There are considerable parallels between the two approaches. It has been proposed as a bridging framework for transdisciplinary health promotion and efforts have been made through data collection and research to operationalize the framework. Over the last decade, the framework has been used to define disability and has since then increasingly been applied in various settings in the health and social care.
Functionings, within this approach, refer specifically to what people are actually doing (e.g., working) or being (e.g., being well-fed), whereas capabilities are the real freedoms or opportunities that people have to do and be what they have reason to value (the opportunity to choose between working or staying at home to raise one’s children, to eat a nourishing meal, or skip a meal during the day by choice). The two main concepts in the CA are functionings and capabilities. The CA is a theoretical framework based on the normative assumption that people should have the freedom to live a life they value. The other framework is the capability approach (CA), initiated by Amartya Sen and further developed jointly with Martha Nussbaum. Publications in which the ICF is applied have increased tremendously over the last 20 years. Since publication in 2001, the ICF has contributed greatly to the shift in “the way we think about, measure, design, collect and analyze data about functioning and disability”. It provides a universal language for describing functioning, and a person’s lived experience of health.
It can be used at individual and population level and contains over 1500 categories related to body functions, activity, social participation, and environmental factors influencing functioning. It is a framework and classification system that integrates biological, individual, and social aspects of health. The ICF is based on an integrative model of health and provides a holistic, multidimensional, and interdisciplinary model which can be used to describe and classify health and health-related conditions. One is the World Health Organization’s International Classification of Functioning, Disability and Health (ICF). Two frameworks have contributed substantially over the past two decades to the transformation toward more holistic and patient-centered care. Indeed, the separate treatment of each of a patient’s condition often does not improve a patient’s health outcomes and can lead to unnecessarily complex interactions with the healthcare system. Traditional practices and attitudes have been identified as barriers to implementing patient-centered care, including the dominance of the biomedical paradigm and the predefined structure of care pathways. However, operationalization in practice remains challenging. Patient-centered interactions between professionals and patients lead to better health outcomes. Patient-centered care was defined in 2001 by the Institute of Medicine as “providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions”. Over the past two decades, healthcare systems have shifted to a more holistic, patient-centered care system.
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