Building Bridges: Self-Perceived Functioning in Care Settings to Enhance Human Agency and Flourishing

Healthcare systems and practices often focus on specific diseases and symptoms, failing to fully address individuals’ goals and values, leading to low satisfaction with care and poor outcomes. There is a need for a different approach to care that boosts individuals’ agency in care settings so as to improve care outcomes. The International Classification of Functioning, Disability, and Health (ICF) and the Capability Approach (CA) are two frameworks that can help frame the delivery of person-centred care. In particular, in care settings individuals should (i) evaluate how they value their own functioning as per the ICF (self-perceived functioning), including body functions, activities, and participation and the contextual factors influencing this functioning, instead of having a professional make the assessment and (ii) have the opportunity to formulate their functioning related goals and action plans to achieve those goals.This article explores the joint application of these frameworks at different levels (individual, community, professionals, organisations, systems, and the environment) in order to facilitate a transformation of care to enhance human agency and flourishing.