Assessment Of Disability In Patients Research Articles

Cross-cultural Adaptation and Validation of Hindi Version of Roland Morris Disability Questionnaire for Chronic Low Back Pain in Indian Population.

A cross-cultural adaptation, validation, and psychometric analysis. The main aim was to assess the validity and reliability of the Hindi version of the Roland Morris Disability Questionnaire (Hi-RMDQ) for chronic low back pain. Roland Morris Disability Questionnaire is a standardized, self-administered tool for disability assessment in patients with chronic low back pain. However, its Hindi version has not been validated. Cognitive debriefing was carried out with 10 patients to ensure the comprehensibility of the Hi-RMDQ. Following this, 120 patients were asked to complete the finalized questionnaire along with the modified Oswestry Disability Index Questionnaire, Quebec Back Pain Disability Score, and the Verbal Numeric Rating Scale. The patients were then asked to again fill out the finalized questionnaire after 72 hours. The internal consistency and retest reliability of the Hindi translated version of the questionnaire was tested. Its correlation with the other scores was also analyzed. The translated questionnaire showed excellent internal consistency (Cronbach α=0.989) and excellent retest reliability (intraclass correlation coefficient=0.978). There was a positive and statistically significant association between the Hi-RMDQ, modified Oswestry Disability Index Questionnaire ( r =0.807; P <0.01), Quebec Back Pain Disability Score ( r =0.839; P <0.01), and Verbal Numeric Rating Scale ( r =0.713; P <0.01). The Hi-RMDQ version is an easy-to-use, acceptable, reliable, and valid tool to measure disability in the Indian population with nonspecific back pain with or without leg pain. 3.

Linguistic Reliability &amp; Validity of Urdu Version of Roland-Morris Disability Questionnaire in Patients with Chronic Non-Specific Low Back Pain

Roland-Morris Disability Questionnaire (RMDQ) is a self-administered tool that produces reliable measurements for drawing implications about disability. Urdu form of the Roland-Morris Disability Questionnaire (U-RMDQ) is considered apprehensive for the population of Pakistan. Furthermore, the Urdu version of this tool is consistent in reliability, validity &amp; content continuity with the English original version. Objective: The aims of the current study were to assess the reliability, validity &amp; utility of the Urdu form of the Roland-Morris Disability Questionnaire (RMDQ) in participants with chronic nonspecific low back pain. Methods: This study design was qualitative tool validation. The sampling technique employed was non-random convenience sampling with 100 individuals including both females and males within the age of 20 years to 70 years. Out of 100, 25 were healthy &amp; 75 were patients Measurements were taken at baseline followed by another measurement after 24 hours. The study was completed in three stages; content validity was evaluated through the content validity index in the first stage, a pilot study was run to evaluate reliability &amp; validity in the second stage followed by an evaluation of patients presenting with low back pain using Urdu version of (U-RMDQ) in the third stage. Data were collected through the Urdu version of the (U-RMDQ). Afterward, IBM SPSS version 25.0 was used to analyze the data. Results: -retest reliability depicted with Intra-class Correlation Coefficient was 0.684 for healthy individuals while 0.998 for participants with non-specific chronic LBP. The outcomes clearly express the tool reliability for the assessment of disability in patients with nonspecific chronic low back pain. An Independent t-test was employed to check the different validity, results showed the significant differences in means of all variables between both groups thereby producing &lt;.05 two-tailed significance of all variables. After factor analysis of samples of 100 patients, Kaiser-Meyer Olkin (KMO) was 0.872 &amp; p-value &lt;0.05 showed the significance of the test. Five variables in (U-RMDQ) were responsible for variance in data. Conclusion: The study concluded the Urdu version of the Roland-Morris Disability Questionnaire is a valid and reliable instrument to evaluate disability associated with chronic non-specific low back pain.

Regarding the disability assessment in patients with chronic obstructive pulmonary disease using International Classification of Functioning, Disability and Health

Regarding the disability assessment in patients with chronic obstructive pulmonary disease using International Classification of Functioning, Disability and Health. Purpose: To optimize the assessment of disability in patients with chronic obstructive pulmonary disease using the International Classification of Functioning, Disability and Health. Material and methods: Analysis of scientific publications selected from medical information databases (MEDLINE, EMBASE, etc.). Results and conclusion: in order to optimize the approach to disability in patients with chronic obstructive pulmonary disease using the International Classification of Functioning, Disability and Health (ICF): the literature was analyzed by specialty, selected from medical databases (Medline, etc.); studied with the categories included in the ICF sets recommended by the WHO and proposed by a number of authors who apply them to patients with COPD and other chronic obstructive pulmonary disease; the topicality of the problem, the unresolved objectives, the perspectives of further scientific research and the relevance of their conclusions for the tasks of medical and social expertise and in the rehabilitation of patients with chronic obstructive pulmonary disease were reflected.

Assessment of disability in patients with alkaptonuria

Background. Alkaptonuria is an orphan, autosomal recessive disease in which clinical symptoms debut in adulthood and are characterized by progressive degenerative changes in large joints (knee, hip, shoulder) and the spine, often leading to the need for joint replacement. Developing changes often lead to persistent disability.&#x0D; The purpose of this study was to evaluate disability among adult patients with alkaptonuria.&#x0D; Materials and methods. The study included 46 adult patients (31 m 67.4% and 15 w 32.6%) with a reliable diagnosis of alkaptonuria at the age of 20 to 76 years (avg age 56.83 10.52). The assessment of the presence of a disability group at the time of patients treatment to a rheumatologist was carried out.&#x0D; Results. It turned out that disability was determined in 34 (75.6%) patients, there were no signs of persistent disability in 11 patients (24.4%). Among the patients who had signs of persistent disability, most often during the survey period, group 2 disability was established (61.8%), the differences between this and other groups were statistically significant (p 0.05). For the first time, disability in the study cohort of patients was established at the age of 31 to 59 years (the average age was 50.83 5.5 years).&#x0D; Conclusions. It is important to note that in the vast majority of cases, persistent disability occurs in patients who were of working age, which underscores the importance of alkaptonuria as a medical and social problem.

P558 Validation of the ‘IBD Disk’ in clinical practice

Abstract Background The inflammatory bowel disease (IBD) Disk is a tool that has been developed from the IBD Disability Index in order to objectively measure the degree of disability in patients suffering from IBD. It provides a visual representation of disability state, thereby increasing the ease of application in a clinical setting. Currently, it has not yet been validated in any population. Our primary aim was to hence validate the IBD Disk in a clinical setting. Methods 40 patients were recruited from an outpatient setting in a tertiary centre in Australia. All patients completed four surveys, the IBD Disk, the IBD Disability Index (IBD-DI), the Hospital Anxiety and Depression Score (HADS) and the Shortened IBD Questionnaire (SIBDQ). Nineteen of these patients then elaborated on their answers in a semi-structured narrative interview based on the IBD Disk. After a consultation with a gastroenterologist, the treating doctors were also asked to fill out an IBD Disk based on their own perceptions of the participant’s degree of disability. The IBD Disk was assessed for its internal consistency, construct validity and factor structure. The qualitative data were analysed and coded using NVIVO and then associated to IBD Disk scores. Results Of the patients recruited 48% were female, 30% had ulcerative colitis and 52% were in clinical remission. Average IBD Disk score was 40.75. Our results suggest the IBD Disk is an internally consistent tool for clinical use when assessing disability (Cronbach’s Α = 0.888). This is supported by statistically significant differences in IBD Disk scores between patients in clinical remission and patients with active disease (p = 0.002). There is also a good correlation between the Patient-Reported IBD Disk scores and the IBD-DI scores (r = 0.864), Doctor Perceived IBD Disk scores (r = 0.794) and the HADS Depression score (r = 0.759). IBD Disk scores also negatively correlated with the Shortened IBD Questionnaire (r = −0.864). Qualitative data also correlate well thematically with IBD Disk scores. These results suggest an appropriate system for grading disability status via the IBD Disk is: 0–24 = no disability; 25–49 = mild disability; 50–74 = moderate disability; and, 75–100 = severe disability. Conclusion This study supports the use of the IBD Disk as a reliable and valid self-reporting tool in clinical situations. There is strong internal consistency, construct validity, factor structure and qualitative thematic association. However, more data are needed to further validate the IBD Disk. Most significantly though, the IBD Disk is likely to become a valuable tool for the practical assessment of disability in patients with IBD in the near future.

Reliability and validity of the 12-item WHODAS 2.0 in patients with Kashin-Beck disease.

The purpose of this study was to check the reliability and validity of the 12-item Chinese version of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) for the assessment of disability in patients with Kashin-Beck disease (KBD). We recruited 219 patients with KBD from the high-risk KBD area in the Shaanxi province, using stratified multistage random sampling. We assessed each patient using the Chinese version of the 12-item WHODAS 2.0 and the Western Ontario and McMaster Universities Index of Osteoarthritis (WOMAC). Statistical evaluations of the instruments consisted of Cronbach's alpha, intraclass correlation coefficient (ICC), confirmatory factor analysis (CFA), and Pearson's correlation coefficient. Cronbach's alpha and ICC for the six domains ranged from 0.704 to 0.906 and 0.690 to 0.852, respectively. A six-factor structure fits the data well (CFI=0.967, TLI=0.944, RMSEA=0.08). Regarding convergent validity, the four domains of the 12-item WHODAS 2.0 (getting around, self-care, life activity, and participation) showed moderate-to-strong correlation for all three domains of the WOMAC (0.428<|r|<0.804). Regarding divergent validity, the two domains of the 12-item WHODAS 2.0 (understanding and communication, and getting along with people) showed weak correlation for the three domains of WOMAC (0.182<|r|<0.295). The Chinese version of 12-item WHODAS 2.0 questionnaire is a reliable and valid instrument when administered to KBD patients.

Missing Values in Patient Reported Outcomes: Assessment of Disability in Patients with Low Back Pain

Missing Values in Patient Reported Outcomes: Assessment of Disability in Patients with Low Back Pain

AB1113 Characteristics of Physical Disability in Patients with Long-Standing Rheumatoid Arthritis: Baseline Analysis of Multicenter Prospective Cohort Study for Evaluation of Joint Reconstructive Procedure

BackgroundEven now, in clinical practice, most of RA patients have long-standing disease and structural damage in their joints. Reconstructive surgery should be needed for further improvements of physical function for...

Validation in the Cross-Cultural Adaptation of the Nepali Version of the Oswestry Disability Index

Background : Standardized outcome measures to improve interventions for low back pain (LBP) have been recommended by many authors. The ODI is a valid and reliable evaluation instrument for disability measurement, but no validated Nepali version is evident. Objectives : The aim of the study was to conduct cross-cultural adaptation in translating the original (English) version of the Oswestry Disability Index (ODI2.1a) into Nepali, and then to assess the psychometric properties of the Nepali versions of the Oswestry Disability Index (NODI2.1a). Study Design : Validation of a translated, culturally adapted questionnaire Method : Translation with cross cultural adaptation of the latest English version of the ODI2.1a was done. A total of 101 outpatients with LBP were assessed using ODI. 27 patients were tested on a second occasion for test-re-test reliability. Results : Cronbach α is found to be 0.723 which is an acceptable level of internal consistency. An acceptable good intraclass correlation coefficient was observed (ICC = 0.875) in the test-retest group. Conclusions : The Nepali version of ODI2.1a has good comprehensibility, internal consistency, and validity and is an adequate and useful instrument for the assessment of disability in patients with LBP.

EPA-0642 – Experience with personalised medicine with respect to disability assessment in patients suffering from autism

Introduction The authors present the outcomes of a new disability assessment paradigm, which ran for three years and concerns patients with autism. Aims Introduction of a new paradigm for assessing the state of health, decrease in the working capacity, and disability in patients with mental and behavioural disorders. Methods The evaluation reflected functional health state assessment and working incapacity in relation to the International Classification of Diseases and the International Classification of Functional Abilities, and principles of personalised medicine. Assessment of a patient's ability to undergo work rehabilitation is also part of personalised medicine. Results In 2009, there were 28 741 of acknowledged cases of disability due to mental illnesses, out of which, 1 262 were cases of autism. In 2012, there were 32 326 cases of disability due to mental illnesses, with autism patients representing 1 866 cases. There was an increase in the number of acknowledgements of the degree of disability due to autism by 47% from 1 262 cases in 2009 to 1 866 cases in 2012; the proportion of persons with disability due to mental disorders increased between 2009 and 2012 by 12.4%. Conclusions The new paradigm of disability assessment represents a personalised evaluation of patients’ ability with special emphasis on their social integration. The increase in the number of disabilities due to autism significantly outweighs the total increase of disabilities caused by a mental illness.

The World Health Organization Short Disability Assessment Schedule: a validation study in patients with schizophrenia

Purpose The World Health Organization Short Disability Assessment Schedule (DAS-s) is used for patients with schizophrenia, although no validation is available. This manuscript addresses this issue by dealing with its psychometric properties in a clinical sample of patients with schizophrenia. Methods Two hundred forty-one patients from 10 Adult Mental Health Care Centers meeting the following inclusion criteria were included: (1) International Classification of Diseases, 10th Revision, diagnosis of schizophrenia; (2) Global Assessment of Functioning scores 50 or less; (3) illness duration of more than 2 years; and (4) clinical stability at assessment time. Patients were evaluated at baseline and at 1-year follow-up regarding disability, sociodemographic and clinical variables, psychosocial measures, and use of mental health services. Results The factor analysis revealed a single factor that explained 60.57% of the variance. Internal consistency values were appropriate for the DAS-s total (0.78 at baseline and 0.78 at 1-year follow-up). Correlations between DAS-s scores and those of global functioning, psychiatric symptoms, social support, and quality of life ranged between small and moderate (range, 0.13-0.39). There were significant differences between groups of patients with schizophrenia in the DAS-s. Patients who were unemployed, with lower global functioning, with cognitive impairment, and lacking social support scored significantly lower in DAS-s scores. After 1-year follow-up, there was a nonsignificant decrease in DAS-s scores; and patients improved significantly in overall functioning and psychiatric symptoms. Discussion This study shows that the DAS-s has good reliability and validity and suggests that it is suitable for the assessment of disability in patients with schizophrenia.

Assessment of Disability in Patients with Acute Traumatic Spinal Cord Injury: A Systematic Review of the Literature

Given the importance of accurately and reliably assessing disability in future clinical trials, which will test therapeutic strategies in acute spinal cord injury (SCI), we sought to appraise comprehensively studies that focused on the psychometric properties (i.e., reliability, validity, and responsiveness) of all previously used outcome measures in the SCI population. The search strategy included Medline, CINAHL, EMBASE, and Cochrane databases. Two reviewers independently assessed each study regarding eligibility, level of evidence (using Sackett's criteria), and quality. Of 363 abstracts captured in our search, 36 full articles fulfilled the inclusion and exclusion criteria. Eight different outcome measures were used to assess disability in the SCI population, including Functional Independence Measure (FIM), Spinal cord Injury Measure (SCIM), Walking Index for Spinal Cord Injury (WISCI), Quadriplegia Index of Function (QIF), Modified Barthel Index (MBI), Timed Up & Go (TUG), 6-min walk test (6MWT), and 10-m walk test (10MWT). While 19 of 36 studies provided level-4 evidence, the remaining 17 articles were classified as level-2b evidence. Most of the instruments showed convergent construct validity in the SCI population, but criterion validity was not examined due to the lack a gold standard for assessment of disability. All instruments were tested in the rehabilitation and/or community setting, but only FIM was examined in the acute care setting. Based on our results of quality assessment, the SCIM has the most appropriate performance regarding the instrument's psychometric properties. Nonetheless, further investigations are required to confirm the adequate performance of the SCIM as a comprehensive measure of functional recovery in patients with SCI in rehabilitative care. The expert panel of the Spinal Cord Injury Solutions Network (SCISN) that participated in the modified Delphi process endorsed these conclusions.

Functioning and disability in Parkinson's disease

Objective. To describe functioning and disability of patients with Parkinson's Disease (PD) according to the model endorsed by the International Classification of Functioning Disability and Health (ICF).Design. Adult PD patients were consecutively enrolled. The ICF checklist and the WHO Disability Assessment Schedule II (WHO-DAS II) were administered in individual sessions. Hoehn and Yahr Staging (HY) was used to define PD severity. Descriptive analyses have been performed to report on HY and WHO-DAS II scores. ICF categories reported as a problem by more than 20% of patients are described in detail.Results. Ninety-six patients with PD (mean age 64.1, 33.3% females) were enrolled, 48.4% of them were in HY class 2. WHO-DAS II mean score was 18.1 and the most severe limitations are reported in getting around and in participation to social situations. A total of 71 ICF categories reached the threshold of 20%, mostly derived from Activities and Participation domain.Conclusions. We reported information on a broad set of domains, expanding those PD-specific, such as reduced mobility. Our results are useful to define what dimensions have to be considered to expand disability assessment in patients with PD, considering both symptoms, activities and the role of environmental factors.

Validation of the World Health Organization disability assessment schedule II (WHODAS-II) in patients with osteoarthritis

The objective of this study is to test the reliability and validity of WHODAS-II (Turkish version) for the assessment of disability in patients with osteoarthritis. This study is designed as follows: the internal construct validity of WHODAS-II in patients with knee osteoarthritis was assessed by Rasch analysis, and external construct validity by association with the Western Ontario and McMaster Universities Index of Osteoarthritis (WOMAC) and the Nottingham Health Profile (NHP); reliability was tested by internal consistency, intra-class correlation coefficient (ICC) and test-retest ICC. Our study presents the results of 225 outpatients assessed with mean age 58.4 years (SD 11.1) of whom 80.9% were female. Cronbach's α, ICC, and test-retest ICC values for the six subscales of WHODAS-II varied between 0.71 and 0.94, 0.71 and 0.94, and 0.87 and 0.97, respectively. Rasch analysis of WHODAS-II indicated that after adjustment for local dependency, satisfactory fit was achieved. Two separate 'activities' and 'participation' components could also be identified. External construct validity of the scale was confirmed with expected correlations with WOMAC and NHP. This study concludes that WHODAS-II provides a reliable and valid health status instrument for measuring disability and components of 'activities' and 'participation' in patients with osteoarthritis. Thus, it provides the opportunity to model the consequences of disease according to the International Classification of Functioning, Disability and Health framework.

The Impact of Cataract Surgery questionnaire: re-evaluation using Rasch analysis

The Impact of Cataract Surgery (ICS) questionnaire was designed to assess cataract surgery outcomes. The aim of this study was to describe the psychometric properties of the ICS questionnaire using the Rasch model in a cataract population. Ninety-one patients waiting to undergo cataract surgery in the first or second eye at the Flinders Medical Centre, Adelaide, South Australia self-administered the four-item ICS questionnaire. Rasch analysis was performed to assess behaviour of response categories, ability to differentiate between participants' visual abilities (person separation; minimum acceptable 2.0), if items measure a single underlying construct [i.e. unidimensionality assessed by fit statistics and further by principal components analysis (PCA)] and matching of item difficulty to participant ability (targeting; ideal < 0.5 logits). Adequate person separation was defined as basic requirement for a measure, failing which further assessment such as PCA was not performed. The four-item ICS questionnaire did not meet the required measurement properties (person separation zero). Response categories did not behave as intended, requiring the collapsing of categories for one item (read ordinary newspaper-size print). One item misfit (estimating distance) indicating that it was not measuring the same construct as other items. However, person separation failed to improve following the deletion of this item. Targeting was -0.46 logits, indicating that the item difficulty was well suited to the visual abilities of the participants. In its present form, the ICS is unsuitable for visual disability assessment in patients awaiting cataract surgery. Other, better visual function questionnaires are available and preferred.

The Oxford hip score: the patient's perspective

BackgroundIn the last 25 years, assessment of orthopaedic intervention has become patient focused, with the development of self-completion patient-centred outcome measures. The Oxford hip score (OHS) is a joint specific outcome measure tool designed to assess disability in patients undergoing total hip replacement (THR). Although the psychometric properties of the OHS have been rigorously examined, there is little research on the patient's perspective of the OHS. Therefore, the aim of this study is to assess whether the OHS is an adequate disability measure from the patient's perspective using qualitative analysis of annotations written on the OHS by patients.MethodsIn total, 276 orthopaedic patients completed an OHS between April 2004 and May 2005. One hundred and fifty six pre-operative patients listed for a THR completed the OHS during a pre-admission assessment clinic, and 120 post-operative patients completed the OHS postally in the home setting. Patient's unprompted annotations in response to the questions on the OHS were recorded and grouped into thematic categories.ResultsIn total, 46 (17%) patients made 52 annotations when completing the OHS. These annotations identified five main areas of difficulty that patients experienced: lack of question clarity (particularly concerning the use of aids), difficulty in reporting measurements of pain, restrictive and irrelevant questions, the influence of co-morbidities on responses, and double-barrelled questions.ConclusionAlthough the OHS is a useful short tool for the assessment of disability in patients undergoing THR, this study identified several problem areas that are applicable to patient-centred outcome tools in general. To overcome these current limitations, further work is underway to develop a more individualised patient-centred outcome measure of disability for use in patients with osteoarthritis.

The reliability and validity of the Nottingham Extended Activities of Daily Living Scale in patients with multiple sclerosis.

To investigate whether the Nottingham Extended Activities of Daily Living Scale (EADL) is reliable and valid for the assessment of disability in patients with multiple sclerosis (MS). Questionnaire measures were administered on two occasions four months apart. A total of 240 patients recruited through a randomized controlled trial of cognitive assessment and treatment in MS. The Nottingham EADL, Guys Neurological Disability Scale (GNDS) and SF-36 quality of life scale. The EADL items did not form a Guttman Scale (CR 0.8, CS 0.3). The EADL and its four subscales all had high internal consistency (alpha 0.72-0.94). Test-retest reliability was satisfactory (r(s) 0.81-0.90) with a mean difference in scores on the two occasions of 0.29. Factor analysis generally supported the subscale structure. There were significant but weak correlations with quality of life measures. The EADL shows promise for the assessment of disability in MS, but the range of items needs to be extended. Further evaluation of the scale seems warranted.

The Assessment of Disability in Patients With Psychotic Disorders: An Application of the ICIDH-2

To describe the application of the International Classification of Functioning and Disability (ICIDH-2) in the assessment of disability in patients with psychotic disorders. The study was conducted at the inpatient unit of St Vincent's Mental Health Service, Melbourne. Twenty inpatients with psychotic disorders were concurrently assessed by two raters. An evaluation of the feasibility of the instrument was made during this process. Inter-rater agreement was determined using raw agreement percentages and weighted kappas. The ICIDH-2 provides a comprehensive framework for the description and measurement of disability, including the dimensions of impairments in body structures and functions, activity limitations, participation restrictions and environmental factors. Certain codes are difficult for clinicians to rate because of the subjective manner in which they are defined. Our inter-rater reliability assessment varied across the dimensions from poor to almost perfect agreement. The ICIDH-2 is potentially useful in the clinical assessment of disability in patients with psychotic disorders although modifications are needed. These could include the use of anchor points defined for each dimension or code to assist the rating process and an alternative rating scale in which categories for rating are more broadly defined. Formal training may also be necessary to enable standardization of the rating process. There is also a need to augment measurements by clinicians with the assessment of the subjective experience of patients using self-rated disability and assessment of quality of life.

The assessment of disability in patients on an acute medical ward for elderly people.

The level of independence in self-care was monitored weekly in 212 patients admitted over 6 months to an acute medical ward for elderly people, and documented on discharge using a standard assessment, the Barthel Index. At discharge from the admitting ward, 39% of patients were independent (Barthel score of 20), 36% were mildly dependent (Barthel 15-19), 15% were moderately dependent (Barthel 10-14), 4% severely dependent (Barthel 5-9) and 6% very severely dependent (Barthel 0-4). Approximately 80% were able to transfer, walk, were continent of urine and could wash their top half, but one-third were unable to dress or use the toilet independently. Over half were unable to bath themselves or climb stairs unaided. It is feasible to assess disability in a busy acute service this way. Information can be provided both to community services on discharge of individual patients, and to managers responsible for planning services for elderly people.

Determinants of vocational disability in patients with low back pain.

Eighty-seven unemployed subjects with low back pain were recruited from an orthopedic back pain clinic and were given a battery of physical and psychologic tests. Subjects were contacted six months later to determine their current compensation status and whether they had returned to work. Age, length of time out of work, how much they had lifted in their previous job, the number of weeks they had been compensated, current activity levels, leg pain, and various psychologic factors significantly differentiated those who worked from those who did not. Physical examination findings and testing of the ability to lift were not significantly related to return to work. It is suggested that demographic, job-related, and psychologic factors should be emphasized, rather than only physical capacity, in the evaluation of vocational potential and the assessment of disability in patients with low back pain.