Development of the International Classification of Functioning, Disability and Health (ICF) core set for stroke survivors in community-based rehabilitation settings in Hong Kong

Abstract

Purpose

This study aimed to develop an ICF core set for assessing stroke survivors in community-based rehabilitation settings in Hong Kong.

Material and Methods

A three-round Delphi process which involved 39 multidisciplinary experts in community-based rehabilitation services was conducted to reach consensus on a preliminary version of ICF core set for stroke survivors. The initial questionnaire included 130 second-level ICF categories while the panel was invited to suggest additional categories. Experts rated the relevance of each category using a 5-point Likert-type scale. Consensus of ratings was assessed using Spearman’s rho and inter-quartile range indices. Two experts were identified as outliers and excluded after the second and third rounds. The remaining 37 experts then then applied the preliminary core set to stroke survivors under their care. After 6 months of application, a fourth Delphi round using the same list of categories from the third round was conducted to refine the core set based on practical feedback.

Results

After refinement through 30 out of 37 experts in the fourth Delphi round, the finalised core set was developed which included 41 categories.

Conclusion

The final core set reflects key dimensions of functioning relevant to stroke survivors receiving community-based rehabilitation services in Hong Kong.

IMPLICATIONS FOR REHABILITATION

  • The developed ICF core set for stroke survivors in Hong Kong provides a framework for evaluating the most relevant functional abilities and key rehabilitation needs in community-based rehabilitation settings.

  • The inclusion of categories addressing cardiovascular functions, acquiring skills, daily routines, communication, and community and social life supports a more holistic approach to improving community reintegration and quality of life of stroke survivors.

  • This research included an additional Delphi round post-application of the preliminary core set, allowing further refinement of the preliminary core set based on clinical application, and establishing a practical example for refining and adapting the core set in other regions.

Keywords

stoke, ICF, core set, community-based rehabilitation, Delphi method, Hong Kong

Link to Publisher Version (URL)

https://doi.org/10.1080/09638288.2025.2557499

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