The aims of this study were to explore the perspective of functioning in community-dwelling people with prior stroke and to confirm, if possible, the Comprehensive International Classification of Functioning, Disability and Health (ICF) Comprehensive Core Set for stroke. Methods: Qualitative interviews were analysed (using the content analysis method and established ICF linking rules) from 22 persons following stroke (age range 59-87 years), as well as their spouses/partners, where relevant. Results: Ninety-nine (76%) of 130 second-level ICF categories in the existing Comprehensive ICF Core Set for stroke were confirmed: 31 categories (of 41) in the component of body functions, 38 categories (of 51) in the component of activities and participation, 26 (of 33) in the component of environmental factors and 4 (of 5) in the component of body structures. Eleven additional ICF categories and one personal factor, a coping style of "I take it as it comes" were also identified in the transcribed text. Conclusion: The Comprehensive ICF Core Set for stroke was largely confirmed.

Personal factors, such as age, gender, place of residence and time since onset of stroke, influence self-perceived functioning and environmental factors.

International Classification of Functioning, Disability and Health (ICF) core sets are short procedures to record and provide information on health. However, further validation is needed. The aim of this study was to validate the Comprehensive ICF Core Set for stroke by exploring the patient's living at home and receiving outpatient rehabilitation perspective on functioning in everyday life. Qualitative interviews of 22 patients with previous stroke in Finland were analyzed using the content analysis method: functional concepts that described the participants' perspective on functioning in everyday life were extracted from the interview transcripts and linked to ICF categories using ICF linking rules. Extracted functional concepts from 372 meaning units were linked to 115 of the 166 categories included in the Comprehensive ICF Core Set for stroke and to six additional ICF categories. Thirty-eight concepts could not be linked to the ICF categories. Sixty-eight percent of the second-level ICF categories in the Comprehensive ICF Core Set for stroke were validated. In total, 28 of 36 categories added to the Comprehensive ICF Core Set for stroke from the Core Sets for patients with neurological conditions in the acute and early postacute phases were not confirmed in this sample of individuals with stroke living in their homes.

Health professionals do not fully capture the magnitude of emotional or social problems experienced by persons after stroke when using the ICF Core Set as a framework for evaluation. Implications for Rehabilitation The ICF Core Set for Stroke provides comprehensive list of possible health and health related outcomes for persons after stroke. Problems reported in condition-specific patient-reported outcome scales can be important in decision making in rehabilitation. Patients and health professionals tend to agree more on physical than cognitive problems. Examination of the relevance of the ICF cores set for stroke by comparing with the Stroke Impact Scale.