Federation, 50 Bestuzhevskaya Street, Saint Petersburg, 195067 Russian Federation, tel.: (812) 543-65-05, (812) 764-96-69, 921-933-07-99, e-mail: terapium@yandex.ru

Shabanova Oksana Antonovna, PhD in Medical sciences, leading researcher at the Department of medical and social expertise and medical rehabilitation of disabled persons, Institute for Rehabilitation and Habilitation of the Disabled, Federal State Budgetary Institution “Federal Scientific Center of Rehabilitation of the Disabled named after G. A. Albrecht” of the Ministry of Labour and Social Protection of the Russian Federation, 50 Bestuzhevskaya Street, Saint Petersburg, 195067 Russian Federation, tel.: +7-911-257-42-64, e-mail: expert-oksana@mail.ru

Annotation:

Introduction. At least 360 million patients worldwide suffer from bronchial asthma [6]. According to the Euro- pean Community of Pulmonologists, the prevalence of bronchial asthma in Russia is 5–8 % in the general population, with 20 % of patients suffering from this disease in severe form [1]. According to some prognostic analytical studies, by 2025, if the urbanization process continues at the same pace and the urban population worldwide increases from 45 to 59 %, bronchial asthma will develop an additional 100–150 million people [2, 5]. The main role in the pathogen- esis of bronchial asthma is played by chronic inflammatory processes. There is a clear connection between inflam- matory changes in the mucous membrane of the respiratory tract with bronchial hyperreactivity and the degree of bronchial obstruction. The implementation of the increased sensitivity of the tracheobronchial tree is manifested by a characteristic triad – bronchospasm, swelling of the mucosa and hypersecretion, and can be caused by both im- munological and non-immunological mechanisms [3].

Aim. The aim of this study is to develop a methodology for describing the objective status of a disabled person in the process of expert rehabilitation diagnosis using the categories of International Classification of Functioning for making an expert decision on the example of bronchial asthma.

Materials and methods. Assessment of life restrictions in the group of people with disabilities due to bronchial asthma was carried out in accordance with the basic set of the International Classification of Functioning [4, 7] for bronchial asthma using the first meter. Within the specific categories of the International Classification of Func- tioning, the degree of impairment of the functions and structures of the body was determined by classical clinical methods of examination. The description of the objective status of a disabled person was carried out on the basis of an individual profile of life restrictions. The group assessment of indicators of life restrictions was made on the basis of individual assessments. Indicators of disability were evaluated within categories. Given that individual profiles of life restrictions differ from each other in different patients, that depends on the set of concomitant diseases, the range of indicators is very wide.

Results. Indicators of life restrictions specific to the underlying disease are usually found in all patients selected for the nosological group. Group analysis allows identify specific nosological forms of the disease inherent life re- strictions. As a result of testing of the International Classification of Functioning when making expert decisions have become disabled due to bronchial asthma by summing data of individual profiles of “disability” depending on the disturbance of body functions and activity limitations were able to identify a generic list of “life restrictions”.

Discussion. As a result of testing the International Classification of Functioning, Disability and Health when mak- ing an expert decision for people with disabilities due to asthma, by summarizing the data of individual profiles of “limitation of vital activity” on the components of impaired body functions and limiting activity, a generalized list of “limitations of vital activity” was revealed.

Conclusion. The individual profile of life restrictions described in the article is not complete, but covers only those sections of the classification that belong to the “area of responsibility” of the therapist as a specialist who makes an expert decision when determining disability in patients with bronchial asthma.

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