Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA.
Division of Rheumatology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Rheumatol Int. 2020 Feb;40(2):273-282. doi: 10.1007/s00296-019-04368-8. Epub 2019 Jul 12.
The objective of this study is to assess the impact of inflammatory arthritis on young adults' activity participation using quantitative and qualitative methods to advance the field's conceptualization of functional status. Young adults diagnosed with juvenile idiopathic arthritis or rheumatoid arthritis completed (1) the Health Assessment Questionnaire-Disability Index to determine functional status and (2) the day reconstruction method to explore experiential dimensions of function, including functional performance, functional satisfaction, and severity of arthritis symptoms during activities on the previous day. Bivariate analyses were conducted to examine relationships between functional status, experiential variables, and demographic variables. Open-ended questions were provided for participants to report ways that arthritis affected their participation that were not otherwise reflected within survey questions; responses were numerically coded using summative content analysis. Among 37 participants (24.8 ± 3.3 years old), 70% reported moderate-to-severe disability. On average, participants experienced pain, stiffness, or fatigue for more than 50% of their waking hours. Functional status significantly correlated with functional performance (r = - 0.39, p = 0.02) and satisfaction (r = - 0.39, p = 0.02), yet did not correlate with stiffness or fatigue severity or duration of symptoms throughout the day. Participants described strategies that improved their ability to participate in certain activities but reduced their overall quality of activity engagement and caused emotional distress. Young adults with arthritis may experience more significant functional limitations than previously reported. Traditional measures of functional assessment may not capture experiential components of activity that affect participation, such as severity of stiffness or fatigue or the duration of symptoms throughout the day.
本研究旨在使用定量和定性方法评估炎症性关节炎对年轻成年人活动参与的影响，以推进该领域对功能状态的概念化。年轻的成年人被诊断患有幼年特发性关节炎或类风湿性关节炎，他们完成了以下两项任务：（1）使用健康评估问卷残疾指数来确定功能状态；（2）使用日间重建方法来探索功能的体验维度，包括前一天活动中的功能表现、功能满意度和关节炎症状的严重程度。进行了双变量分析，以研究功能状态、体验变量和人口统计学变量之间的关系。为参与者提供了开放式问题，以便报告关节炎影响他们参与的方式，这些方式在调查问题中没有反映出来；使用总结性内容分析对回答进行数字编码。在 37 名参与者（24.8±3.3 岁）中，70%的人报告有中度至重度残疾。平均而言，参与者经历疼痛、僵硬或疲劳超过其清醒时间的 50%。功能状态与功能表现（r=−0.39，p=0.02）和满意度（r=−0.39，p=0.02）显著相关，但与僵硬或疲劳严重程度或全天症状持续时间无关。参与者描述了一些策略，这些策略提高了他们参与某些活动的能力，但降低了他们整体活动参与质量，并导致了情绪困扰。患有关节炎的年轻人可能经历比以前报告的更显著的功能限制。传统的功能评估方法可能无法捕捉到影响参与的活动体验成分，例如僵硬或疲劳的严重程度或全天症状的持续时间。
