Katz Patricia
Department of Medicine, Division of Rheumatology and Institute for Health Policy Studies, University of California, San Francisco, San Francisco, Calif. 94143-0920, USA.
Adv Psychosom Med. 2004;25:41-62. doi: 10.1159/000079057.
Disability research in arthritis, as in disability research in general, has focused on functional limitations and activities of daily living/instrumental activities of daily living (ADL/IADL) disability, and has thus ignored a great deal of daily life. Unfortunately, the areas of life that have been ignored may be those that are most important to individuals, and may also be the most sensitive to the first signs of developing disability. The ability to perform valued life activities, the wide range of activities that individuals find meaningful or pleasurable above and beyond activities that are necessary for survival or self-sufficiency, has strong links to psychological well-being--in some cases, stronger links than functional limitations and disability in basic activities of daily living. A broader assessment of disability has great potential for interrupting the disablement and distress process, thereby improving the quality of life of individuals with arthritis. Assessment of the effects of arthritis, pain, or other chronic health conditions should expand beyond assessment of functional limitations and disability in basic activities to include assessment of disability in advanced, valued activities.
与一般残疾研究一样，关节炎领域的残疾研究一直专注于功能限制以及日常生活活动/工具性日常生活活动（ADL/IADL）残疾，因此忽略了大量的日常生活。不幸的是，被忽略的生活领域可能是对个人最重要的领域，也可能是对残疾发展的最初迹象最敏感的领域。进行有价值的生活活动的能力，即个人认为有意义或愉快的广泛活动，这些活动超出了生存或自给自足所需的活动，与心理健康有紧密联系——在某些情况下，这种联系比基本日常生活活动中的功能限制和残疾更为紧密。对残疾进行更广泛的评估具有极大潜力来中断致残和痛苦过程，从而改善关节炎患者的生活质量。对关节炎、疼痛或其他慢性健康状况影响的评估应从对基本活动中的功能限制和残疾评估扩展到包括对高级、有价值活动中的残疾评估。
