Identification of Hemodialysis Patients’ Physical and Psychosocial Problems Using the International Classification of Functioning, Disability and Health (ICF)

We aimed to identify hemodialysis (HD) patients’ physical and psychosocial problems using the International Classification of Functioning, Disability and Health (ICF)-based checklist we developed. The ICF belongs to the WHO’s family of international classifications, and it is the instrument for comprehensive understanding of patients. HD patients have diverse physical and psychosocial problems, and ICF-based approach may be useful to improve management and quality of life (QOL) of patients on HD. In this article, we introduced the new data associated with physical and psychosocial problems of 222 patients in HD, which extends our previous report (Tsutsui et al. 2009). In Japan, the number of patients on HD was 36,397 in 1980 and increased to 290,675 in 2009 (Patient Registration Committee, Japanese Society for Dialysis Therapy, 2010). In addition to the physical limitations in functioning caused by renal failure and its comorbidities, HD patients have various restrictions resulting from HD therapy requiring radical lifestyle changes. Therefore, HD patients tend to have both physical and psychosocial problems. Thus, evaluation of QOL is especially important, and the Kidney Disease Quality of Life (KDQOLTM) (Hays et al, 1994) and the Kidney Disease Quality of Life-Short Form (KDQOLSFTM) (Hays et al, 1994) have been widely used. The KDQOL-SFTM includes multi-item scales targeted at the particular health-related concerns of individuals who have kidney disease and are on dialysis. In the present study, we aimed to investigate the use of the International Classification of Functioning, Disability and Health (ICF) (WHO 2001), which is the instrument for comprehensive understanding of patients. In addition to evaluate physical and psychosocial problems of patients, ICF can be used as a tool for team medical treatment to make plans for treatment and care of patients. We have reported the checklist for HD patients based on ICF (Tsutsui et al. 2009). The data in this article include those of patients on HD with diabetic nephropathy, which was excluded in the previous report.