Botha-Scheepers S, Riyazi N, Kroon H M, Scharloo M, Houwing-Duistermaat J J, Slagboom E, Rosendaal F R, Breedveld F C, Kloppenburg M
Departments of Rheumatology, Leiden University Medical Center, The Netherlands.
Osteoarthritis Cartilage. 2006 Nov;14(11):1104-10. doi: 10.1016/j.joca.2006.04.011. Epub 2006 Jun 5.
Using the International Classification of Functioning, Disability and Health as framework, we evaluated modifying effects of illness perceptions and mental health on the association between impairments in body structures and functions due to osteoarthritis (OA) and limitation in activities in the lower extremities.
Self-reported limitation in activities was assessed by the Western Ontario and McMaster Universities OA index (WOMAC) function subscale in 316 patients with knee or hip pain or evidence of OA on knee or hip radiographs. Body structures and functions were evaluated during clinical and radiological assessments. Illness perceptions and mental health were assessed with the revised Illness Perception Questionnaire (IPQ-R) and the mental component summary score of the RAND 36-item Health Survey, respectively. For each patient an expected WOMAC function score was calculated, using an equation based on a multivariate model of the association of body structures and functions with limitation in activities.
The median (interquartile) self-reported WOMAC function score was 22.2 (9.6-43.5). Ninety-one patients reported more and 120 patients reported less limitation in activities than expected. Patients with lumbar spine degeneration, physical or exercise therapy and high IPQ-R identity, consequences and chronic timeline scores had an increased risk to report more limitation in activities than the expected range. Low IPQ-R identity, consequences and emotional representation scores and better mental health were associated with reporting less limitation in activities than the expected range.
Illness perceptions and mental health modify the association between self-reported limitation in activities and calculated limitation in activities based on impairments in body structures and functions due to OA.
以《国际功能、残疾和健康分类》为框架，我们评估了疾病认知和心理健康对骨关节炎（OA）所致身体结构和功能损伤与下肢活动受限之间关联的调节作用。
采用西安大略和麦克马斯特大学骨关节炎指数（WOMAC）功能子量表，对316例膝关节或髋关节疼痛患者或膝关节或髋关节X线片有OA证据的患者进行自我报告的活动受限评估。在临床和放射学评估期间对身体结构和功能进行评估。分别使用修订后的疾病认知问卷（IPQ-R）和兰德36项健康调查的心理成分汇总得分评估疾病认知和心理健康。对于每位患者，使用基于身体结构和功能与活动受限关联的多变量模型的方程计算预期的WOMAC功能得分。
自我报告的WOMAC功能得分中位数（四分位间距）为22.2（9.6 - 43.5）。91例患者报告的活动受限比预期更多，120例患者报告的活动受限比预期更少。腰椎退变、接受物理或运动治疗以及IPQ-R的认同、后果和慢性时间线得分较高的患者报告活动受限超出预期范围的风险增加。IPQ-R的认同、后果和情感表征得分较低以及心理健康状况较好与报告的活动受限低于预期范围相关。
疾病认知和心理健康调节了自我报告的活动受限与基于OA所致身体结构和功能损伤计算出的活动受限之间的关联。
