| 1. |
- Bremander, Ann, 1957-, et al.
(författare)
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Cultural adaptation, validity, reliability and responsiveness of the Swedish version of the effective musculoskeletal consumer scale (EC-17)
- 2012
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Ingår i: Musculoskeletal Care. - Chichester : John Wiley & Sons. - 1478-2189 .- 1557-0681. ; 10:1, s. 43-50
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Endorsed by the Outcome MEasures in Rheumatoid Arthritis in Clinical Trials (OMERACT) group, The Effective Consumer Scale (EC-17) was developed in English for patients with musculoskeletal diseases to assess the skills and perceptions important for participating in and managing health care. The objective of this study was culturally to adapt the questionnaire into Swedish and to study its psychometric properties.METHODS: After translation of the questionnaire into Swedish, two different groups of outpatients from two specialist rheumatology departments participated in the study. Face validity was assessed, together with internal consistency, test-retest and responsiveness of the questionnaire. Construct validity was assessed using the Arthritis Self-Efficacy Scale (ASES), and responsiveness to a five day educational intervention was analysed using the standardized response mean (SRM).RESULTS: Analyses were based on 124 patients with inflammatory rheumatic diseases, of whom 50 attended the intervention. Data quality met the requirements, with missing values <5%, and floor and ceiling effects <15%. Item total correlations were all >0.4, ranging from 0.49 to 0.88. Cronbach's alpha was 0.93 and 0.95 for the two groups. The test-retest correlation (ICC₂.₁) was 0.94, and there was a significant improvement as a result of the intervention, with an SRM of 0.43. However, the questionnaire had a higher construct validity with the ASES subscale 'other symptoms' than hypothesized a priori (r(s) 0.75).CONCLUSION: The Swedish version of the EC-17 met the required recommendations for face validity, internal consistency, test-retest reliability and responsiveness. Its construct validity needs to be further established, and the questionnaire needs further testing in different groups of patients and in different interventions. © 2012 John Wiley & Sons, Ltd.
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| 2. |
- Grotle, Margreth, et al.
(författare)
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What's in the black box of arthritis rehabilitation? : A comparison of rehabilitation practice for patients with inflammatory arthritis in northern europe
- 2013
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Ingår i: Journal of Rehabilitation Medicine. - Uppsala : Foundation Rehabilitation Information. - 1650-1977 .- 1651-2081. ; 45:5, s. 458-466
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Tidskriftsartikel (refereegranskat)abstract
- Background: In evaluating complex interventions, it is a challenge for researchers to provide transparent reporting of the intervention content with sufficient detail and clarity such that effects can be compared across studies or countries. Objective: To describe and compare the content of current rehabilitation for patients with inflammatory arthritis across 4 northern European countries. Patients and methods: A total of 731 patients with inflammatory rheumatic diseases participated in a multicentre, longitudinal observational study carried out in Sweden, The Netherlands, Denmark and Norway. Data on context, structure and process were reported by patients and teams at the different participating study sites according to the Scandinavian Team Arthritis Register European Team Intiative for Care Research (STAR-ETIC) framework. Results: Although large similarities were found in the context, there were important differences between the Netherlands and the Scandinavian countries. Regarding structure, there were considerable differences in the length of the rehabilitation period across settings and countries. The most evident differences concerned process variables, especially the type and dosage of individual treatment modalities. Conclusion: The variation in important aspects of arthritis rehabilitation found in the present study underline the need for transparent and standardized description of these variables when comparing effects across settings and countries. A standardized description of current practice can be achieved by the STAR-ETIC framework.
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| 3. |
- Hagel, Sofia, et al.
(författare)
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Content Validity of the Arthritis Self-Efficacy Scale
- 2017
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Ingår i: Reumabulletinen. - Stockholm : Svensk reumatologisk förening. - 2000-2246 .- 2001-8061. ; :119; 4, s. 59-60
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Tidskriftsartikel (refereegranskat)abstract
- Background: Appropriate evaluation is important to optimize health care interventions and to understand patient’s experiences of their situation. Self-efficacy has been proven to have impact on pain, fatigue, physical activity and on cardiovascular risk in patients with inflammatory arthritides, and adequate evaluation is important. The arthritis self-efficacy scale (ASES) is one patient reported outcome measure recommended for evaluation of self-efficacy in arthritides. The aim of this study was to start analyzing the content validity of the ASES through linking to the International Classification of Functioning (ICF), and by using the proposed structure for personal factors (PF).Material and methods: The linking to the ICF was performed through identification of each meaningful concept of heading, introduction and all question including answering options of the ASES subscales for pain and symptoms. Each identified meaningful concept was linked to the third level ICF domain, according to established linking rules. Concepts identified as potential personal factors were sorted into the proposed structure of personal factors (Geyh, 2011) when applicable. The two authors independently identified meaningful concepts and performed the linking to the ICF, and sorted into the structure of personal factors (PF). Disagreements were discussed thoroughly, and reviewed until consensus was reached. Results: The ASES subscales for pain and symptom comprised 5 and 6 questions respectively. All questions were linked to the ICF domain body functions, at a minimum through each answering option that was linked to the b126 “temperament and personality functions”. Other body function domains covered were b130 (energy and drive functions), b134 (sleep functions), b152 (emotional functions), b160 (thought functions) and b280 (pain).Seven questions and the introduction of the ASES subscales for pain and symptom were linked to the ICF domain activity and participation (3 and 4 questions respectively). Five questions were linked to d570 (looking after one’s health), while d220 (undertaking multiple tasks) and d230 (carrying out daily routine) were captured by both subscales although somewhat less well represented.Three questions were linked to the ICF domain environmental factors. Two ASES pain questions were linked to e110 (products and substances for personal consumption) while one ASES symptom question was linked to e425 (individual attitudes of acquaintances, peers, colleagues, neighbors and community members).Personal factors were identified in both ASES subscales. The answering options for all questions except two could be sorted into the PF concept “feelings”, the headings, introductions and six questions could be sorted into the PF concept “patterns of experience and behavior”, and three questions could be sorted into “thoughts and beliefs”.Conclusion: The ASES subscales for pain and symptom showed satisfying content validity since important constructs on all ICF domains (except for body structure) were included. Both ASES subscales also covered PF that contribute with important aspects on health, and impact of the disease, further improving the content validity.
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| 4. |
- Hagel, Sofia, et al.
(författare)
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Team-based rehabilitation improves long-term aerobic capacity and health-related quality of life in patients with chronic inflammatory arthritis.
- 2010
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 32, s. 1686-1696
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Tidskriftsartikel (refereegranskat)abstract
- Purpose. To examine the effect of an interdisciplinary, out-patient rehabilitation programme for patients with chronic inflammatory arthritis on aerobic capacity and health-related quality of life (HRQOL). Method. One hundred and seventy-four patients, 115 with peripheral arthritis (PA) (91 women, mean age 53 years, disease duration 16 years) and 59 with spondylarthropathies (SpA), (27 women, mean age 46 years, disease duration 14 years) were consecutively enrolled in 18 days of interdisciplinary rehabilitation. We report data from evaluations at inclusion, at discharge, and at 4 and 12 months using a sub-maximal treadmill test of aerobic capacity and the Nottingham Health Profile (NHP) (t-test). Results. At inclusion, less than 20% of all patients tested had aerobic capacity classified as 'average' or better. At discharge, 41% (PA) and 54% (SpA) reached the 'average' level or better with improvements maintained for 12 months. The total NHP scores improved in both groups (mean change -12 (99%CI -15, -9) for PA; mean change -13 (99%CI -19, -8) for SpA) and were maintained. Conclusion. Aerobic capacity and HRQOL improved significantly in this interdisciplinary out-patient rehabilitation study, and improvements were maintained for 12 months. The preserved level of aerobic capacity after 12 months indicated a change to a more physically active lifestyle among the participants.
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| 5. |
- Hagel, Sofia
(författare)
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Team rehabilitation and health care utilization in chronic inflammatory arthritis patients
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis was to study outcome and evaluation of rheumatological multidisciplinary team rehabilitation programmes in patients with chronic inflammatory arthritis (CIA); rheumatoid arthritis (RA), ankylosing spondylitis, psoriatic arthritis and other spondyloarthritides, and to analyse health care utilization over the last decade in patients with RA. In Study I the outcome of an 18 days outpatient multidisciplinary team rehabilitation programme in 174 patients with CIA was analysed. The patients were evaluated pre- and post the rehabilitation programme and 4 and 12 months thereafter. Health related quality of life (HRQoL), general health and aerobic capacity was significantly improved at the end of the rehabilitation programme and after 12 months. In Study II 731 patients with CIA participated in different team rehabilitation programmes in four European countries and were evaluated pre- and post rehabilitation. Through analysis of covariance we studied which patients improved the most by team rehabilitation. Females experiencing more pain, fatigue and lower psychosocial wellbeing improved most in HRQoL. HRQoL for half of the patients improved according to analysis of Minimal Important Difference. In Study III we analysed the validity and responsiveness of 15 standardized outcome measures used to evaluate outcomes from multidisciplinary team rehabilitation in 216 patients with CIA. According to our linking of the outcome measures to the International Classification of Functioning, Disability and Health (ICF) most ICF components were reasonably well covered except environmental aspects.Further, out of three outcome measures used to evaluate HRQoL, the Euroqol-5Dimensions (EQ-5D) performed as well as the more extensive short form 36 health survey (SF-36) and Nottingham health profile (NHP). Aerobic capacity did not correlate to other measures of observed physical functioning . It was highly responsive to change. In Study IV we wanted to study health care utilization in patients with RA over time. By using the Skåne Health Care Register we identified 3977 persons who had been diagnosed with RA when consulting health care during 1998-2001. Two referents from the general population per RA patient were matched for age, sex, and area of residence. The annual mean number of hospitalizations and outpatient clinic visits 2001-2010 and the annual ratio (RA cohort/referents) were analysed. The overall inpatient and outpatient health care utilization was found to decrease in RA patients as compared to the general population. To conclude, multidisciplinary team rehabilitation is beneficial for patients with CIA with regards to HRQoL, general health and aerobic capacity, both short and long term. Further, patients with more severe disease consequences benefit most from rheumatological team rehabilitation. When evaluating HRQoL in rheumatological team rehabilitation the commonly used questionnaires EQ-5D, NHP and SF-36, showed important differences in construct validity and responsiveness and are thus not interchangeable. Improving aerobic capacity is an important aspect of team rehabilitation not covered by other outcome measures on physical function and thus important to evaluate. Patients with RA have utilized less health care during the last decade which might be an effect of changing treatment strategies.
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| 6. |
- Hagel, Sofia, et al.
(författare)
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Trends in 21st century Health Care Utilization in a Rheumatoid Arthritis Cohort Compared to the General Population
- 2012
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Ingår i: Arthritis and Rheumatism. - Hoboken, NJ : John Wiley & Sons. - 0004-3591 .- 1529-0131. ; 64:S10, s. S31-S32
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Tidskriftsartikel (refereegranskat)abstract
- Statement of purpose: To study twenty-first century trends in health care utilization by rheumatoid arthritis (RA) patients compared to the general population. Methods: Observational cohort study; using Swedish health care register data, we identified 3977 Region Skåne residents (mean age year 2001, 62.7 years and 73% women) consulting for RA (ICD-10 codes M05 or M06) in 1998-2001. We randomly sampled two referents from the general population per RA patient matched for age, sex, and area of residence. We calculated the year 2001-2010 trends for the annual ratio (RA cohort/referents) of the mean number of hospitalizations and outpatient clinic visits. Results: By the end of the 10-year period 62% of RA patients and 74% of referents were still alive and resident in the region. From 2001 to 2010 the ratio (RA cohort/referents) of the mean number of hospitalizations for men and women decreased by 27% (p=0.01) and 28% (p=0.004), respectively. The corresponding decrease was 29% (p=0.005), and 16% (p=0.004) for outpatient physician care, 34% (p=0.009) and 18% (p=0.01) for nurse visits, and 34% (p=0.01) and 28% (p=0.004) for physiotherapy (Figure 1 and 2). Figure 1.Health care utilization during the first decade of the twenty-first century by patients in a closed rheumatoid arthritis cohort and their matched referents from the general population. The y-axes show the mean number of visits per subject per calendar year. Figure 2.Health care utilization during the first decade of the twenty-first century by patients in a closed rheumatoid arthritis cohort and their matched referents from the general population. The y-axes show the mean number of visits per subject per calendar year. Conclusions: During the twenty-first century, coinciding with increasing use of earlier and more active RA treatment including biological treatment, the overall inpatient and outpatient health care utilization by a cohort of RA patients decreased relative to the general population.
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| 7. |
- Hagel, Sofia, et al.
(författare)
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Trends in the first decade of 21st century healthcare utilisation in a rheumatoid arthritis cohort compared with the general population.
- 2013
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Ingår i: Annals of the Rheumatic Diseases. - London : BMJ. - 1468-2060 .- 0003-4967. ; 72:7, s. 1212-1216
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To study 21st century trends in healthcare utilisation by patients with rheumatoid arthritis (RA) compared with the general population. METHODS: Observational cohort study. Using Swedish healthcare register data, we identified 3977 Region Skåne residents (mean age in 2001, 62.7 years; 73% women) presenting with RA (International Classification of Diseases-10 codes M05 or M06) in 1998-2001. We randomly sampled two referents from the general population per RA patient matched for age, sex and area of residence. We calculated the year 2001-2010 trends for the annual ratio (RA cohort/referents) of the mean number of hospitalisations and outpatient clinic visits. RESULTS: By the end of the 10-year period, 62% of patients and 74% of referents were still alive and resident in the region. From 2001 to 2010, the ratio (RA cohort/referents) of the mean number of hospitalisations for men and women decreased by 27% (p=0.01) and 28% (p=0.004), respectively. The corresponding decrease was 29% (p=0.005) and 16% (p=0.004) for outpatient physician care, 34% (p=0.009) and 18% (p=0.01) for nurse visits, and 34% (p=0.01) and 28% (p=0.004) for physiotherapy. The absolute reduction in number of hospitalisations was from an annual mean of 0.79 to 0.69 in male patients and from 0.71 to 0.59 in female patients. The corresponding annual mean number of consultations in outpatient physician care by male and female RA patients changed from 9.2 to 7.7 and from 9.9 to 8.7, respectively. CONCLUSIONS: During the first decade of the 21st century, coinciding with increasing use of earlier and more active RA treatment including biological treatment, overall inpatient and outpatient healthcare utilisation by a cohort of patients with RA decreased relative to the general population.
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| 8. |
- Hagel, Sofia, et al.
(författare)
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Validation of outcome measurement instruments used in a multidisciplinary rehabilitation intervention for patients with chronic inflammatory arthritis: Linking of the International Classification of Functioning, Disability and Health, construct validity and responsiveness to change.
- 2011
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1651-2081 .- 1650-1977. ; 43:5, s. 411-419
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To determine the validity of 15 standardized instruments frequently used to measure the outcome of chronic arthritis treatment. Methods: Analyses were performed on data collected at a rehabilitation programme (n=216). The outcome measures evaluated were health-related quality of life, global health, pain, physical function and aerobic capacity. The instrument items were linked to the International Classification of Functioning, Disability and Health (ICF) (content validity), construct validity was analysed based on predetermined hypothesis (Spearman's correlations, r(s)), and responsiveness (after 18 days and 12 months) by the standardized response mean. Results: Most instruments covered the ICF component body function and/or activity-participation, only a few covered the environmental component. The short Euroqol-5 Dimensions performed as well as the longer health-related quality of life instruments in covering the ICF and in responsiveness. The health-related quality of life instruments did not measure similar constructs as hypothesized, neither did pain measures. The Bath Ankylosing Spondylitis indices covered several components of the ICF often exhibiting a large responsiveness. Aerobic capacity had the largest responsiveness of all measures. Conclusion: Many instruments are not highly correlated, although at face value they appear to measure the same construct, information also applying to content validity and responsiveness. Results from this study can assist in choosing outcome measures in the clinic and in research.
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| 9. |
- Hagel, Sofia, et al.
(författare)
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Which patients improve the most after arthritis rehabilitation? A study of predictors in patients with inflamatory arthritis in northern Europe, the STAR-ETIC collaboration
- 2014
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Ingår i: Journal of Rehabilitation Medicine. - Uppsala : Foundation of Rehabilitation Information. - 1650-1977 .- 1651-2081. ; 46:3, s. 250-257
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study health-related quality of life (HRQoL) in arthritis rehabilitation performed by multidisciplinary teams in patients with chronic inflammatory arthritis. Predictors of change in health-related quality of life and the proportion of patients with clinical improvement were investigated.DESIGN: Multicentre prospective observational study in 4 European countries.METHODS: HRQoL was measured with the European Quality 5 Dimensions (EQ-5D) and the Short Form 36 Health Survey (SF-36) in 731 patients who underwent multidisciplinary rehabilitation. Potential predictors were physical functioning (Health Assessment Questionnaire (HAQ)), self-efficacy (Arthritis Self Efficacy Scale (ASES)), psychological health (Hopkins Symptom Check List (HSCL-25)), pain/fatigue (numeric rating scales (NRS)), age, sex, diagnosis, comorbidity, education, clinical setting and change of medication during rehabilitation. Analysis of covariance (ANCOVA) was used to assess for potential predictors and interactions. The minimal important differences for HRQoL were analysed.RESULTS: Reporting worse function (b 0.05, p = 0.01), less psychological well-being (b 0.09, p = 0.000), and experiencing more pain (b 0.03, p = 0.000) or fatigue (b 0.02, p = 0.000) at admission predicted improved HRQoL. Change in medication during rehabilitation (b 0.08, p = 0.013) was associated with greater improvement in HRQoL. These EQ-5D findings were supported by SF-36 findings. Positive minimal important differences were noted in 46% (EQ-5D) and 23-47% (SF-36 subscales) of the patients.CONCLUSION: Patients with more severe symptoms experienced the largest gain in HRQoL post-intervention. The results of this study are of value for selecting the right patients for rheumatological team rehabilitation. © 2014 The Authors
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| 10. |
- Hagel, Sofia, et al.
(författare)
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Which patients improve the most from arthritis rehabilitation? Results from patients with inflammatory arthritis in northern Europe, the STAR-ETIC collaboration.
- 2014
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1651-2081 .- 1650-1977. ; 46:3, s. 250-257
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To study health-related quality of life (HRQoL) in arthritis rehabilitation performed by multidisciplinary teams in patients with chronic inflammatory arthritis. Predictors of change in health-related quality of life and the proportion of patients with clinical improvement were investigated. Design: Multicentre prospective observational study in 4 European countries. Methods: HRQoL was measured with the European Quality 5 Dimensions (EQ-5D) and the Short Form 36 Health Survey (SF-36) in 731 patients who underwent multidisciplinary rehabilitation. Potential predictors were physical functioning (Health Assessment Questionnaire (HAQ)), self-efficacy (Arthritis Self Efficacy Scale (ASES)), psychological health (Hopkins Symptom Check List (HSCL-25)), pain/fatigue (numeric rating scales (NRS)), age, sex, diagnosis, comorbidity, education, clinical setting and change of medication during rehabilitation. Analysis of covariance (ANCOVA) was used to assess for potential predictors and interactions. The minimal important differences for HRQoL were analysed. Results: Reporting worse function (b 0.05, p = 0.01), less psychological well-being (b 0.09, p = 0.000), and experiencing more pain (b 0.03, p = 0.000) or fatigue (b 0.02, p = 0.000) at admission predicted improved HRQoL. Change in medication during rehabilitation (b 0.08, p = 0.013) was associated with greater improvement in HRQoL. These EQ-5D findings were supported by SF-36 findings. Positive minimal important differences were noted in 46% (EQ-5D) and 23-47% (SF-36 subscales) of the patients. Conclusion: Patients with more severe symptoms experienced the largest gain in HRQoL post-intervention. The results of this study are of value for selecting the right patients for rheumatological team rehabilitation.
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| 11. |
- Hagel, Sofia, et al.
(författare)
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Who will achieve individually set goals after arthritis team rehabilitation?
- 2013
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Ingår i: Arthritis and Rheumatism. - Hoboken, NJ : John Wiley & Sons. - 0004-3591 .- 1529-0131. ; 65:Special issue, Supplement 10, s. S898-S898, Meeting Abstract: 2110
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Tidskriftsartikel (refereegranskat)abstract
- Background/Purpose: To study goal achievement among patients with chronic inflammatory arthritis after arthritis rehabilitation performed in multidisciplinary team rehabilitation programs.Methods: 146 consecutive patients with rheumatoid arthritis (RA) and spondylarthritis (SpA), age 18 years or older, completing arthritis rehabilitation for 5 days or more at 2 rheumatology specialist units were included in this study. At admission and discharge the patients were evaluated with measures on functioning (HAQ), self efficacy (ASES), psychological health (Hopkins Symptom Checklist – HSCL-25), pain and fatigue (NRS) and on health related quality of life (HRQoL) as captured by the EQ-5D and the SF-36. Comorbidity and social demographics was also reported. The patients, in cooperation with the health professionals, set individual goals for their rehabilitation period. At discharge the patients reported if the goal was achieved completely, partially or not at all.Non parametric statistical analyses were performed and Chi2 and Kruskal-Wallis analyses were used to study the relationship between goal achievement and baseline and change variables. Results: 108/146 patients reported whether goals were achieved or not, and were included in further analyses. 76% were females and 55% had RA. At baseline median age was 54 years (IQR 17), median HAQ 0.88 (IQR 0.88), median HRQoL as captured by the EQ-5D 0.62 (IQR 0.57) and median psychological wellbeing according to HSCL-25 1.62 (IQR 0.68). The patients reported median fatigue 6.0 (IQR 4.0) and median pain 5.0 (IQR 3.0) when entering the rehabilitation program that lasted for median 18 days (IQR 2).58/108 patients (54%) rated their goal to be completely achieved, 40 patients (37%) reported partial goal achievement while 10 (9%) patients had not achieved their goal. Positive reporting of having followed the recommendations (compliance) during the rehabilitation period was obtained from 100 (93%) of the patients.Change after intervention and compliance did not affect reports of goal achievement after rehabilitation. Females reported goal achievement more often than men did (p=0.019). Those not achieving their goals reported less psychological wellbeing (HSCL-25, p=0.011) at admission together with reports of worse pain (SF-36bp, p=0.011). Conclusion: 54% of the included patients reported complete goal achievement after arthritis team rehabilitation. Neither change after intervention nor compliance affected patients’ reports of goal achievement. Female patients were more prone to achieve their goals while patients experiencing less psychological wellbeing or more pain at baseline were less prone to report goal achievement.
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| 12. |
- Hewlett, Sarah, et al.
(författare)
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The revised Bristol Rheumatoid Arthritis Fatigue measures and the Rheumatoid Arthritis Impact of Disease scale : Validation in six countries
- 2018
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Ingår i: Rheumatology (United Kingdom). - : Oxford University Press (OUP). - 1462-0324 .- 1462-0332. ; 57:2, s. 300-308
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To evaluate the Bristol Rheumatoid Arthritis Fatigue Multidimensional Questionnaire (BRAFMDQ), the revised Bristol Rheumatoid Arthritis Numerical Rating Scales (BRAF-NRS V2) and the Rheumatoid Arthritis Impact of Disease (RAID) scale in six countries. Methods. We surveyed RA patients in France, Germany, The Netherlands, Spain, Sweden and the UK, including the HAQ, 36-item Short Form Health Survey (SF-36) and potential revisions of the BRAF-NRS coping and Spanish RAID coping items. Factor structure and internal consistency were examined by factor analysis and Cronbach's α and construct validity by Spearman's correlation. Results. A total of 1276 patients participated (76% female, 25% with a disease duration < 5 years, median HAQ 1.0). The original BRAF-MDQ four-factor structure and RAID single-factor structure were confirmed in every country with ≥66% of variation in items explained by each factor and all item factor loadings of 0.71-0.98. Internal consistency for the BRAF-MDQ total and subscales was a Cronbach's α of 0.75-0.96 and for RAID, 0.93-0.96. Fatigue construct validity was shown for the BRAF-MDQ and BRAF-NRS severity and effect scales, correlated internally with SF-36 vitality and with RAID fatigue (r = 0.63-0.93). Broader construct validity for the BRAFs and RAID was shown by correlation with each other, HAQ and SF-36 domains (r = 0.46-0.82), with similar patterns in individual countries. The revised BRAF-NRS V2 Coping item had stronger validity than the original in all analyses. The revised Spanish RAID coping item performed as well as the original. Conclusion. Across six European countries, the BRAF-MDQ identifies the same four aspects of fatigue, and along with the RAID, shows strong factor structure and internal consistency and moderate-good construct validity. The revised BRAF-NRS V2 shows improved construct validity and replaces the original.
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| 13. |
- Hewlett, Sarah, et al.
(författare)
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Translating patient reported outcome measures: methodological issues explored using cognitive interviewing with three rheumatoid arthritis measures in six European languages.
- 2016
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Ingår i: Rheumatology (Oxford, England). - : Oxford University Press (OUP). - 1462-0332 .- 1462-0324.
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Tidskriftsartikel (refereegranskat)abstract
- Cross-cultural translation of patient-reported outcome measures (PROMs) is a lengthy process, often performed professionally. Cognitive interviewing assesses patient comprehension of PROMs. The objective was to evaluate the usefulness of cognitive interviewing to assess translations and compare professional (full) with non-professional (simplified) translation processes.METHODS:A full protocol used for the Bristol RA Fatigue Multi-dimensional Questionnaire and Numerical Rating Scale (BRAF-MDQ, BRAF-NRS) was compared with a simplified protocol used for the RA Impact of Disease scale (RAID). RA patients in the UK, France, the Netherlands, Germany, Spain and Sweden completed the PROMs during cognitive interviewing (BRAFs in the UK were omitted as these were performed during development). Transcripts were deductively analysed for understanding, information retrieval, judgement and response options. Usefulness of cognitive interviewing was assessed by the nature of problems identified, and translation processes by percentage of consistently problematic items (⩾40% patients per country with similar concerns).RESULTS:Sixty patients participated (72% women). For the BRAFs (full protocol) one problematic item was identified (of 23 items × 5 languages, 1/115 = 0.9%). For the RAID (simplified protocol) two problematic items were identified (of 7 items × 6 languages, 2/42 = 4.8%), of which one was revised (Dutch). Coping questions were problematic in both PROMs.CONCLUSION:Conceptual and cultural challenges though rare were important, as identified by formal evaluation, demonstrating that cognitive interviewing is crucial in PROM translations. Proportionately fewer problematic items were found for the full than for the simplified translation procedure, suggesting that while both are acceptable, professional PROM translation might be preferable. Coping may be a particularly challenging notion cross-culturally.
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| 14. |
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| 15. |
- Leggett, Sarah, et al.
(författare)
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Test-retest Reliability and Correlations of 5 Global Measures Addressing At-work Productivity Loss in Patients with Rheumatic Diseases.
- 2016
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Ingår i: Journal of Rheumatology. - : The Journal of Rheumatology. - 0315-162X .- 1499-2752. ; 43:2, s. 433-439
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Tidskriftsartikel (refereegranskat)abstract
- Several global measures to assess at-work productivity loss or presenteeism in patients with rheumatic diseases have been proposed, but the comparative validity is hampered by the lack of data on test-retest reliability and comparative concurrent and construct validity. Our objective was to test-retest 5 global measures of presenteeism and to compare the association between these scales and health-related well-being.
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| 16. |
- Olsson, Marianne, et al.
(författare)
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Challenged by the jaw - an interview study on patients' experiences of temporomandibular disorders in rheumatic inflammatory diseases
- 2024
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Ingår i: Disability and Rehabilitation. - : Taylor & Francis Group. - 0963-8288 .- 1464-5165.
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Tidskriftsartikel (refereegranskat)abstract
- PurposeRheumatic inflammatory diseases affecting the temporomandibular joint and the masticatory system (TMD) have been described as painful and limiting. However, the condition is often overlooked in primary care. The objective of this qualitative study was to explore and describe TMD-related experiences and perceptions of persons with rheumatic inflammatory disease, and to put this into a rehabilitation perspective.Materials and methodsSeven participants with rheumatic inflammatory disease and concomitant TMD were interviewed using a semi-structured interview guide. Giorgi's phenomenological method was used for analysis of the material.ResultsThe general structure of the results after phenomenological reduction indicated that the phenomenon could be described as the process of being challenged by the jaw. Five themes emerged from the analysis; 1. Physical challenges of the jaw and the struggle to retain control, 2. Shame and social challenges, 3. Worrying about the future, frustration, grief, and loss of freedom, 4. Defiance, endurance, and efforts to maintain self-esteem, and 5. Health-care experiences.ConclusionsTMD in rheumatic inflammatory diseases are complex problems associated with various challenges to the sufferer. An increased awareness of the condition and earlier interventions could reduce both suffering and worsening of the condition. The connection between the jaw and the rest of the body tends to be neglected.Questions about the jaw should be asked to detect eventual temporomandibular disorder (TMD) at an early stage to prevent worsening of the condition.Patient's experiences of TMD must be considered in the rehabilitation process.Health care providers are important for an earlier, more consistent, and more accessible diagnosis and treatment for this group of people.
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| 17. |
- Rydholm, Maria, et al.
(författare)
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The relation between upper extremity joint involvement and grip force in early rheumatoid arthritis : a retrospective study
- 2019
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Ingår i: Rheumatology International. - : Springer Science and Business Media LLC. - 0172-8172 .- 1437-160X. ; 39:12, s. 2031-2041
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Tidskriftsartikel (refereegranskat)abstract
- To investigate the relation between joint involvement in the upper extremities and grip force in patients with early rheumatoid arthritis (RA). An inception cohort of 225 patients with early RA was followed according to a structured protocol. The same rheumatologist assessed all patients for swollen joints and joint tenderness. Grip force was measured (Grippit; AB Detektor, Gothenburg, Sweden) at the same visit. Average grip force values for the dominant hand were expressed as % of expected, based on age- and sex-specific reference values from the literature. Associations between grip force and current synovitis or tenderness of individual joints, and other disease parameters measured at the same visit, were examined. Patients with current synovitis of the wrist joint or ≥ 1 metacarpophalangeal (MCP) joint of the dominant hand had a significantly lower grip force at inclusion, at 1 year and at 5 years. Proximal interphalangeal joint tenderness and MCP joint tenderness were consistently associated with reduced grip force. In multivariate analysis, extensive MCP joint synovitis was associated with lower grip force at inclusion (β − 2.8% per joint; 95% CI − 5.3 to − 0.4), and also at the 1-year follow-up. Patient reported pain scores and erythrocyte sedimentation rates had independent negative associations with grip force at all time points. In patients with early RA, extensive synovitis of the MCP joints was associated with reduced grip force, independently of other upper extremity joint involvement. Pain and inflammation have effects on hand function beyond those mediated by local synovitis.
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