Assessment of patient satisfaction in activities of daily living using a modified Stanford Health Assessment Questionnaire.
ABSTRACT Patient satisfaction in performing activities of daily living (ADL) was assessed by using a self-administered questionnaire modified from the Stanford Health Assessment Questionnaire (HAQ). The HAQ includes questions to determine a patient's degree of difficulty and need for help and assistive devices in ADL. A modification of the HAQ (MHAQ) was developed to include questions concerning perceived patient satisfaction regarding the same ADL, along with perceived change in degree of difficulty. In order to add additional questions while maintaining the length of the questionnaire in a format suitable in routine care, the number of ADL included in the MHAQ was reduced from 20 to 8. Information regarding degree of difficulty derived from 8 questions in the MHAQ is comparable with that derived from 20 questions in the HAQ. The response of a patient that a specific activity is associated with difficulty in functional capacity was not inevitably associated with the absence of patient satisfaction; 43.7% of patients responding "with some difficulty" and 19.1% of patients responding "with much difficulty" expressed satisfaction with their functional capacity. A major determinant of expression of patient satisfaction was perceived change in difficulty: 81.4% of patients noting that their function was "less difficult now," in contrast to 16.9% of patients responding "more difficult now," expressed satisfaction. These studies suggest that data regarding patient satisfaction and perceived change in difficulty can be assessed to more completely characterize patients' functional status in ADL.
- Official journal of the South African Academy of Family Practice/Primary Care 08/2014; 51(1):42-45.
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ABSTRACT: Introduction: Hepatitis C virus (HCV) is frequently associated with rheumatic autoim-mune manifestations including rheumatoid-like arthritis. Aim of the work: This work is aimed to study the impact of concomitant HCV infection on rheu-matoid arthritis (RA) patients. Patients and methods: 110 RA patients (mean age 44.6 ± 12.7, disease duration 7.92 ± 6.56 years) were included. HCV infection was diagnosed by HCV-antibody (HCV-Ab) and poly-merase chain reaction. Disease activity was assessed using the disease activity score 28 (DAS28) and radiological damage by a modified Larsen method. Functional disability was assessed by the Modified Health Assessment Questionnaire (MHAQ). Results: HCV-Ab was detected in 20% and viremia in 12.7% of RA patients. HCV-Ab positive patients were significantly older (p < 0.001) and had a longer disease duration (p = 0.02). No dif-ferences were found between HCV-Ab positive and -negative patients in DAS28 and modified Lar-sen's scores, however, HCV-Ab positive patients had a higher frequency of deformities (p < 0.005) associated with older age (p < 0.001) and higher MHAQ scores (p = 0.002), independent of age and disease duration. They also had a higher frequency of hepatomegaly (p < 0.001) and vasculitis (p < 0.001). Hepatomegaly was associated with older age (p = 0.004) and longer disease duration (p = 0.003) while vasculitis was associated with older age (p = 0.02). Conclusion: Concomitant HCV infection in RA patients is associated with significant disability and comorbidities in the form of hepatomegaly and vasculitis. Hepatomegaly and vasculitis were associated with older age. Hepatomegaly was also associated with longer disease duration. Screen-ing for HCV infection is recommended in Egyptian RA patients. Ó 2011 Egyptian Society for Joint Diseases and Arthritis. Production and hosting by Elsevier B.V. All rights reserved.World Pumps 05/2011; 33:139-145.
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ABSTRACT: Objective: Fibromyalgia (FM) is a disease that causes widespread pain and increased sensitivity to pain because of a dysfunction in the central nervous system. This study investigated the effect of music combined with vibration on acupuncture points for the treatment of FM. Methods: A total of 120 patients with FM were allocated randomly to four groups (30 patients each). One group listened to a sequence of Bach's compositions. The second group was subjected to vibratory stimuli on a combination of acupuncture points on the skin. The third group (complete) underwent both procedures in a simultaneous and synchronized manner, with inclusion of binaural beats. The fourth group (control) received no stimulation. The participants underwent the experimental procedure during five sessions performed on alternate days. They were assessed by the Fibromyalgia Impact Questionnaire (FIQ) and the Health Assessment Questionnaire (HAQ) before the first session and after the last session (20 days). Results: All groups showed a significant improvement in FIQ and HAQ scores at the evaluation after the intervention. The complete group exhibited the best result on both the FIQ and HAQ (p<0.001), and the improvement in HAQ score was significant (p<0.004). Conclusions: The results suggest that the placebo effect in FM may be substantial. However, comparison between groups revealed that the complete group had the greatest reduction in both FIQ and HAQ, with a significant improvement in HAQ, suggesting that the combined use of music and vibration exerts a greater effect on FM symptoms.Journal of alternative and complementary medicine (New York, N.Y.) 01/2015; · 1.69 Impact Factor