Table 3.

Fawcett and DeSanto-Madeya (2013) Evaluation of Conceptual Frameworks Modified by the International Classification of Functioning, Disability, and Health Framework

Evaluation criteria	Mitra et al. (2015)	Kalpakjian et al. (2020)
Explication of origins	Yes. Philosophical assumptions about disability and perinatal health are explicitly stated. Influential conceptual frameworks are referenced (Misra et al., 2003; Nosek et al., 1995).	No. Philosophical assumptions about disability and reproductive health are not explicitly stated. “Prior work” is mentioned as informing the conceptual framework, but no references are provided.
Comprehensiveness of content	Moderate to high. All ICF constructs are sufficiently incorporated in the conceptual framework. Researchers are provided sufficient information to ask questions. Providers are not given sufficient guidance to make practice changes.	Low to moderate. Disability and functioning are not included in the conceptual framework. Most of the environmental and personal concepts recommended by the ICF are also omitted. The narrow focus of the conceptual framework on reproductive care settings supports feasible practice changes. Researchers are provided sufficient direction to create patient-reported outcome measures.
Logical congruence	Yes. The outcomes category of knowledge is ontologically consistent with the reciprocal interaction worldview (Fawcett & DeSanto-Madeya, 2013).	Yes. The outcomes and interactions categories of knowledge are ontologically consistent with the reciprocal interaction worldview (Fawcett & DeSanto-Madeya, 2013).
Generation of theory	Moderate. No theories were originated from the conceptual framework. It has contributed to the development of a conceptual framework for perinatal health outcomes among women with cognitive disabilities.	Moderate. No theories were originated from the conceptual framework. It has contributed to the development of a conceptual framework for sexual well-being among women with physical disabilities.
Legitimacy	Mixed. The conceptual framework was used to guide multiple qualitative studies to explore barriers to perinatal care among women with physical and sensory disabilities (Long-Bellil et al., 2017a; Long-Bellil et al., 2017b; Mitra et al., 2016; Powell et al., 2018; Smeltzer et al., 2016). Only one quantitative study employed the conceptual framework and outcomes were specific to women with cognitive disabilities (Kassee et al., 2023).	Mixed. Few studies used the conceptual framework to interpret their qualitative findings (Alhusen et al., 2021; Horner-Johnson et al., 2022). Only one study developed patient-reported outcome measures from the conceptual framework (Kalpakjian et al., 2023).
Social utility	Moderate to High. Some knowledge of the ICF is required to understand how disability and functioning are defined in the conceptual framework. Practice protocols may not feasibly integrate all environmental concepts (e.g., societal attitudes).	Moderate to High. An understanding of instrument development is needed for researchers that utilize the conceptual framework to develop patient-reported outcome measures. Practice protocols may be more readily implemented due to the narrow scope of the conceptual framework on reproductive care settings and providers.
Social congruence	Low. The conceptual framework has generated research among predominantly White women with physical disabilities in the United States and Canada.	Low. The conceptual framework was developed based on qualitative interviews with mostly White women with physical disabilities living in urban areas in the United States. Demographic factors are not included in the conceptual framework.
Social significance	High. The focus on individual, environmental, and healthcare system determinants in combination with a life-span approach to perinatal health outcomes has the potential to reduce perinatal disparities among women with physical disabilities.	High. By supporting the development of patient-reported outcome measures, the conceptual framework has the potential to guide intervention development and reduce reproductive disparities among women with physical disabilities. The focus on interactions with providers can also support qualitative research study designs.
Contributions to the discipline	Moderate. First conceptual framework to adopt ICF definitions of disability and functioning to support perinatal health research for women with physical disabilities. Future quantitative research studies are needed to support the relational propositions of the conceptual framework.	Moderate. First conceptual framework to support patient-reported outcome measures for the reproductive health of women with physical disabilities. More research is needed to evaluate its utility to support patient-reported outcome measures.

Note. Adapted from Contemporary Nursing Knowledge: Analysis of and Evaluation of Nursing Models (3^rd ed., p. 47–54), by J. Fawcett & S. DeSanto-Madeya, 2013, F. A. Davis Company. with content from the ICF from The ICF: An Overview, by World Health Organization, n.d. (https://www.cdc.gov/nchs/data/icd/icfoverview_finalforwho10sept.pdf)