Biomedical Engineering Reference
In-Depth Information
life situation, and the client's abilities to
function in his or her environment are
described as follows.
The
health condition
is the hearing
loss.
Body structures
refers to the affected
anatomical portions that factor into the
condition (e.g., outer hair cell loss in the
cochlea or fused bones in the middle ear).
Body functions
refer to the abilities of the
auditory system, given the damaged or
malfunctioning body structures.
Activi-
ties
are just that—what tasks or actions
the person can perform.
Participation
has a broader meaning and includes
events and situations that the individual
can engage in. Stated in this way,
activi-
ties
and
participation
are defined in a
positive way—that is, what the individual
can do. However, in practice, we speak
about
activity limitations
, or problems
the individual has to complete tasks, and
participation restrictions
, difficulties the
individual experiences while in particu-
lar situations. Contextual factors has two
components,
environmental factors
(the
physical world of the person, the society
and that society's ethos, mores, and laws)
and
personal factors
(e.g., age, sex, coping
style, education, profession, life experi-
ence, character, and how the person expe-
riences the disability).
There are several additional points
to be made about this model. First, note
that each component is interdependent
with every other component. What does
that mean? Practically speaking, that
means a change in any one component
could cause changes in all the others, in
either a positive or negative direction, or
both. Another characteristic of the ICF
model is that it classifies three human
functioning levels: (1) body or body part,
(2) whole person, and (3) whole person in
a social context (WHO, 2002). In school,
audiologists are taught that we are treat-
ing the person, not the hearing loss. The
interdependent nature of the components
of the ICF model coupled with the rec-
ognition of factors at these three levels
should reinforce that message, and also
make us think that the situation may be
even more complex than we originally
thought. The key is that we perform an
adequate needs assessment that addresses
each of the components in the ICF model.
We turn to the needs assessment now.
Needs Assessment
Before we think about particular tests,
instruments, and questions we might use
in our assessment, we want to acknowl-
edge an important idea connected with
treating clients:
patient- and family-cen-
tered care
(PFCC). Although PFCC is not
a new concept, it has received increased
attention by the health care industry in
recent years. The overarching concept of
PFCC is that the client and her/his family
should be included as team members in
all aspects of the client's health care, from
being given accurate, timely, and unbi-
ased information, to developing and car-
rying out the treatment plan. Individuals
and families may participate to whatever
degree they feel comfortable with, which
we, as professionals, should honor. In
audiology, we have long recognized how
important it is to include family members
and other communication partners in the
