Objective This study examined whether the functional implications of deafblindness can be understood as the simple sum of vision loss and hearing loss or whether deafblindness constitutes a distinct sensory disability. By comparing the comprehensive ICF Core Sets for vision loss, hearing loss, and deafblindness, the study aimed to determine the extent to which deafblindness reflects unique patterns of functioning beyond additive single sensory difficulties. Method A secondary comparative analysis was conducted using all items from the three Core Sets that were classified according to the four ICF components (body functions, body structures, activities and participation, and environmental factors). Items were merged into a single dataset and coded for their presence in each condition. A systematic item-level comparison was performed to identify categories that were common to all three Core Sets, shared by two, or unique to a single sensory condition. No weighting was applied; all items were treated equally. The final output grouped items, reflecting different patterns of overlap and uniqueness. Results The Core Sets contained 98 items for vision loss, 118 for hearing loss, and 219 for deafblindness. A total of 435 distinct categories were identified. Of these, 53 items appeared in all three conditions. Overlap showed 27 items shared between vision loss and deafblindness, 34 between hearing loss and deafblindness, and 11 between vision and hearing loss. Unique items were most pronounced in the deafblindness Core Set (n = 105), followed by hearing loss (n = 20) and vision loss (n = 7), indicating a substantial condition-specific functional profile for deafblindness. Conclusion The results demonstrate that deafblindness is not merely the additive coexistence of vision and hearing loss but reflects a distinct and more complex functional profile. These findings support the need for condition-specific clinical approaches, policies, and assessment frameworks tailored to the unique demands of deafblindness.
Introduction The questionnaire for postamputation pain (Q-PAP) introduced here has undergone modifications over a decade of research on postamputation pain. It has so far been used as a form of study specific questionnaire. Here, we present the latest attempt to consolidate it as a tool useful for both research and clinical practice by involving experts on postamputation pain worldwide. Methods A three-round Delphi study was conducted online, utilising email and digital forms as tools for communication and providing feedback. We included a purposive sample of 13 clinicians and researchers with expertise in postamputation pain from eight countries. The experts ranked each questionnaire item for relevance, clarity, and completeness on a 5-point Likert scale. Consensus on each item was considered reached when the level of agreement was above 50%. Results The preliminary version of the Q-PAP comprised an introduction and sections with questions on phantom limb pain, residual limb pain, neuroma pain, and situational changes. Based on the group’s feedback, the section on neuroma pain was removed, as it required clinician-administered tests, which conflicted with the self-report nature of the questionnaire. In addition, individual items on telescoping, prosthesis use, and bone pain were removed, as experts deemed them too specific. The final version of the Q-PAP assesses pain intensity, descriptors, frequency, interference, phantom limb position, phantom limb movements, phantom limb sensation, and situational changes. Conclusion The findings support content validity of the Q-PAP as a self-report instrument for the multidimensional assessment of postamputation pain, providing a clinically relevant and patient-centred tool for capturing key pain characteristics and experiences. The psychometric validation of the Q-PAP is a crucial part of future work, establishing its reliability, validity, and comparability for use in PAP research and clinical practice.
Objective:To evaluate the construct validity and clinical associations of the Clinical Functioning Information Tool (ClinFIT) with routinely collected preoperative risk and functional capacity measures in a colorectal cancer prehabilitation cohort. Design:Prospective observational study of routinely collected prehabilitation clinic data. Methods:Adults with colorectal cancer at a tertiary cancer centre were assessed in the prehabilitation clinic using validated tools and anaesthetic and surgical risk indices, including ClinFIT, Community Integration Questionnaire-Revised (CIQ-R), prehabilitation multidisciplinary risk ratings, functional capacity and cardiopulmonary exercise testing (CPET)-derived risk category, nutrition screening and socioeconomic indices. Associations were examined using Spearman's rank correlations. Results:Participants (n = 64, mean age: 60.8±13.5 years, 54.7% male) had a median acute length of stay (LoS) of 15 days (IQR: 10-20.5). Higher ClinFIT scores moderately correlated with higher American Society of Anesthesiologists physical status (p <0.001), CPET physiological vulnerability/risk (p =0.013), and prehabilitation multidisciplinary risk ratings (p <0.001). ClinFIT showed strong inverse correlations with self-reported functional capacity on the Duke Activity Status Index (p <0.001) and participation (CIQ-R total score) (p <0.001). ClinFIT did not correlate significantly with LoS, procedure-focused surgical risk indices, nutrition screening, or socioeconomic disadvantage. Conclusion:ClinFIT showed strong associations with participation, functional capacity, and selected preoperative vulnerability measures in this colorectal cancer prehabilitation cohort. These findings support its potential role as a multidimensional screening and assessment tool from a rehabilitation perspective. Further work should examine whether ClinFIT provides clinically useful information beyond existing preoperative measures and supports its practical use in preoperative oncology care.
Objective Common hearing assessments often overlook key aspects of hearing loss and its impact on daily-life. This study evaluates a broad dataset of audiological and functional measures by applying the World Health Organization’s International Classification of Functioning, Disability, and Health (ICF) Core Sets for Hearing Loss. The aim is to clarify which aspects of hearing loss-related functioning are represented in the dataset and which aspects are not addressed, thereby supporting appropriate interpretation and use of the data in clinical and research contexts. Design The dataset includes results from otoscopy, pure-tone audiometry, a self-reported hearing and functioning questionnaire (HEAR-COMMAND Tool), speech intelligibility tests (Göttinger Sentence Test, GöSA and Oldenburger Sentence Test, OLSA), listening effort evaluation (Adaptive Categorical Listening Effort Scaling, ACALES), loudness perception assessments (Loudness Validation Method and Adaptive Categorical Loudness Scaling), a multi-talker conversation task (Concurrent Oldenburger Sentence Test, CCOLSA), coupler measurements, in-situ recordings, tone-in-noise perception, and the Dialogue Picture Task (DIAPIX). Using the ICF linking rules, all measures, performed on 76 participants, were systematically mapped to ICF categories. Results For the brief CSHL, the dataset addressed 92.5% of the categories, missing only brain and inner ear structures. For the comprehensive CSHL, the dataset addressed 50.4% of the categories. This included 81.8% of Body Functions, 40% of Body Structures, 59.5% of Activities and Participation, and 29.1% of Environmental Factors. Conclusion The results demonstrate that the dataset captures many key aspects of hearing loss and its consequences while also clarifying which areas of functioning are not addressed. By applying the ICF framework as a standardized reference, this study provides guidance for the transparent interpretation and appropriate use of the dataset in clinical and research settings, while enabling the creation of detailed profiles of an individual’s hearing loss that are relevant for modeling speech intelligibility and listening effort.
Objective:To assess the longer-term functional and participation outcomes in survivors with colorectal cancer with peritoneal metastasis (CRCPM) and pseudomyxoma peritonei (PMP) following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy intervention (CRS-HIPEC). Method:Adult CRCPM/PMP in the community following CRS-HIPEC completed validated questionnaires. Descriptive statistics summarized participant characteristics, while multivariate linear regression (p < 0.05) identified predictors of functional and psychosocial outcomes, and a binary logistic regression model identified factors associated with poorer quality of life (QoL). Results:Of 100 participants (59 CRCPM, 41 PMP), mean age: 59.1±12.2 years, 52% male, mean time since CRS-HIPEC: 2.4±2.5 years, overall, many reported persistent issues: fatigue (86%), fear of recurrence (79%), pain (58%), insomnia (52%) and bowel dysfunction (32%). Despite this, overall functional recovery was good (Clinical Functioning Information Tool median [IQR]: 28 [19.3-52.5]), with low perceived psychological impact (Depression Anxiety Stress Scale total: 6 [0-17.5]) and relatively preserved QoL (European Quality of Life VAS score: 78 [60-85]). The CRC-specific QoL was poorer (Functional Assessment of Cancer Therapy-Colorectal: 106 [91-115.6]) and community integration was modest (Community Integration Questionnaire: 20.3 [16-24]). The PMP cohort reported a lower persistent symptom burden and a more favourable QoL. Overall, older age and unemployment were strong predictors of poorer outcomes. Employment status and symptom burden independently predicted longer-term functional and participation outcomes in CRCPM survivorship, with female gender, stoma, and radiotherapy as additional influencing factors. Conclusion:Overall, despite participants being functionally well, many experience substantial longer-term symptom burden and participation-related challenges (especially in CRCPM) following CRS-HIPEC, reflecting significant unmet rehabilitation needs. Systematic integration of rehabilitation across the CRC care continuum is therefore essential to optimise longer-term functional and participation outcomes in this population.
