Personal perception and personal factors: incorporating health-related quality of life into the International Classification of Functioning, Disability and Health

Purpose. The International Classification of Functioning, Disability and Health (ICF), introduced by the World Health Organisation in 2001, offers a unique perspective from which to view the role of rehabilitation in one's lived experience of a health condition. However, the ICF does not capture the individual's perception of that experience that is key to understanding functioning, disability and quality of life (QOL) and more specifically health-related quality of life (HRQOL). The purpose is to explore expansion of the ICF framework to incorporate personal perception to offer a more complete expression of functioning and disability. Method. We examine the concepts of HRQOL and personal perception, as well as how they have been linked to the ICF in the literature. Through a review of the foundations of the biopsychosocial model, we propose an enhanced version of the ICF that integrates HRQOL within the framework by expanding the personal factors component. Results. Through operationalising aspects of personal perception and situating them among the personal factors, we demonstrate how HRQOL may be integrated within the ICF framework. Conclusion. Using several case examples, we illustrate that if personal perception is housed within the personal factors component all other components may be influenced through mechanisms of the ICFs reciprocal interactions. In doing so, HRQOL becomes part of the experience of a health condition and functioning and disability are completely described.