Pollard Beth, Dixon Diane, Johnston Marie
Aberdeen Health Psychology Group, University of Aberdeen , Aberdeen , UK and.
Disabil Rehabil. 2014;36(17):1445-51. doi: 10.3109/09638288.2013.847123. Epub 2013 Oct 29.
Abstract Purpose: The aim of the study was to explore if the impact of osteoarthritis varies with respect to age, gender and social deprivation. Impact was defined as impairment, activity limitations and participation restriction (International Classification of Functioning, Disability and Health (ICF)). Investigating the functioning of the ICF model for subgroups is important both practically and theoretically.
The sample comprised a community sample of 763 people diagnosed with osteoarthritis. Uncontaminated measures of the ICF constructs were developed using discriminant content validity from a pool of 134 items, including the WOMAC and SF-36. Multigroup Structural Equation Modelling was used to explore if the same pathways exist for subgroups of gender, age and social deprivation.
Different significant paths were found for gender and social deprivation: impairment did not predict participation restriction for women and those most deprived, whereas these paths were significant for men and those less deprived. No difference in the paths was found for age.
The impact of osteoarthritis appears to vary with respect to gender and social deprivation but not age. This suggests both that osteoarthritis per se does not adequately explain the health outcomes observed and that different clinical approaches may be appropriate for people of different gender and levels of deprivation. Implications of Rehabilitation The ICF model appears to vary with respect to gender and social deprivation for people with osteoarthritis. The ICF model did not appear to vary with respect to age for people with osteoarthritis. Different treatments and interventions for osteoarthritis may need to be targeted for specific gender and social deprivation groups.
摘要目的:本研究旨在探讨骨关节炎的影响是否因年龄、性别和社会剥夺程度而异。影响被定义为损伤、活动受限和参与限制(《国际功能、残疾和健康分类》(ICF))。研究ICF模型在亚组中的功能在实践和理论上都很重要。
样本包括763名被诊断患有骨关节炎的社区居民。使用从134个项目(包括WOMAC和SF - 36)中筛选出的具有判别内容效度的项目,开发了ICF结构的无污染测量方法。采用多组结构方程模型来探讨性别、年龄和社会剥夺亚组是否存在相同的路径。
在性别和社会剥夺方面发现了不同的显著路径:损伤对女性和最贫困者的参与限制没有预测作用,而这些路径对男性和较不贫困者具有显著性。在年龄方面未发现路径差异。
骨关节炎的影响似乎因性别和社会剥夺程度而异,但与年龄无关。这表明骨关节炎本身并不能充分解释所观察到的健康结果,并且不同的临床方法可能适用于不同性别和贫困程度的人群。康复的意义ICF模型对于骨关节炎患者在性别和社会剥夺方面似乎有所不同。ICF模型对于骨关节炎患者在年龄方面似乎没有差异。针对骨关节炎的不同治疗和干预可能需要针对特定的性别和社会剥夺群体。