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  • 1
    ISSN: 0340-1855
    Keywords: Schlüsselwörter Chronische Polyarthritis ; Health Assessment Questionnaire Disability Index ; deutsche Version ; Funktionsfragebogen Hannover ; Key words Rheumatoid arthritis ; Health Assessment Questionnaire Disability Index ; German version ; Hannover Functional Ability Questionnaire
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Zielsetzung: Ziel der Studie war die Übersetzung und die Validierung einer deutschen Version des Health Assessment Questionnaire Disability Index (HAQ) und der Vergleich seiner psychometrischen Eigenschaften mit der Version-P und der Version-PR des Funktionsfragebogens Hannover. Methoden: Nach der Übersetzung wurde die Test-Retest-Reliabilität bei 32 ambulanten Patienten der Abteilung Rheumatologie der Medizinischen Hochschule Hannover mit Hilfe der Pearson-Korrelation überprüft. Eine Woche nach der ersten Beantwortung wurde den Patienten der Fragebogen erneut zugesandt. Zur Validierung wurden 110 stationären Patienten in 3 verschiedenen Kliniken vorgelegt. Alle Patienten erfüllten die Kriterien des American College of Rheumatology von 1987 oder die Rom-Kriterien der inaktiven chronischen Polyarthritis (cP). Zur Beurteilung der Kriteriumsvalidität zogen wir den Keitel-Funktionstest (KFT) und die modifizierte Steinbrocker-Klassifikation (mSK) der funktionellen Behinderung heran. Die interne Konsistenz wurde mit Hilfe des Cronbach Koeffizienten Alpha (CKA) bestimmt. Zur Erfassung der Konstruktvalidität wurden die HAQ- und FFbH-Scores mit verschiedenen klinischen und laborchemischen Variablen verglichen und zur Aufklärung der Varianz multiple Regressionen berechnet. Ergebnisse: Die Test-Retest-Reliabilität des HAQ betrug r=0,94. Es zeigte sich ein CKA von 0,91 (HAQ), 0,90 (FFbH-P) und 0,93 (FFbH-PR). Im Vergleich zum KFT ergab sich ein Korrelationskoeffizient von r=–0,73 (HAQ), r=+0,74 (FFbH-P) und r=+0,71 (FFbH-PR) im Vergleich zur mSK ein r=+0,75 (HAQ), r=–0,72 (FFbH-P) und r= –0,70 (FFbH-PR). Der Korrelationskoeffizient des HAQ/FFbH-P betrug r=–0,87 bzw. r=–0,88 beim HAQ/FFbH-PR. Die Korrelationen zwischen den klinischen und laborchemischen Parametern reichten von r=±0,58 (Schmerz/HAQ) bis r=±0,11 (Anzahl der geschwollenen Gelenke/FFbH-PR). In multiplen, rückwärtsgerichteten Regressionsanalysen fanden sich r2-Werte von 0,64 (HAQ), 0,61 (FFbH-P) und 0,59 (FFbH-PR). Der Schmerz erklärte etwa 1/3 und die Bewegungseinschränkung 16–21% der Varianz. Schlußfolgerung: Die hier vorgestellte deutsche Version des HAQ und die zwei verschiedenen Versionen des FFbH erwiesen sich als reliable und valide Instrumente zur Messung der funktionellen Behinderung in einem deutschsprachigen Patientenkollektiv mit cP. Das mit dem HAQ und den beiden Versionen des FFbH gemessene Konstrukt zeigte eine hohe Übereinstimmung.
    Notes: Summary Objective: To translate the Health Assessment Questionnaire Disability Index (HAQ) into a German version, to validate and to compare its properties with two different versions of the Hannover Functional Ability Questionnaire (HFAQ) in a German speaking population. Methods: The test-retest reliability was tested by Pearson correlation in 32 outpatients of the Department of Rheumatology of the Medizinische Hochschule Hannover. For retesting, the questionnaire was mailed to them 1 week later. To validate the questionnaire it was administered to 110 inpatients in three different hospitals. All patients fulfilled the American College of Rheumatology 1987 revised criteria of rheumatoid arthritis (RA) or the Rome criteria of definitive inactive RA. The internal consistency was measured by Cronbach‘s coefficient alpha (CCA). To assess criterion validity we compared the HAQ and the two versions of the HFAQ with Keitel‘s test (KT) and the modified Steinbrocker classification (mSC). Construct validity was assessed by comparing these instruments with different clinical and laboratory variables. A multivariate analysis was used to identify the most important factors that are influencing the HAQ- and HFAQ-scores. Results: Test-retest reliability of the HAQ was r=0.94. CCA was 0.91 (HAQ), 0.90 (HFAQ-P) and 0.93 (HFAQ-PR). The KT Pearson correlation coefficients reached r=–0.73 (HAQ), r=+0.74 (HFAQ-P) and r=+0.71 (HFAQ-PR). The mSC correlated r=+0.75 (HAQ), r=–0.72 (HFAQ-P) and r=–0.70 (HFAQ-PR). The correlation coefficients of HAQ/HFAQ-P was r=–0.87 and of HAQ/HFAQ-PR r=–0.88. The correlations between other clinical and laboratory variables reached from r=±0,58 (pain/HAQ) to r=±0,11 (number of swollen joints/HFAQ-PR). In backward multiple regression analysis 59–64% of the variance of disability measured by the questionnaires was explained predominantly by pain (32–33%) and by range of motion (16–21%). Conclusion: The German version of the HAQ presented here and the two versions of the HFAQ are reliable and valid instruments for measuring functional disability in a German-speaking population with RA. The construct measured by the HAQ and both versions of the HFAQ showed a high degree of correspondence.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Zeitschrift für Rheumatologie 57 (1998), S. 248-250 
    ISSN: 0340-1855
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 0340-1855
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 0340-1855
    Keywords: Schlüsselwörter Gelenkschwellung – Allgemeinmediziner –¶Rheumatologe –Überweisung ; Key words Joint swelling –¶general practitioner –¶rheumatologist – referral
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The guideline “Joint Swelling” is addressed to primary care physicians – general practitioners, internists or orthopedists without special experience in rheumatology. It provides a framework for interviewing patients, as well as for physical, laboratory and imaging examinations and for selection of treatment appropriate to the level of primary care. Situations which call for urgent evaluation and criteria for referral to rheumatologists are described. The appendix contains comments on signs and symptoms to differentiate arthralgia from joint swelling and on the diagnostic value of a history of joint swelling without confirmation by the physician. Further recommendations for the evaluation of patient history and physical and technical examinations are given in a tabular form. The significance of laboratory and imaging procedures is discussed.
    Notes: Zusammenfassung Die Leitlinie „Gelenkschwellung” richtet sich an den Hausarzt – Allgemeinarzt oder hausärztlicher Internist – sowie an den nicht spezialisierten Orthopäden. Sie beschreibt die Anamnese, die problemorientierte klinische Untersuchung, die labormedizinische und bildgebende Diagnostik sowie therapeutische Maßnahmen, die auf der primärärztlichen Ebene einzuleiten sind. Situationen, die sofortiger Abklärung bedürfen und Überweisungsindikationen zum Spezialarzt werden genannt. Der Anhang enthält Erläuterungen zur Differenzierung der Symptome von Gelenkschmerz und Gelenkschwellung, zur Wertigkeit der anamnestischen Angabe einer früheren Gelenkschwellung ohne Nachweis durch den Arzt und zu Gelenkschwellungen aus mechanischer Ursache. In tabellarischer Form werden nähere Hinweise zur Anamnese und Untersuchung gegeben und die Bedeutung der labormedizischen und bildgebenden Diagnostik diskutiert.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Clinical rheumatology 6 (1987), S. 20-25 
    ISSN: 1434-9949
    Keywords: Rheumatoid Arthritis ; Inception Cohort ; Prospective Study ; Work Situation ; Depression ; Anxiety
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Seventy-five patients with an early RA (disease duration between 2 and 12 months; 79% female; average age 49 years; 72% with “definite” RA) were followed in a prospective study over a period of 2 years. Within this 24 month observation period there was a drop in the average diagnostic ARA count from 5.0 to 4.2, in the ESR from 48 to 31 mm within the first hour and also in the number of affected joints from 13 to 9. Pain intensity and functional capacity showed a slight decrease in the average score. Despite a consistent antirheumatic therapy (72% on RID's after one year) there was a noticeable increase from 23 to 58% in the prevalence of patients with any erosive changes in the X-ray. Within the two years of this study one third of the patients employed at the onset had to quit their job. The number of patients retired due to RA rose from 0 to 23%. A comparison of two groups of patients (employed versus retired) revealed no significant differences in the initial examination with one exception: The patients eventually retired by the end of the study were significantly older with an average age of 51 versus 39 in the group of still employed patients. On the other hand, by the end of the study the patients remaining employed for the duration of the 2 years were significantly less active and also less severely diseased and handicapped. The number of patients with clinically relevant depression (BDI) or anxiety (STAI) did not change significantly over the 24 month period. The prevalence rates showed a maximum of 30 and 37% respectively. Both characteristics demonstrate a high intraindividual stability. The linear correlation between the depression scores at month 0 and 24 revealed an rtt of 0.52 (0.53 for anxiety). Despite substantial changes in the somatic and social state the extent of the mental suffering remained approximately the same for the whole group as well as intraindividually.
    Type of Medium: Electronic Resource
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