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Unger J, Mattsson M, Drăgoi RG, Avram C, Boström C, Buttgereit F, Lackner A, Witte T, Raffeiner B, Peichl P, Durechova M, Hermann J, Stamm TA, Dejaco C. The Experiences of Functioning and Health of Patients With Primary Sjögren's Syndrome: A Multicenter Qualitative European Study. Front Med (Lausanne) 2021; 8:770422. [PMID: 34869487 PMCID: PMC8637170 DOI: 10.3389/fmed.2021.770422] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 10/05/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: To identify a spectrum of perspectives on functioning and health of patients with primary Sjögren's syndrome (pSS) from the five European countries in order to reveal commonalities and insights in their experiences. Methods: A multicenter focus group study on the patients with pSS about their perspectives of functioning and health was performed. Focus groups were chaired by trained moderators based on an interview guide, audiotaped, and transcribed. After conducting a meaning condensation analysis of each focus group, we subsequently combined the extracted concepts from each country and mapped them to the International Classification of Functioning, Disability and Health (ICF). Results: Fifty-one patients with pSS participated in 12 focus groups. We identified a total of 82 concepts meaningful to people with pSS. Of these, 55 (67%) were mentioned by the patients with pSS in at least four of five countries and 36 (44%) emerged in all the five countries. Most concepts were assigned to the ICF components activities and participation (n = 25, 30%), followed by 22 concepts (27%) that were considered to be not definable or not covered by the ICF; 15 concepts (18%) linked to body structures and functions. Participants reported several limitations in the daily life due to a mismatch between the capabilities of the person, the demands of the environment and the requirements of the activities. Conclusion: Concepts that emerged in all the five non-English speaking countries may be used to guide the development and adaption of the patient-reported outcome measures and to enhance the provision of treatment options based on the aspects meaningful to patients with pSS in clinical routine.
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Affiliation(s)
- Julia Unger
- Department of Rheumatology and Immunology, Medical University of Graz, Graz, Austria.,Department of Health Studies, Institute of Occupational Therapy, University of Applied Sciences FH JOANNEUM, Bad Gleichenberg, Austria
| | - Malin Mattsson
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, and Affiliated to Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physical Therapy, Karolinska University Hospital, Stockholm, Sweden.,Department of Physiotherapy, Sunderby Hospital, Luleå, Sweden
| | - Răzvan G Drăgoi
- Department of Balneology, Rehabilitation Medicine and Rheumatology, "Victor Babeş" University of Medicine and Pharmacy Timisoara, Timisoara, Romania
| | - Claudiu Avram
- Department of Physical Therapy and Special Motility, West University of Timisoara, Timisoara, Romania
| | - Carina Boström
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, and Affiliated to Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physical Therapy, Karolinska University Hospital, Stockholm, Sweden
| | - Frank Buttgereit
- Department of Rheumatology and Clinical Immunology, Charitè University Medicine, Berlin, Germany
| | - Angelika Lackner
- Department of Rheumatology and Immunology, Medical University of Graz, Graz, Austria
| | - Torsten Witte
- Department of Rheumatology and Immunology, Medical University of Hanover, Hanover, Germany
| | - Bernd Raffeiner
- Department of Rheumatology, Hospital of Bolzano (SABES-ASDAA), Bolzano, Italy
| | | | - Martina Durechova
- Division of Rheumatology and Immunology, Department of Internal Medicine, Medical University Vienna, Vienna, Austria
| | - Josef Hermann
- Department of Rheumatology and Immunology, Medical University of Graz, Graz, Austria
| | - Tanja A Stamm
- Section for Outcomes Research, Centre for Medical Statistics, Informatics, and Intelligent Systems, Medical University Vienna, Vienna, Austria
| | - Christian Dejaco
- Department of Rheumatology and Immunology, Medical University of Graz, Graz, Austria.,Department of Rheumatology, Hospital of Brunico (SABES-ASDAA), Brunico, Italy
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Lemmers M, Versluijs Y, Kortlever JTP, Gonzalez AI, Ring D. Misperception of Disease Onset in People with Gradual-Onset Disease of the Upper Extremity. J Bone Joint Surg Am 2020; 102:2174-2180. [PMID: 33027085 DOI: 10.2106/jbjs.20.00420] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Misperception that an established, gradual-onset disease such as osteoarthritis started when the symptoms were first noticed might lead to testing and treatment choices that are inconsistent with what matters most to a patient. In the present study, the primary null hypothesis was that there are no factors associated with patient-reported symptom duration (in months). The secondary null hypotheses were that there are no factors independently associated with (1) a sudden versus gradual perception of disease onset, (2) an event or injury-related versus age-related perceived cause of disease onset, and (3) the magnitude of physical limitations. METHODS In this cross-sectional study, 121 patients with an atraumatic, established, gradual-onset condition of the upper extremity completed a demographic questionnaire, measures of mental health (symptoms of depression and anxiety, worst-case thinking, and self-efficacy [the ability to adapt and continue with daily activity] when in pain), measurement of the magnitude of upper extremity-specific limitations, and questions about the perceived course and cause of the disease. RESULTS The median patient-reported symptom duration was 12 months (interquartile range, 3 to 36 months). Twenty-two patients (18%) perceived their disease as new, and 29 patients (24%) believed that the condition was related to ≥1 event (injury) rather than being time and age-related. In multivariable analysis, patients with Medicare insurance were independently associated with longer reported symptom duration (in months). Greater self-efficacy was associated with longer symptom duration in bivariate, but not multivariable, analysis. No factors were independently associated with a sudden versus gradual onset of symptoms. Hispanic ethnicity and federal, county, or no insurance were independently associated with the perception that the problem was caused by an injury or event. CONCLUSIONS Approximately 1 in 5 patients misperceived new symptoms as representing a new disease, often as a type of injury. Misperception of the pathology as new had a limited association with unhealthy thoughts and is likely generally responsive to reorientation. We speculate that gentle, strategic reorientation of misperception can protect patients from choices inconsistent with their values.
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Affiliation(s)
- Maartje Lemmers
- Department of Surgery and Perioperative Care, Dell Medical School-The University of Texas at Austin, Austin, Texas
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