Assessment of patient satisfaction in ADL using a modified Stanford Health Assessment Questionnaire
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.
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- "Demographic data and disease history taking regarding onset, duration, course, progression and associated diseases were obtained from all patients. Number of painful and swollen joints (28 joints) and visual analogue scale (VAS) of pain (ranged from 0-10; 0 means there is no pain, 10 means that it is the worst possible pain patient had felt) were evaluated and disability was assessed according to the Modified Health Assessment Questionnaire (MHAQ). Disease activity was assessed with disease activity score in 28 joints (DAS28). "
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ABSTRACT: This study was designed to measure the serum level of matrix metalloproteinase-3 (MMP-3) in rheumatoid arthritis (RA) patients and its correlation with functional status, disease activity and joint damage.
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- "The mHAQ is calculated as the average of the single scores. To do that the following scoring is applied: without difficulty = 0, with some difficulty = 1, with much difficulty = 2, unable to do = 3, Values <0.3 are considered normal (Pincus et al 1983). "
- "The MHAQ includes questions to determine a patient's degree of difficulty and need for help and assistive devices in ADL. The patients answer if they have difficulty performing ADL from 0 = no difficulty; 1 = some difficulty; 2 = much difficulty, and 4 = unable to do (Pincus et al. 1983). "
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ABSTRACT: Rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA) are inflammatory diseases which involve increased risk of cardiovascular disease (CVD). High intensity interval training (HIIT) is known to be effective in improving cardiovascular health. The aim of this study was to investigate whether 10 weeks of HIIT at 85-95 % of HRmax would improve important risk factors of CVD in rheumatic patients, and if these patients would tolerate exercise intensities above today's recommendations.
Seven women with RA and eleven with adult-JIA, 20-50 years, were recruited to this cross-over study. Participants performed HIIT, consisting of 4 × 4 min intervals at 85-95 % of HRmax twice a week for 10 weeks on spinning bikes. Maximal oxygen uptake (VO2max), heart rate recovery, blood pressure, body composition, and blood variables were measured before and after the exercise and control period. Disease activity was determined and questionnaire data were collected.
HIIT resulted in 12.2 % increase in VO2max and 2.9 % improvement in heart rate recovery (p < 0.05). BMI, body fat, and waist circumference decreased 1.2, 1.0, and 1.6 %, respectively, whereas muscle mass increased 0.6 % (p < 0.05). A trend toward decreased CRP was detected after HIIT (p = 0.08). No changes were detected in disease activity or pain.
Despite rigorous high intensity exercise, no increase was detected in disease activity or pain, indicating that HIIT was well tolerated by these patients. Furthermore, HIIT had positive effects on several CVD risk factors. In light of this pilot study, HIIT seems like a promising non-pharmacological treatment strategy for patients with RA and adult-JIA.
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