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ABSTRACT: People with spondyloarthritis (SpA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) have identified the importance of understanding how their disease and its treatment impacts on their social roles. This requires a reliable and valid standardised measure, and this study evaluates these measurement properties of the Social Role Participation Questionnaire (SRPQ).
109 participants (44 with AS, 65 with PsA) completed questionnaires on demographics, participation measures (SRPQ, Keele Assessment of Participation (KAP), Late Life Disability Instrument (LLDI)), disease severity (physician global) and activity (pain, fatigue, Bath Ankylosing Spondylitis Disease Activity Index), psychological measures (depressive symptoms (Hospital Anxiety and Depression Scale), Illness Intrusiveness)) and function (Health Assessment Questionnaire, Bath Ankylosing Spondylitis Functional Index). After testing scaling properties, test-retest reliability of the SRPQ was evaluated using intraclass correlation coefficients (ICC) and hypotheses of construct validity were evaluated using correlation coefficients.
Patients with AS had a mean age of 40 years and 65% were male, whereas patients with PsA had a mean age of 53 years and 63% were male. Although there were some differences between AS and PsA participants in their social role participation, scaling properties were good for both groups. ICCs were >0.90 for the satisfaction subscales of the SRPQ. For construct validity, SRPQ satisfaction subscales were moderately correlated with the KAP and LLDI (0.64-0.78), and less satisfaction was associated with higher disease severity and activity, more depressive symptoms, more illness intrusiveness and more disability (coefficients -0.67 to -0.88).
Social role participation is an important concept for people with SpA, and the SRPQ is a reliable and valid measure for use with people with AS and PsA.
Annals of the rheumatic diseases 07/2011; 70(10):1765-9. · 8.11 Impact Factor
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ABSTRACT: Symptoms and functional limitations are commonly reported primary outcome measures in ankylosing spondylitis (AS); however, participation has not been widely evaluated, as reflected by the scarcity of literature on the subject. People with AS suggest that participation in social roles (e.g. employment, leisure, and relationships with others) is a critical outcome that is often adversely affected by the sequelae of the disease and by the demands of managing them. Confusion surrounding the concept of 'social role participation' has presented difficulties in defining, developing and using participation as an outcome measure. Specifically, distinguishing participation in a social role from the performance of activities that might be associated with that role is critical for measuring participation, as the repertoire of associated activities will vary between individuals. Furthermore, considering which roles are important to individuals and evaluating their satisfaction with participating in a role at the times and in the ways they would like are also key elements of this measurement. Participation as an outcome measure takes on increased importance in diseases such as AS where, in the absence of a cure, the benefits of interventions often arise from improvements to patients' quality of life. Participation is a predictor of quality of life in diseases other than AS; therefore, evaluating social role participation, understanding the factors that affect it, and intervening to prevent or alleviate participation restrictions will be critical for people with AS.
Nature Clinical Practice Rheumatology 02/2009; 5(1):46-51. · 5.85 Impact Factor
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ABSTRACT: To evaluate outcome expectations of patients undergoing revision total knee replacement (TKR) and to examine personal factors, patient functioning, previous experiences with knee replacement surgery, concerns about surgery, and general health as predictors of expectations.
Revision TKR patients (n = 184, 54% women; mean age 69 years) completed a questionnaire up to 2 weeks before surgery. This included demographics, experience with previous knee surgery, concerns about surgery, the Life Orientation Test (LOT), the Arthritis Helplessness Scale, the Western Ontario and McMaster Universities Osteoarthritis Index, and a rating of overall health. Outcome expectations were evaluated as 5 questions assessing global benefit; relief of pain; ease of disability; expectations of having complications; and whether the person expected to be fully recovered from surgery in <6 months, 6-12 months, >12 months, or did not expect to recover. Predictors of each of the 5 outcome expectations were evaluated using univariable and multivariable regression analyses.
Expectations are a multidimensional construct (Cronbach's alpha = 0.63). Expectation of global benefit of surgery was high, but was lower for benefits related to ease of pain and improved function. Concerns about surgery were a consistent predictor of all expectation outcomes in multivariable modeling. When concerns about surgery and general health were entered into the model as an interaction with expectation of recovery time as the outcome, past experience (P = 0.05), pain (P = 0.03), LOT (P = 0.03), and interaction between concerns about surgery and general health were significant predictors.
Clinicians need to understand and help patients shape appropriate expectations for recovery from revision TKR.
Arthritis & Rheumatism 05/2006; 55(2):314-21. · 7.87 Impact Factor
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ABSTRACT: We examined how perceived need for workplace accommodation affects labor-force participation in people with disabilities. We analyzed a Canadian survey with structural equation modeling to test a model incorporating activity limitations and perceived need for workplace accommodations. The results suggested that the effect of upper- and lower-body activity limitation on labor-force participation was mediated by perceived need for workplace accommodations. Thus, the provision of adequate workplace accommodations could enhance labor-force participation in people with disabilities.
American Journal of Public Health 10/2004; 94(9):1515-8. · 3.93 Impact Factor