Utilizing the International Classification of Functioning, Disability and Health to Describe Quality-of-Life Assessment in Older Adults in a Middle-Income Country.
Maik Berber Freitas, Gustavo Pietracatelli Janizello, Wallace Pereira Silva and 6 others
In 52 older adults in Brazil, SF-36 scores converted to ICF qualifiers showed moderate problems in pain, general health, and vitality, mild problems in physical, social, and mental functioning, and no problems in role domains.
The method is descriptive only.
Key findings
1The SF-36-to-ICF conversion classified Bodily Pain, General Health, and Vitality as moderate problems (qualifier 0.2), Physical Functioning, Social Functioning, and Mental Health as mild problems (0.1), and Role Physical and Role Emotional as no problem (0.0).
2The ICF qualifiers were derived from the group median score of each domain, not from individual participant scores, so they describe the group's central tendency rather than any single patient's profile.
3No inferential or comparative analyses were performed; the study is purely descriptive and does not test whether any demographic or clinical variable is associated with different qualifier classifications.
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What it does not show
Convenience sampling from a single university clinic in São Paulo; the sample may not represent community-dwelling older adults who do not regularly access healthcare, and the authors note the findings apply primarily to this specific context. 92.3% of the sample was women, which the authors acknowledge may have influenced domain scores, particularly Bodily Pain and Vitality, where sex-related differences are known. ICF qualifiers were assigned from the group median of each domain, not from individual scores, so they describe the group's central tendency and do not capture how any single patient's profile would be classified. The cutoff values used to convert SF-36 scores into ICF qualifiers come from a prior study (Fréz et al. 2014) and have not been independently validated in community-dwelling older adults. No inferential analyses were performed; with n = 52 and a purely descriptive design, no associations between demographic variables and qualifier classifications can be drawn. Cross-sectional design: a single time-point measurement with no follow-up, so no information about change over time.
Declared interests
Partially funded by CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior), the Brazilian federal agency for graduate education. The authors declare no conflicts of interest.
The easy way to misread this
Do not apply these ICF qualifiers to an individual patient. They were calculated from the group median of each SF-36 domain, not from any single person's score, so a patient with a pain score of 30 would still fall under the group's 'moderate problem' label (0.2) even though their own score would map to a different qualifier. The qualifiers describe the group's central tendency, not any individual's profile, and the 92.3% female convenience sample limits how far the findings can be generalised.
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