A Patient-Specific Version of the Disabilities of the Arm, Shoulder, and Hand Questionnaire

Abstract

We modified the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire to be weighted according to a patient's priorities (patient-specific [PS-DASH]) and compared it with the DASH in terms of its mean and variance and its relationship with coping styles (pain avoidance, pain catastrophizing, anxiety sensitivity, and hypochondriasis), depression, and overall stress. Ninety-eight patients with carpal tunnel syndrome completed questionnaires measuring depression, pain catastrophizing, avoidance, hypochondriasis, anxiety sensitivity, and ordinal measures of self-reported stress and disability. They also completed the DASH and a modification of the DASH that weighted each item according to personal priorities. The DASH scores had a significantly higher mean and greater standard deviation than the PS-DASH (mean +/- standard deviation, 54.1 +/- 16.8 vs 32.7 +/- 11.0). Health anxiety (r = 0.355), anxiety sensitivity (r = 0.258), and pain catastrophizing (r = 0.421) were significantly related to PS-DASH; health anxiety (r = 0.298), depression (r = 0.225), and pain catastrophizing (r = .350) were significantly related to DASH. Multivariable regression analyses were statistically significant, but accounted for only 35% of the variance in PS-DASH and 17% of the variance in DASH. Pain catastrophizing and gender were the sole significant predictors for PS-DASH (B = 0.290, B = 0.384), whereas only pain catastrophizing predicted DASH (B = 0.251). A version of the DASH weighted according to patient priorities narrowed the variability in DASH scores but did not appear to have sufficient advantage over DASH to warrant this much more cumbersome questionnaire.