Development and validation of a functional assessment tool for Chinese inpatient rehabilitation: insights from a Delphi study based on the International Classification of Functioning, Disability, and Health (ICF).

Objectives: To develop and validate a functional assessment tool for inpatient rehabilitation in China using the International Classification of Functioning, Disability, and Health (ICF) Rehabilitation Set (ICF-RS) framework and the Delphi method. Methods: A three-round Delphi process engaged 15 experts to refine ICF-RS items via a 5-point importance questionnaire. Validation involved 2,574 inpatients assessed with a numerical rating scale. Reliability (Cronbach's alpha) and structural validity (factor analysis) were evaluated. Results: Through three rounds of Delphi meetings, 10, 2, and 1 ICF items with mean importance scores below the threshold were respectively removed, resulting in 17 ICF items achieving expert consensus for inclusion in the final assessment tool, named ICF-RS-17. Expert authority coefficient was 0.81. Cronbach's alpha exceeded 0.9. Factor analysis identified two factors explaining 68.86% (admission) and 73.25% (discharge) of variance, confirming structural validity. Conclusions: The study developed a 17-item functional assessment tool, ICF-RS-17, demonstrating strong reliability and validity for inpatient rehabilitation. These findings help promote the application of the ICF in clinical settings, enhance rehabilitation clinical management, and potentially support the further development of rehabilitation insurance policies.