Bala Sidona-Valentina, Andersson Maria L E, Forslind Kristina, Svensson Björn, Hafström Ingiäld
Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
Department of Medicine, Section of Rheumatology, Helsingborg's Hospital, Helsingborgs lasarett, Olympiahuset plan 2, S-251 87, Helsingborg, Sweden.
BMC Rheumatol. 2021 May 3;5(1):13. doi: 10.1186/s41927-021-00184-5.
The self-reported Health Assessment Questionnaire (HAQ) is specifically designed to assess disability in arthritic patients. In many studies women report higher functional disability than men. The reasons for this difference are suggested to be multifactorial. We therefore evaluated functional disability assessed by HAQ in women and men with rheumatoid arthritis (RA) in relation to observed disability, grip force and physical function.
Patients with RA, 51 women and 49 men, completed the HAQ on three occasions, some weeks apart. Between HAQ1 and HAQ2, all patients performed 17 of the 20 activities (7 domains) included in the HAQ under observation in a specially designed environment, the observed HAQ. During the same day, grip force, measured by GRIPPIT and physical function assessed by the SOFI (Signals of Functional Impairment) index were evaluated. Differences between groups were studied by the chi-square test, Mann-Whitney U test and Wilcoxon Sign Rank test. Correlations were analysed by Spearman rank correlation. Comparisons between repeated measures were performed using Friedman's test.
Median (IQR) total HAQ1 score was 0.50 (0.88) for women and 0.25 (0.84) for men, p = 0.038, and the observed HAQ score (7 domains) 0.57 (0.9) for women and 0.43 (0.96) for men, p = 0.292. The correlations between reported HAQ1 score (7 domains) and observed HAQ score were strong, r = 0.860, p < 0.001 in women, and r = 0.820, p < 0.001 in men. For some activities the patients, both women and men, reported lower difficulty than that observed. Women had lower grip force than men, median (IQR), right and left 126 (84) Newton, versus 238 (146), p < 0.001, and there was a negative correlation between grip force and most of the separate activities in HAQ in both genders. SOFI index was similar in women and men, median (IQR) 0 (3.0) versus 0 (2.0), p = 0.277, with a moderate correlation to HAQ.
The results indicate that in well-treated patients with RA the correlations between reported and observed HAQ scores were strong, similarly in women and men. We found no evidence that the patient's opinion was dependent on unawareness of her/his own ability.
自我报告的健康评估问卷（HAQ）专门用于评估关节炎患者的残疾情况。在许多研究中，女性报告的功能残疾程度高于男性。这种差异的原因被认为是多因素的。因此，我们评估了类风湿关节炎（RA）女性和男性通过HAQ评估的功能残疾与观察到的残疾、握力和身体功能之间的关系。
51名女性和49名男性RA患者在相隔数周的三个时间点完成了HAQ。在HAQ1和HAQ2之间，所有患者在一个专门设计的环境（观察到的HAQ）中进行了HAQ所包含的20项活动（7个领域）中的17项活动的观察。在同一天，评估了通过GRIPPIT测量的握力和通过SOFI（功能损害信号）指数评估的身体功能。通过卡方检验、曼-惠特尼U检验和威尔科克森符号秩检验研究组间差异。通过斯皮尔曼等级相关性分析相关性。使用弗里德曼检验进行重复测量之间的比较。
女性HAQ1总分中位数（IQR）为0.50（0.88），男性为0.25（0.84），p = 0.038；观察到的HAQ评分（7个领域）女性为0.57（0.9），男性为0.43（0.96），p = 0.292。报告的HAQ1评分（7个领域）与观察到的HAQ评分之间的相关性很强，女性中r = 0.860，p < 0.001，男性中r = 0.820，p < 0.001。对于某些活动患者，无论男女，报告的难度都低于观察到的难度。女性的握力低于男性，中位数（IQR），左右分别为126（84）牛顿，而男性为238（146），p < 0.001，并且握力与两性HAQ中大多数单独活动之间存在负相关。女性和男性的SOFI指数相似，中位数（IQR）为0（3.0），而男性为0（2.0），p = 0.277，与HAQ有中度相关性。
结果表明，在接受良好治疗的RA患者中，报告的和观察到的HAQ评分之间的相关性很强，男女情况相似。我们没有发现证据表明患者的意见取决于对自身能力的不了解。
