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Zaguri-Vittenberg S, Weintraub N, Tal-Saban M. Young Adults' Daily Participation Scale: A measure of objective and subjective participation. Aust Occup Ther J 2024. [PMID: 39103283 DOI: 10.1111/1440-1630.12987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 07/03/2024] [Accepted: 07/08/2024] [Indexed: 08/07/2024]
Abstract
INTRODUCTION Participation in occupations is considered essential for individuals' health and wellbeing. Participation is a multidimensional construct that encompasses objective and subjective dimensions that transform over the course of life. Nonetheless, there is a lack of comprehensive measures that examine young adults' participation in age-appropriate activities. Therefore, we developed the Young Adults' Daily Participation Scale (YADAPS) and aimed to explore its psychometric properties. METHODS In Study 1, the content validity of the YADAPS was established based on nine experts. Its internal consistency, criterion, convergent, and construct validity were explored among 115 typical young adults (21-35 years). Using a different sample, Study 2 examined YADAPS discriminant validity among 33 young adults with developmental coordination disorder (DCD) and 52 typical peers. CONSUMER AND COMMUNITY INVOLVEMENT No consumer and community involvement was included in these studies. RESULTS The relevance of YADAPS items was sufficient. Internal consistency was acceptable to excellent in most scales (.74 ≤ α ≤ .89). Criterion validity was supported by correlations between the subjective participation scales and a wellbeing measure. Convergent validity was found for all scales. No gender effect was observed (p ≥ .05). However, significant differences (p ≤ .05) were found between individuals with and without DCD. CONCLUSIONS The YADAPS appears to be a promising measure of objective and subjective dimensions of participation in young adults. The results support the importance of examining various participation dimensions, including occupational experience. Thus, it may be used for clinical purposes among young adults as well as for occupational science research, to broaden our understanding on the interplay between participation dimensions in various life situations in young adulthood. However, further research is needed on psychometric properties, the most suited scoring method, and to consolidate their robustness among diverse populations of young adults. PLAIN LANGUAGE SUMMARY Participation, or how one engages in daily life activities, greatly affects wellbeing. The activities in one's routine change over the lifespan, in accordance with one's developmental phase. Existing assessments of participation have limitations, like not considering young adults' concerns or only focussing on certain aspects of participation. By focussing on both the objective-observable and subjective-experiential aspects of participation, the Young Adults' Daily Participation Scale (YADAPS) strives to be a comprehensive assessment tool designed specifically for reflecting activities relevant in young adulthood. This manuscript provides preliminary validity and reliability for the YADAPS, a new questionnaire that assesses objective and subjective aspects of participation in activities relevant for individuals in young adulthood. Furthermore, the questionnaire is able to distinguish between young adults with and without participation difficulties; therefore, it is suitable for research and clinical use.
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Affiliation(s)
- Shahar Zaguri-Vittenberg
- The Neuro-Developmental Disabilities and Writing Research Laboratory, School of Occupational Therapy, The Hebrew University, Jerusalem, Israel
| | - Naomi Weintraub
- The Neuro-Developmental Disabilities and Writing Research Laboratory, School of Occupational Therapy, The Hebrew University, Jerusalem, Israel
| | - Miri Tal-Saban
- The Neuro-Developmental Disabilities and Writing Research Laboratory, School of Occupational Therapy, The Hebrew University, Jerusalem, Israel
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Atkins N, Mukhida K. The relationship between patients’ income and education and their access to pharmacological chronic pain management: A scoping review. Can J Pain 2022; 6:142-170. [PMID: 36092247 PMCID: PMC9450907 DOI: 10.1080/24740527.2022.2104699] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Nicole Atkins
- Department of Anesthesiology, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Karim Mukhida
- Department of Anesthesiology, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
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Espiritu EW, Michaels NN, Schmidt K, Gegen M, King HR, Miller C, Munro H, Uzzell-Baggett K. Comparing self-reported vs. parent/caregiver reported levels of social participation for young adults with intellectual disabilities: A pilot study. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2022; 26:885-899. [PMID: 34711089 DOI: 10.1177/17446295211037223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND This study focused on the level of satisfaction of social participation reported by young adults with intellectual disabilities, and the comparison of these levels to those reported by their caregivers. METHODS Fifteen young adults with intellectual disabilities and their parents/caregivers completed the Patient-Reported Outcomes Measurement Information System Satisfaction with Participation in Discretionary Social Activities-Calibrated Items (PROMIS SF-Social Sat DSA) and the Satisfaction with Social Roles and Activities-Short Form (Neuro-QoL SF). RESULTS Reports from these young adults were compatible to that of the general population. There was general agreement on the Social Sat DSA between the individuals and their caregivers, but there were differences between groups on the Neuro-QoL SF, with the caregivers typically giving higher scores (p = .025). CONCLUSION This pilot study demonstrates the importance of involving both the individuals with intellectual disabilities, and their parents/caregivers when conducting survey research. Further research is encouraged.
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Hashidate H, Shimada H, Fujisawa Y, Yatsunami M. An Overview of Social Participation in Older Adults: Concepts and Assessments. Phys Ther Res 2021; 24:85-97. [PMID: 34532203 DOI: 10.1298/ptr.r0013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 05/31/2021] [Indexed: 11/23/2022]
Abstract
In older adults, social participation is an important component of rehabilitation and health promotion. Several studies have attempted to describe the definition and concepts of social participation, and there were many outcomes to measure social participation. This overview provides information about representative social participation and related concepts that have been defined in the literature. A standardized definition of social participation has not been developed; commonly, recognition for social participation was proposed as focused on involvement in social activities that provide interaction with others in a society or community. Many instruments assess the various aspects of social participation. Because of operational definition and diversity in social participation, performance in social participation was adopted as an aspect of assessment. Further discussions are needed to clarify the definition of social participation and evaluate the instruments used to assess social participation for it to be useful for rehabilitation and health promotion. In doing so, determining and developing assessment and intervention based on the purpose or perspective of social participation in older adults with and without disabilities is important.
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Affiliation(s)
- Hiroyuki Hashidate
- Department of Physical Therapy, School of Health Sciences, Kyorin University, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Japan
| | - Yuhki Fujisawa
- Department of Physical Therapy, School of Health Sciences, Kyorin University, Japan
| | - Mitsunobu Yatsunami
- Department of Physical Therapy, School of Health Sciences, Kyorin University, Japan
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Cytera C, Thyen U. ["I Think it is Important in Many Aspects in Life" - Young Adults' Perception of Participation]. REHABILITATION 2021; 60:384-392. [PMID: 34058772 DOI: 10.1055/a-1491-7365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE This study explores young adults' lay perception of participation. It focuses on the definition of the concept and the life areas in which the target group views it as important to take part in. METHODS In guided group interviews (N=6), 20 young adults with and without disabilities were surveyed about their perception of participation. To also include people with more severe disabilities, proxy interviews (N=3) were conducted. The data of the interview were analyzed via qualitative content analysis based on Mayring. RESULTS Participation is understood as being multifaceted and individually different. Six aspects of participation definition could be detected: togetherness; social inclusion/participation in society; open-mindedness/interest; equal opportunities/equal treatment; freedom of choice/autonomy; to have a voice. Besides that, seven areas of participation were mentioned as important for young adults: social environment; work/education; leisure; media; mobility; politics/finances; self-administration. CONCLUSION Within young adults' complex perception of participation, social aspects are particularly important, besides equal rights and autonomy. Participation in sexuality and new media is given a crucial value, which is why these topics should be given more attention to. Life areas in which participation is described as relevant can vary depending on the interests of the individual. This demonstrates the subjective character of the concept, and the importance to consider the perception and preference of a person or a group.
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Affiliation(s)
- Chirine Cytera
- Klinik für Kinder- und Jugendmedizin, Universität zu Lübeck, Deutschland.,Institut für Psychologie, Universität Greifswald, Deutschland
| | - Ute Thyen
- Klinik für Kinder- und Jugendmedizin, Universität zu Lübeck, Deutschland
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Ibrahim A, Chong MC, Khoo S, Wong LP, Chung I, Tan MP. Virtual Group Exercises and Psychological Status among Community-Dwelling Older Adults during the COVID-19 Pandemic-A Feasibility Study. Geriatrics (Basel) 2021; 6:geriatrics6010031. [PMID: 33810155 PMCID: PMC8005958 DOI: 10.3390/geriatrics6010031] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/11/2021] [Accepted: 03/19/2021] [Indexed: 11/16/2022] Open
Abstract
Social isolation, magnified by the restriction of movement order during the COVID-19 pandemic, may lead to negative psychosocial health impacts among community-dwelling older adults. We, therefore, aimed to evaluate recruitment rates, data collection, and group exercises conducted through virtual technology among individuals aged 60 years and over in Malaysia. Participants were recruited from the Promoting Independence in Seniors with Arthritis (PISA) pilot cohort through social media messaging. A four-week course of virtual group exercise was offered. Anxiety and depression were assessed with the Hospital Anxiety and Depression Scale (HADS) during the last attended follow-up of the cohort study (pre-pandemic), pre-intervention, and post-intervention. Exercise adherence was recorded using diaries with daily entries and attendance to the virtual group exercise sessions were also captured electronically daily. The outcomes of interest were changes in anxiety and depression scores from baseline to pre-intervention (pandemic-related) and post-intervention (virtual exercise related). Forty-three individuals were recruited. A significant increase in anxiety scores from baseline to pre-intervention was observed. Comparisons using repeated-measures analysis of variance between those who attendance ≥14 and <14 group exercise sessions revealed no between-within subject differences in depression scores. There was a 23% dropout rate in the post intervention survey and 60.5% of diaries were returned. Virtual group exercises could be conducted among older adults residing in a middle-income country, though recruitment would have been limited to those with internet access.
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Affiliation(s)
- Amirah Ibrahim
- Ageing and Age-Associated Disorders Research Group, University of Malaya, Kuala Lumpur 50603, Malaysia;
| | - Mei Chan Chong
- Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia;
| | - Selina Khoo
- Centre for Sport and Exercise Sciences, University of Malaya, Kuala Lumpur 50603, Malaysia;
| | - Li Ping Wong
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia;
| | - Ivy Chung
- Department of Pharmacology, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia;
| | - Maw Pin Tan
- Ageing and Age-Associated Disorders Research Group, University of Malaya, Kuala Lumpur 50603, Malaysia;
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
- Department of Medical Sciences, Faculty of Healthcare and Medical Sciences, Sunway University, Selangor 47500, Malaysia
- Correspondence:
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Björk M, Bergström M, Sverker A, Brodin N. Measures of Participation in Persons With Musculoskeletal Conditions. Arthritis Care Res (Hoboken) 2020; 72 Suppl 10:486-498. [PMID: 33091247 DOI: 10.1002/acr.24226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 04/14/2020] [Indexed: 11/07/2022]
Affiliation(s)
- M Björk
- Linköping University, Linköping, Sweden
| | - M Bergström
- Linköping University, Norrköping Campus, Norrköping, Sweden
| | - A Sverker
- Linköping University, Linköping, Sweden
| | - N Brodin
- Karolinska Institutet, Huddinge, Sweden, and Danderyd Hospital, Stockholm, Sweden
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Berenschot L, Grift Y. Validity and reliability of the (adjusted) Impact on Participation and Autonomy questionnaire for social-support populations. Health Qual Life Outcomes 2019; 17:41. [PMID: 30808341 PMCID: PMC6390377 DOI: 10.1186/s12955-019-1106-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 02/07/2019] [Indexed: 11/10/2022] Open
Abstract
Background Decentralisation of social support and budget cuts spurred interest in outcome-oriented payment systems in the Netherlands. Hence, measurement of relevant outcomes, such as self-reliance and participation, is needed. The Impact on Participation and Autonomy (IPA) questionnaire for rehabilitation clients was adapted for social support, called IPA-MO, and its validity and reliability were tested among social support clients in eight municipalities in 2014 and 2016. Methods The total research sample comprised of 4120 persons. Homogeneous subgroups were distinguished based on 1) disability and 2) age. Exploratory factor analysis (PCF) was used to identify domains for IPA-MO. Model fit was assessed with Confirmatory Factor Analysis (CFA) using structural equation modelling. Results PCF revealed that the IPA-MO model consists of all five original IPA domains: Autonomy indoors, Family role, Autonomy outdoors, Social life and relations, and Work and education. As a result of new items added, a new, sixth domain was developed: Financial autonomy. Due to high non-response on Work & education, construct validity was first tested for a five-domain IPA-MO model. The composition of the IPA-MO domains showed slight differences: the item on ‘mobility indoor’ shifted from Autonomy indoors (IPA) to Family Role in IPA-MO. The item on reciprocity shifted from Social Life and relations (IPA) to Autonomy outdoors (IPA-MO). Internal reliability was confirmed for all domains (Cronbach’s alpha >.80). CFA showed acceptable construct validity of the five-domain IPA-MO model for the social support population (CFI .936, TLI .925, SRMR .051), all age groups and most disability-based groups. Construct validity including Work & education was tested for 234 participants. Then, PCF revealed six domains and the model fit was acceptable (CFI .915, TLI .903, SRMR .067). Conclusions IPA-MO is a valid and reliable instrument to assess outcomes of social support. Further research on the domain Financial autonomy is needed. Social-support clients are numerous and dispersed and, in spite of the best intentions, hard to involve widely in policy processes. A valid outcome measure offers municipalities possibilities to gain insight in social costs and benefits of new policies. Outcome measurement also allows to contract bundled-services of providers, thereby changing the incentives for providers from increasing production to much needed innovation. Taking the perceptions of autonomy and participation of social-support clients as the acid test for the effectiveness of social support policies, may prove a serious game-changer in politics.
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Affiliation(s)
- Lucienne Berenschot
- Berenschot Onderzoek en Advies, Hogekampweg 50, Apeldoorn, 7316MT, the Netherlands
| | - Yolanda Grift
- Faculty of Law, Economics and Governance, University Utrecht School of Economics, PO Box 80125, Utrecht, 3508 TC, the Netherlands.
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Altan L, Çeliker R, Ercan İ, Birtane M, Akgün K, Zateri C, Taştekin N, Rezvani A, Aktaş İ, Özdolap Ş, Dursun E, Dursun N, Sarıkaya S. The reliability and validity of the Turkish version of the Fibromyalgia Participation Questionnaire. Eur J Rheumatol 2018; 5:40-44. [PMID: 29657874 DOI: 10.5152/eurjrheum.2017.16090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 03/23/2017] [Indexed: 11/22/2022] Open
Abstract
Objective The objective of this study was to test the reliability and validity of the Turkish version of the Fibromyalgia Participation Questionnaire (FPQ). Methods One hundred and eighty-four female patients with fibromyalgia syndrome were included in the study. All patients filled out the Turkish FPQ (FPQ-T) questionnaire, which was obtained by translation from German according to the guideline for the process of cross-cultural adaptation The patients filled out the revised Fibromyalgia Impact Questionnaire (FIQ) and reevaluated the FPQ-T two hours later. Internal consistency reliability of the FPQ-T was assessed by calculating the "if item deleted" using Cronbach's alpha and the "item-total correction" coefficient for each item of the questionnaire. The consistency of the subscales and the correlation of the test-retest values were assessed. The test-retest values were compared using the Wilcoxon test. Criterion validity was measured using FIQ scales by Spearman's rank correlation coefficient. Results For internal reliability, Cronbach's alpha coefficient was calculated as 0.957 for nonworking patients and 0.958 for working patients. Cronbach's alpha values of 0.939, 0.871, and 0.914 were obtained for daily, social, and work life, respectively. Correlation coefficients were 0.888 for daily life, 0.859 for social life, and 0.901 overall in the nonworking group versus 0.896 the in working group. The comparison of scores obtained from test-retest measurements showed no significant difference except for Item 3. The correlation of the symptom severity score (SSS) and the FPQ-T was r=0.385 (p<0.001) and r=0.390 (p<0.001) for the nonworking and working subgroups, respectively. The evaluation of construct validity showed a significant correlation between the SSS and FPQ-T. Conclusion The results of our study showed that the FPQ-T is reliable and valid for assessing participation and social functioning in fibromyalgia patients in Turkish society.
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Affiliation(s)
- Lale Altan
- Department of Physical Medicine and Rehabilitation, Uludag University School of Medicine, Bursa, Turkey
| | - Reyhan Çeliker
- Department of Physical Medicine and Rehabilitation, Acibadem University, School of Medicine, İstanbul, Turkey
| | - İlker Ercan
- Department of Biostatistics, Uludag University School of Medicine, Bursa, Turkey
| | - Murat Birtane
- Department of Physical Medicine and Rehabilitation, Trakya University School of Medicine, Edirne, Turkey
| | - Kenan Akgün
- Department of Physical Medicine and Rehabilitation, Istanbul University Cerrahpaşa School of Medicine, İstanbul, Turkey
| | - Coşkun Zateri
- Department of Physical Medicine and Rehabilitation, Onsekiz Mart University School of Medicine, Çanakkale, Turkey
| | - Nurettin Taştekin
- Department of Physical Medicine and Rehabilitation, Trakya University School of Medicine, Edirne, Turkey
| | - Aylin Rezvani
- Department of Physical Medicine and Rehabilitation, Bezmialem University School of Medicine, İstanbul, Turkey
| | - İlknur Aktaş
- Department of Physical Medicine and Rehabilitation, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey
| | - Şenay Özdolap
- Department of Physical Medicine and Rehabilitation, Bülent Ecevit University School of Medicine, Zonguldak, Turkey
| | - Erbil Dursun
- Department of Physical Medicine and Rehabilitation, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Nigar Dursun
- Department of Physical Medicine and Rehabilitation, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Selda Sarıkaya
- Department of Physical Medicine and Rehabilitation, Bülent Ecevit University School of Medicine, Zonguldak, Turkey
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Seaton L, Brown T. The Relationship between Body Function and Structure Factors and the Activity-Participation of Healthy Community-Dwelling Older Adults. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2018. [DOI: 10.1080/02703181.2018.1443193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Linda Seaton
- Occupational Science and Therapy Program, School of Health and Social Development, Faculty of Health, Deakin University – Waterfront Campus, Geelong, Victoria, Australia
| | - Ted Brown
- Department of Occupational Therapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University – Peninsula Campus, Frankston, Victoria, Australia
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Lacroix PA, Pelletier AJ, Blondin MP, Dugal A, Langlois C, Levasseur M, Larivière N. Traduction et validation du Questionnaire sur l’engagement dans les activités signifiantes. The Canadian Journal of Occupational Therapy 2018; 85:11-20. [PMID: 29506410 DOI: 10.1177/0008417417702925] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Barnabe C, Crane L, White T, Hemmelgarn B, Kaplan GG, Martin L, Maksymowych WP. Patient-reported Outcomes, Resource Use, and Social Participation of Patients with Rheumatoid Arthritis Treated with Biologics in Alberta: Experience of Indigenous and Non-indigenous Patients. J Rheumatol 2018; 45:760-765. [PMID: 29449496 DOI: 10.3899/jrheum.170778] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To characterize patient-reported outcomes, resource use, and social participation during the course of biologic therapy for indigenous and non-indigenous patients with rheumatoid arthritis (RA). METHODS Patients initiating biologic therapy (2004 to 2012) were characterized longitudinally for patient-reported outcomes including physical function measured by the Health Assessment Questionnaire, EQ-5D, well-being [Medical Outcomes Study Short Form-36 (SF-36)], and visual analog scales for pain, fatigue, sleep, stiffness, and patient's global assessment. Resource use, participation in activities of daily living, and effect of RA on work productivity were also evaluated for change during therapy. RESULTS Indigenous patients (n = 90) presented with significantly worse scores for global evaluation, pain, sleep, quality of life, well-being, and physical function compared to non-indigenous patients (n = 1400). All patient-reported outcomes improved significantly during treatment for patients in both groups, but pain, sleep, and SF-36 physical health score changes occurred at slower rates for indigenous patients [difference in slopes 0.09 (p = 0.029), 0.08 (p = 0.043), and -0.35 (p = 0.03), respectively]. Performance of daily activities was affected for 50% of indigenous compared to 37% of non-indigenous patients, with more use of community services and assistance from others. Employed indigenous patients reported twice the number of days being unable to work owing to RA compared to employed non-indigenous patients. Of the unemployed indigenous patients, 82% indicated they had stopped working because of arthritis, versus 48% of non-indigenous patients (p < 0.0001). CONCLUSIONS Indigenous patients have greater consequences of RA regarding experienced symptoms, health-related quality of life, disruption of performance of activities of daily living, and reduced employment participation.
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Affiliation(s)
- Cheryl Barnabe
- From the Department of Medicine and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary; Canadian Arthritis Patient Alliance; Siksika Health and Wellness, Siksika Nation; Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada. .,C. Barnabe, MD, MSc, Department of Medicine and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary; L. Crane, MA, Patient Advocate, Canadian Arthritis Patient Alliance; T. White, CEO, Siksika Health and Wellness, Siksika Nation; B. Hemmelgarn, MD, PhD, Department of Medicine and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary; G.G. Kaplan, MD, MPH, Department of Medicine and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary; L. Martin, MB, Department of Medicine, Cumming School of Medicine, University of Calgary; W.P. Maksymowych, MD, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta.
| | - Louise Crane
- From the Department of Medicine and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary; Canadian Arthritis Patient Alliance; Siksika Health and Wellness, Siksika Nation; Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.,C. Barnabe, MD, MSc, Department of Medicine and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary; L. Crane, MA, Patient Advocate, Canadian Arthritis Patient Alliance; T. White, CEO, Siksika Health and Wellness, Siksika Nation; B. Hemmelgarn, MD, PhD, Department of Medicine and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary; G.G. Kaplan, MD, MPH, Department of Medicine and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary; L. Martin, MB, Department of Medicine, Cumming School of Medicine, University of Calgary; W.P. Maksymowych, MD, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta
| | - Tyler White
- From the Department of Medicine and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary; Canadian Arthritis Patient Alliance; Siksika Health and Wellness, Siksika Nation; Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.,C. Barnabe, MD, MSc, Department of Medicine and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary; L. Crane, MA, Patient Advocate, Canadian Arthritis Patient Alliance; T. White, CEO, Siksika Health and Wellness, Siksika Nation; B. Hemmelgarn, MD, PhD, Department of Medicine and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary; G.G. Kaplan, MD, MPH, Department of Medicine and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary; L. Martin, MB, Department of Medicine, Cumming School of Medicine, University of Calgary; W.P. Maksymowych, MD, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta
| | - Brenda Hemmelgarn
- From the Department of Medicine and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary; Canadian Arthritis Patient Alliance; Siksika Health and Wellness, Siksika Nation; Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.,C. Barnabe, MD, MSc, Department of Medicine and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary; L. Crane, MA, Patient Advocate, Canadian Arthritis Patient Alliance; T. White, CEO, Siksika Health and Wellness, Siksika Nation; B. Hemmelgarn, MD, PhD, Department of Medicine and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary; G.G. Kaplan, MD, MPH, Department of Medicine and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary; L. Martin, MB, Department of Medicine, Cumming School of Medicine, University of Calgary; W.P. Maksymowych, MD, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta
| | - Gilaad G Kaplan
- From the Department of Medicine and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary; Canadian Arthritis Patient Alliance; Siksika Health and Wellness, Siksika Nation; Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.,C. Barnabe, MD, MSc, Department of Medicine and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary; L. Crane, MA, Patient Advocate, Canadian Arthritis Patient Alliance; T. White, CEO, Siksika Health and Wellness, Siksika Nation; B. Hemmelgarn, MD, PhD, Department of Medicine and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary; G.G. Kaplan, MD, MPH, Department of Medicine and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary; L. Martin, MB, Department of Medicine, Cumming School of Medicine, University of Calgary; W.P. Maksymowych, MD, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta
| | - Liam Martin
- From the Department of Medicine and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary; Canadian Arthritis Patient Alliance; Siksika Health and Wellness, Siksika Nation; Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.,C. Barnabe, MD, MSc, Department of Medicine and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary; L. Crane, MA, Patient Advocate, Canadian Arthritis Patient Alliance; T. White, CEO, Siksika Health and Wellness, Siksika Nation; B. Hemmelgarn, MD, PhD, Department of Medicine and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary; G.G. Kaplan, MD, MPH, Department of Medicine and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary; L. Martin, MB, Department of Medicine, Cumming School of Medicine, University of Calgary; W.P. Maksymowych, MD, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta
| | - Walter P Maksymowych
- From the Department of Medicine and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary; Canadian Arthritis Patient Alliance; Siksika Health and Wellness, Siksika Nation; Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.,C. Barnabe, MD, MSc, Department of Medicine and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary; L. Crane, MA, Patient Advocate, Canadian Arthritis Patient Alliance; T. White, CEO, Siksika Health and Wellness, Siksika Nation; B. Hemmelgarn, MD, PhD, Department of Medicine and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary; G.G. Kaplan, MD, MPH, Department of Medicine and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary; L. Martin, MB, Department of Medicine, Cumming School of Medicine, University of Calgary; W.P. Maksymowych, MD, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta
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13
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Carandang KM, Pyatak EA. Feasibility of a Manualized Occupation-Based Diabetes Management Intervention. Am J Occup Ther 2018; 72:7202345040p1-7202345040p6. [PMID: 29426394 DOI: 10.5014/ajot.2018.021790] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE We investigated the feasibility and acceptability of an occupational therapy intervention targeting diabetes management for underserved young adults. METHOD Eight participants completed the intervention and a battery of assessments at baseline and after the intervention. At completion, the participants and occupational therapist were interviewed about their experiences with the study. Four categories of assessment questions were used to guide the study: process, resource, management, and scientific. RESULTS Successes included recruitment; fulfillment of tasks by staff and partnering clinics; adequate space, financial support, and equipment; and meaningfulness of the intervention for participants. Challenges included scheduling participants for the intervention and follow-up focus groups and providing client centeredness and flexibility while reducing burden on the intervener. CONCLUSION This feasibility study allowed us to make necessary revisions to our study protocol before implementing a larger pilot study.
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Affiliation(s)
- Kristine M Carandang
- Kristine M. Carandang, MS, OTR/L, is PhD Candidate, Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
| | - Elizabeth A Pyatak
- Kristine M. Carandang, MS, OTR/L, is PhD Candidate, Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
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Jongen PJ, Ruimschotel RP, Museler-Kreijns YM, Dragstra T, Duyverman L, Valkenburg-Vissers J, Cornelissen J, Lagrand R, Donders R, Hartog A. Improved health-related quality of life, participation, and autonomy in patients with treatment-resistant chronic pain after an intensive social cognitive intervention with the participation of support partners. J Pain Res 2017; 10:2725-2738. [PMID: 29238216 PMCID: PMC5716312 DOI: 10.2147/jpr.s137609] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Despite the availability of various specific treatments, most patients with chronic pain (CP) consider their pain problem as undertreated. Recently, multiple sclerosis (MS) patients who were given an intensive 3-day social cognitive treatment with the participation of support partners experienced lasting improvements in health-related quality of life (HRQoL) and self-efficacy. In this study, a similar intervention was given to treatment-resistant CP patients with stressors, relational problems with support partner, and distress, anxiety or depression. Before and 1, 3, and 6 months after the intervention, patients completed the Euro-Qol 5 Dimensions 5 Levels (EQ-5D-5L) and Impact on Participation and Autonomy (IPA) questionnaires (primary outcomes), and the Survey Of Pain Attitudes (SOPA), the Four-Dimensional Symptom Questionnaire (4DSQ) (distress, depression, anxiety, and somatization), and Visual Analog Scale for pain intensity, whereas the support partners completed the Caregiver Strain Index (CSI) questionnaire. Differences between baseline and post-treatment were tested via paired t-tests (significance level 0.05). Of the 39 patients who were included, 34 (87.2%) completed the 3-day treatment. At 1, 3, and 6 months, improvements were seen in EQ-5D-5L-Index (+40.6%; +22.4%; +31.7%), Health Today (+61.8%; +36.3%; +46.8%), Control attitude (+45.8%; not significant [NS]; +55.0%) and decreases in IPA-Problems (−14.8%; NS; −20.4%), Harm attitude (−18.9%; −15.0%; −17.7%), Distress (−17.7%; −31.8%; −37.1%), and Depression (−37.4%; −31.4%; −35.7%) scores. The CSI score had decreased by −29.0%, −21.4%, and −25.9%, respectively. In conclusion, after an intensive 3-day social cognitive intervention, treatment-resistant CP patients experienced substantial and lasting improvements in HRQoL and in problematic limitations to participation and autonomy, in association with improvements in pain attitudes, depression, and distress. To assess whether this innovative approach may be an effective treatment for this subgroup of CP patients, future randomized controlled studies are needed.
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Affiliation(s)
- Peter Joseph Jongen
- Department of Community and Occupational Medicine, University Medical Centre Groningen, Groningen.,MS4 Research Institute, Nijmegen
| | | | | | | | | | | | | | - R Lagrand
- Fysio- en Manuele Therapie R. & Y.M. Lagrand, Rotterdam
| | - Rogier Donders
- Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - A Hartog
- DC Klinieken Rotterdam, Rotterdam
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Klokkerud M, Dagfinrud H, Uhlig T, Dager TN, Furunes KA, Klokkeide Å, Larsen M, Nygård S, Nylenna S, Øie L, Kjeken I. Developing and testing a consensus-based core set of outcome measures for rehabilitation in musculoskeletal diseases. Scand J Rheumatol 2017; 47:225-234. [PMID: 28988517 DOI: 10.1080/03009742.2017.1347959] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Rehabilitation is important for people with musculoskeletal diseases (MSDs), and evaluating the effect of rehabilitation on both an individual and group level is advocated. A consensus concerning use of outcome measures will improve collaboration between healthcare providers, and increase the possibility of conducting meta-analyses in future research. The aim of this study was to develop a consensus-based core set of outcome measures for rehabilitation in MSDs, and to test the feasibility and responsiveness of the set. METHOD The core set was developed through a stepwise process comprising a Delphi consensus procedure, systematic literature searches, and a pilot study, including 386 patients, to test the feasibility and responsiveness of the set. RESULTS The following aspects and outcome measures were selected: pain [numeric rating scale (NRS)], fatigue (NRS), physical fitness (the 30-second Sit to Stand test), mental health (Hopkins Symptom Checklist 5), daily activities (Hannover Functional Questionnaire), goal attainment (Patient-Specific Functional Scale including motivation score for baseline assessment), quality of life (5-level EuroQol 5 Dimensions), social participation (the social participation item from COOP/WONCA) and coping (Effective Musculoskeletal Consumer Scale-17). All tested outcome measures were found to be feasible, with high completion rates and acceptable score distribution. Standard response means varied from 0.3 to 0.9. CONCLUSIONS A consensus-based core set of patient reported outcome measures is presented for evaluating rehabilitation in MSDs. The core set is feasible and responsive for use in Norway, but needs further testing in other countries.
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Affiliation(s)
- M Klokkerud
- a National Advisory Unit on Rehabilitation in Rheumatology, Department of Rheumatology , Diakonhjemmet Hospital , Oslo , Norway
| | - H Dagfinrud
- a National Advisory Unit on Rehabilitation in Rheumatology, Department of Rheumatology , Diakonhjemmet Hospital , Oslo , Norway
| | - T Uhlig
- a National Advisory Unit on Rehabilitation in Rheumatology, Department of Rheumatology , Diakonhjemmet Hospital , Oslo , Norway
| | - T N Dager
- b Norwegian National Unit for Rehabilitation for Rheumatic Patients with Special Needs, Department of Rheumatology , Diakonhjemmet Hospital , Oslo , Norway
| | | | - Å Klokkeide
- d Haugesund Rheumatism Hospital AS , Haugesund , Norway
| | - M Larsen
- e The Norwegian Rheumatism Association , Oslo , Norway
| | - S Nygård
- f Municipality of Skedsmo , Skedsmo , Norway
| | - S Nylenna
- g Patient Research Panel, Department of Rheumatology , Diakonhjemmet Hospital , Oslo , Norway
| | - L Øie
- h North-Norway Rehabilitation Center , Tromsø , Norway
| | - I Kjeken
- a National Advisory Unit on Rehabilitation in Rheumatology, Department of Rheumatology , Diakonhjemmet Hospital , Oslo , Norway
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Moen VP, Drageset J, Eide GE, Klokkerud M, Gjesdal S. Validation of World Health Organization Assessment Schedule 2.0 in specialized somatic rehabilitation services in Norway. Qual Life Res 2017; 26:505-514. [PMID: 27506525 PMCID: PMC5288428 DOI: 10.1007/s11136-016-1384-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2016] [Indexed: 01/30/2023]
Abstract
PURPOSE The World Health Organization Disability Assessment Schedule (WHODAS) 2.0 is a generic instrument to assess disability covering six domains. The purpose of this study was to investigate the potential of the instrument for monitoring disability in specialized somatic rehabilitation by testing reliability, construct validity and responsiveness of WHODAS 2.0, Norwegian version, among patients with various health conditions. METHODS For taxonomy, terminology and definitions, the Consensus-based Standards for the Selection of Health Measurement Instruments were followed. Reproducibility was investigated by the intra-class correlation coefficient (ICC) in a randomly selected sample. Internal consistency was assessed by Cronbach's alpha. Construct validity was evaluated by correlations between WHODAS 2.0 and the Medical Outcomes Study 36-item Short Form, and fit of the hypothesized structure using confirmatory factor analysis (CFA). Responsiveness was evaluated in another randomly selected sample by testing a priori formulated hypotheses. RESULTS Nine hundred seventy patients were included in the study. Reproducibility and responsiveness were evaluated in 53 and 104 patients, respectively. The ICC for the WHODAS 2.0 domains ranged from 0.63 to 0.84 and was 0.87 for total score. Cronbach's alpha for domains ranged from 0.75 to 0.94 and was 0.93 for total score. For construct validity, 6 of 12 expected correlations were confirmed and CFA did not achieve satisfactory fit indices. For responsiveness, 3 of 8 hypotheses were confirmed. CONCLUSION The Norwegian version of WHODAS 2.0 showed moderate to satisfactory reliability and moderate validity in rehabilitation patients. However, the present study indicated possible limitations in terms of responsiveness.
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Affiliation(s)
- Vegard Pihl Moen
- Centre for Habilitation and Rehabilitation, Haukeland University Hospital, Østre Nesttunveg 2, 5221, Bergen, Norway.
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
| | - Jorunn Drageset
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Geir Egil Eide
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
| | - Mari Klokkerud
- National Advisory Unit on Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Sturla Gjesdal
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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Turk DC, Fillingim RB, Ohrbach R, Patel KV. Assessment of Psychosocial and Functional Impact of Chronic Pain. THE JOURNAL OF PAIN 2016; 17:T21-49. [DOI: 10.1016/j.jpain.2016.02.006] [Citation(s) in RCA: 174] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 02/08/2016] [Accepted: 02/16/2016] [Indexed: 12/20/2022]
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Wilkie R, Blagojevic-Bucknall M, Belcher J, Chew-Graham C, Lacey RJ, McBeth J. Widespread pain and depression are key modifiable risk factors associated with reduced social participation in older adults: A prospective cohort study in primary care. Medicine (Baltimore) 2016; 95:e4111. [PMID: 27495019 PMCID: PMC4979773 DOI: 10.1097/md.0000000000004111] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
In older adults, reduced social participation increases the risk of poor health-related quality of life, increased levels of inflammatory markers and cardiovascular disease, and increased mortality. Older adults frequently present to primary care, which offers the potential to deliver interventions at the point of care to increase social participation. The aim of this prospective study was to identify the key modifiable exposures that were associated with reduced social participation in a primary care population of older adults.The study was a population-based prospective cohort study. Participants (n = 1991) were those aged ≥65 years who had completed questionnaires at baseline, and 3 and 6-year follow-ups. Generalized linear mixed modeling framework was used to test for associations between exposures and decreasing social participation over 6 years.At baseline, 44% of participants reported reduced social participation, increasing to 49% and 55% at 3 and 6-year follow-up. Widespread pain and depression had the strongest independent association with reduced social participation over the 6-year follow-up period. The prevalence of reduced social participation for those with widespread pain was 106% (adjusted incidence rate ratio 2.06, 95% confidence interval 1.72, 2.46), higher than for those with no pain. Those with depression had an increased prevalence of 82% (adjusted incidence rate ratio 1.82, 95% confidence interval 1.62, 2.06). These associations persisted in multivariate analysis.Population ageing will be accompanied by increasing numbers of older adults with pain and depression. Future trials should assess whether screening for widespread pain and depression, and targeting appropriate treatment in primary care, increase social participation in older people.
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Affiliation(s)
- Ross Wilkie
- Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, UK
- Correspondence: Dr Ross Wilkie, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire ST5 5BG, UK (e-mail: )
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Morley D, Dummett S, Kelly L, Dawson J, Fitzpatrick R, Jenkinson C. Validation of the Oxford Participation and Activities Questionnaire. Patient Relat Outcome Meas 2016; 7:73-80. [PMID: 27366108 PMCID: PMC4913975 DOI: 10.2147/prom.s96822] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
PURPOSE There is growing interest in the management of long-term conditions and in keeping people active and participating in the community. Testing the effectiveness of interventions that aim to affect activities and participation can be challenging without a well-developed, valid, and reliable instrument. This study therefore aims to develop a patient-reported outcome measure, the Oxford Participation and Activities Questionnaire (Ox-PAQ), which is theoretically grounded in the World Health Organization's International Classification of Functioning, Disability, and Health (ICF) and fully compliant with current best practice guidelines. METHODS Questionnaire items generated from patient interviews and based on the nine chapters of the ICF were administered by postal survey to 386 people with three neurological conditions: motor neuron disease, multiple sclerosis, and Parkinson's disease. Participants also completed the Medical Outcomes Study (MOS) 36-Item Short Form Health Survey (SF-36) and EQ-5D-5L. RESULTS Thus, 334 participants completed the survey, a response rate of 86.5%. Factor analysis techniques identified three Ox-PAQ domains, consisting of 23 items, accounting for 72.8% of variance. Internal reliability for the three domains was high (Cronbach's α: 0.81-0.96), as was test-retest reliability (intraclass correlation: 0.83-0.92). Concurrent validity was demonstrated through highly significant relationships with relevant domains of the MOS SF-36 and the EQ- 5D-5L. Assessment of known-groups validity identified significant differences in Ox-PAQ scores among the three conditions included in the survey. CONCLUSION Results suggest that the Ox-PAQ is a valid and reliable measure of participation and activity. The measure will now be validated in a range of further conditions, and additional properties, such as responsiveness, will also be assessed in the next phase of the instrument's development.
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Affiliation(s)
- David Morley
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Sarah Dummett
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Laura Kelly
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Jill Dawson
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Ray Fitzpatrick
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Crispin Jenkinson
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Abstract
The rheumatology community began incorporating patient-reported outcomes in the early 1980s, helping shift the care of chronic diseases from a narrower biomedical model to a broader biopsychosocial model of health. Early efforts were focused primarily in clinical trials and clinical research, but over the last decade there has been increasing use in routine rheumatology clinical care. More than 250 valid and reliable scales to assess domains of importance to patients with rheumatic conditions have been developed. The approach to measurement continues to be refined. Rheumatology has much to be proud of in contributions to the important field of patient-reported outcomes.
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Affiliation(s)
- Leigh F Callahan
- Department of Medicine, Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, 3330 Thurston Building, CB 7280, Chapel Hill, NC 27599, USA.
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Kelly L, Jenkinson C, Dummett S, Dawson J, Fitzpatrick R, Morley D. Development of the Oxford Participation and Activities Questionnaire: constructing an item pool. Patient Relat Outcome Meas 2015; 6:145-55. [PMID: 26056503 PMCID: PMC4447000 DOI: 10.2147/prom.s82121] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The Oxford Participation and Activities Questionnaire is a patient-reported outcome measure in development that is grounded on the World Health Organization International Classification of Functioning, Disability, and Health (ICF). The study reported here aimed to inform and generate an item pool for the new measure, which is specifically designed for the assessment of participation and activity in patients experiencing a range of health conditions. METHODS Items were informed through in-depth interviews conducted with 37 participants spanning a range of conditions. Interviews aimed to identify how their condition impacted their ability to participate in meaningful activities. Conditions included arthritis, cancer, chronic back pain, diabetes, motor neuron disease, multiple sclerosis, Parkinson's disease, and spinal cord injury. Transcripts were analyzed using the framework method. Statements relating to ICF themes were recast as questionnaire items and shown for review to an expert panel. Cognitive debrief interviews (n=13) were used to assess items for face and content validity. RESULTS ICF themes relevant to activities and participation in everyday life were explored, and a total of 222 items formed the initial item pool. This item pool was refined by the research team and 28 generic items were mapped onto all nine chapters of the ICF construct, detailing activity and participation. Cognitive interviewing confirmed the questionnaire instructions, items, and response options were acceptable to participants. CONCLUSION Using a clear conceptual basis to inform item generation, 28 items have been identified as suitable to undergo further psychometric testing. A large-scale postal survey will follow in order to refine the instrument further and to assess its psychometric properties. The final instrument is intended for use in clinical trials and interventions targeted at maintaining or improving activity and participation.
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Affiliation(s)
- Laura Kelly
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Crispin Jenkinson
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Sarah Dummett
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Jill Dawson
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Ray Fitzpatrick
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - David Morley
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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22
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Assessment of the patient with osteoarthritis and measurement of outcomes. Rheumatology (Oxford) 2015. [DOI: 10.1016/b978-0-323-09138-1.00178-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Sverker A, Östlund G, Thyberg M, Thyberg I, Valtersson E, Björk M. Dilemmas of participation in everyday life in early rheumatoid arthritis: a qualitative interview study (The Swedish TIRA Project). Disabil Rehabil 2014; 37:1251-9. [PMID: 25243767 DOI: 10.3109/09638288.2014.961658] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE To explore the experiences of today's patients with early rheumatoid arthritis (RA) with respect to dilemmas of everyday life, especially regarding patterns of participation restrictions in valued life activities. METHODS A total of 48 patients, aged 20-63, three years post-RA diagnosis were interviewed using the Critical Incident Technique. Transcribed interviews were condensed into meaningful units describing actions/situations. These descriptions were linked to ICF participation codes according to the International Classification of Functioning, Disability and Health (ICF) linking rules. RESULTS Dilemmas in everyday life were experienced in domestic life, interpersonal interactions and relationships, community, social and civic life. Most dilemmas were experienced in domestic life, including participation restrictions in, e.g. gardening, repairing houses, shovelling snow, watering pot plants, sewing or walking the dog. Also many dilemmas were experienced related to recreation and leisure within the domain community, social and civic life. The different dilemmas were often related to each other. For instance, dilemmas related to community life were combined with dilemmas within mobility, such as lifting and carrying objects. CONCLUSIONS Participation restrictions in today's RA patients are complex. Our results underline that the health care needs to be aware of the patients' own preferences and goals to support the early multi-professional interventions in clinical practice. Implications of Rehabilitation Today's rheumatoid arthritis (RA) patients experience participation restrictions in activities not included in International Classification of Functioning, Disability and Health (ICF) core set for RA or in traditionally questionnaires with predefined activities. The health care need to be aware of the patients' own preferences and goals to meet the individual needs and optimize the rehabilitation in early RA in clinical practice.
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Affiliation(s)
- Annette Sverker
- Department of Rehabilitation and Department of Medical and Health Sciences, Linköping University , Linköping , Sweden
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Mikkola TM, Portegijs E, Rantakokko M, Gagné JP, Rantanen T, Viljanen A. Association of self-reported hearing difficulty to objective and perceived participation outside the home in older community-dwelling adults. J Aging Health 2014; 27:103-22. [PMID: 24951368 DOI: 10.1177/0898264314538662] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate whether hearing difficulty is associated with objective and perceived participation in social and leisure activities outside the home in older adults. METHOD Self-reported hearing difficulty, frequency of participation, perceived participation and Mini-Mental State Examination (MMSE) were obtained from 848 community-dwelling men and women aged 75 to 90. RESULTS Among persons with MMSE ≤ 24, hearing was not associated with participation. In persons with MMSE > 24, relative to persons who reported no difficulty hearing, participants with major hearing difficulty had a higher odds ratio [OR] for infrequent participation in group activities (OR 2.1, 95% confidence interval [CI] [1.2, 3.6]) and more restricted perceived participation (OR 2.1, 95% CI [1.2, 3.7]). Participants with and without hearing difficulty did not differ in their frequency of attending non-group activities or meeting (grand)children or acquaintances. DISCUSSION Hearing difficulty may restrict older adults with normal cognition from participating in social and leisure activities and living their life as they would like to outside the home.
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Affiliation(s)
| | | | | | - Jean-Pierre Gagné
- Université de Montréal, Québec, Canada Institut Universitaire de Gériatrie de Montréal, Québec, Canada
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Stallinga HA, Dijkstra PU, Bos I, Heerkens YF, Roodbol PF. The ambiguity of the concept of participation in measurement instruments: operationalization of participation influences research outcomes. Clin Rehabil 2014; 28:1225-36. [DOI: 10.1177/0269215514537092] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Objective: This study explores, based on the International Classification of Functioning, Disability and Health, the consequences of different operationalizations of participation in regression models predicting participation in one sample of patients. Design: Cross-sectional, comparative study. Setting: Department of Neurology of a University Hospital. Subjects: A total of 677 patients with a Neuromuscular Disease. Measures: Participation was measured using the Neuromuscular Disease Impact Profile questionnaire, the RAND-36 Item Health Survey (social functioning, role limitations—physical, role limitations—emotional) and the Impact on Participation and Autonomy questionnaire (autonomy outdoors, social relations). Potential predictors of participation included type of neuromuscular disease, body functions (measured with Neuromuscular Disease Impact Profile), activities (measured with Neuromuscular Disease Impact Profile), environmental factors (measured with Neuromuscular Disease Impact Profile), and personal factors (measured with the 13-item Sense of Coherence questionnaire). The results were controlled for patient characteristics. Results: Participation was statistically predicted by different determinants depending on the operationalization used for participation. Additionally, the regression coefficients differed significantly. Body functions and activities were predictors in five out of six operationalizations of participation. Sense of coherence predicted participation in all of the operationalizations. The explained variance of the different models ranged from 25% (RAND-36 role limitations—emotional) to 65% (Neuromuscular Disease Impact Profile). Conclusions: Different operationalizations of participation result in different prediction models. Lack of conceptual consensus makes participation an ambiguous concept in research, and this ambiguity makes evidence-based decisions directed at enhancing participation difficult. Participation needs to be operationalized in an unambiguous and standard way in order to improve the comparability of outcomes.
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Affiliation(s)
| | - Pieter U Dijkstra
- Department of Rehabilitation Medicine, University of Groningen, Groningen, The Netherlands
- Department of Oral and Maxillofacial Surgery, University of Groningen, Groningen, The Netherlands
| | - Isaac Bos
- Department of Neurology, University of Groningen, Groningen, The Netherlands
| | - Yvonne F Heerkens
- Dutch Institute of Allied Health Professions, Amersfoort, The Netherlands
- Department of Occupation and Health, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Petrie F Roodbol
- Wenckebach Institute, University of Groningen, Groningen, The Netherlands
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Morley D, Dummett S, Kelly L, Dawson J, Fitzpatrick R, Jenkinson C. The Oxford Participation and Activities Questionnaire: study protocol. Patient Relat Outcome Meas 2013; 5:1-6. [PMID: 24399888 PMCID: PMC3865144 DOI: 10.2147/prom.s53762] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND With an ageing population and increasing demands on health and social care services, there is growing importance attached to the management of long-term conditions, including maximizing the cost-effectiveness of treatments. In line with this, there is increasing emphasis on the need to keep people both active and participating in daily life. Consequently, it is essential that well developed and validated instruments that can meaningfully assess levels of participation and activity are widely available. Current measures, however, are largely focused on disability and rehabilitation, and there is no measure of activity or participation for generic use that fully meets the standards set by regulatory bodies such as the US Food and Drug Administration. Here we detail a protocol for the development and validation of a new patient-reported outcome measure (PROM) for assessment of participation and activity in people experiencing a variety of health conditions, ie, the Oxford Participation and Activities Questionnaire (Ox-PAQ). The stages incorporated in its development are entirely in line with current regulations and represent best practice in the development of PROMs. METHODS Development of the Ox-PAQ is theoretically grounded in the World Health Organization International Classification of Functioning, Disability, and Health. The project incorporates a new strategy of engaging with stakeholders from the outset in an attempt to identify those characteristics of PROMs considered most important to a range of potential users. Items will be generated through interviews with patients from a range of conditions. Pretesting of the instrument will be via cognitive interviews and focus groups. A postal survey will be conducted, with data subject to factor and Rasch analysis in order to identify appropriate dimensions and redundant items. Reliability will be assessed by Cronbach's alpha and item-total correlations. A second, large-scale postal survey will follow, with the Ox-PAQ being administered in conjunction with generic measures of health status to further test the validity of the measure. The Ox-PAQ will again be administered at 2 weeks to assess test-retest reliability and at 3 months to assess responsiveness. CONCLUSION The development of the Ox-PAQ is a timely one. With increasing emphasis being placed on the importance of keeping people active and participating in daily life, the instrument has the potential for significant uptake. Its primary use is intended to be in clinical trials and for evaluation of interventions targeted at maintaining activity and participation.
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Affiliation(s)
- David Morley
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Sarah Dummett
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Laura Kelly
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Jill Dawson
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Ray Fitzpatrick
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Crispin Jenkinson
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Farin E, Ullrich A, Hauer J. Participation and social functioning in patients with fibromyalgia: development and testing of a new questionnaire. Health Qual Life Outcomes 2013; 11:135. [PMID: 23914807 PMCID: PMC3750280 DOI: 10.1186/1477-7525-11-135] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 08/01/2013] [Indexed: 11/23/2022] Open
Abstract
Background While there are numerous instruments for capturing the symptoms of fibromyalgia syndrome (FMS) patients, there is a lack of questionnaires capable of measuring in detail FMS patients’ participation and social functioning. It was our aim to develop and methodologically test a new patient questionnaire specific to FMS measuring these concepts (the “Fibromyalgia Participation Questionnaire” FPQ). Methods We first conducted a qualitative prestudy (focus groups, N = 38) to identify which impairments FMS patients experience in daily life because of their illness. To analyze the data we developed a coding system that contained 10 supercategories and a total of 105 subcategories. Items for the FPQ were developed from the subcategories. The psychometric analysis was done on a sample of N = 256 FMS patients undergoing inpatient rehabilitation in Germany. Results The final version of the FPQ contained 27 items and three scales (participation in social life FPQ-S, 11 items; participation in daily life FPQ-D, 11 items, participation in work-life FPQ-W 5 items). The FPQ displays good distribution properties, all the scales are unidimensional, and the scales fit to the Rasch model. Cronbach’s Alpha range from 0.85 to 0.94. We noted indications of construct validity in that the FPQ correlates as expected with the Fibromyalgia Impact Questionnaire (physical scale), Pain Disability Index and scales from the PROMIS® item banks for satisfaction with participation. The FPQ scales generally reveal greater responsiveness than other instruments. By linking FPQ items to the categories of the International Classification of Functioning, Disability and Health (ICF) we demonstrate content validity. Conclusions The FPQ captures participation and social functioning in FMS patients. As its psychometric properties are good, it can be recommended for use in evaluation studies and clinical trials.
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Affiliation(s)
- Erik Farin
- Department of Quality Management and Social Medicine, University Freiburg-Medical Center, Engelbergerstr 21, Freiburg D-79106, Germany.
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