RESEARCH - Prevalence and predictors of disability in valued life activities among individuals with RA

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Ann Rheum Dis. 2006 Jun;65(6):763-9. Epub 2005 Oct 25.

Prevalence and predictors of disability in valued life activities among

individuals with rheumatoid arthritis.

Katz PP, A, Yelin EH.

University of California, San Franciso, Department of Medicine, San

Francisco, CA, USA. patti.katz@...

OBJECTIVE: To identify the prevalence of disability in a wide range of life

activities and identify factors associated with such disability using the

Verbrugge and Jette disablement model as a framework. METHODS: Data were

from a panel study of 548 individuals with rheumatoid arthritis, interviewed

annually by telephone. Valued life activity (VLA) disability was assessed

using a 26-item scale rating difficulty in carrying out each activity. Three

types of summary measure were calculated: activities unable to perform,

activities affected, and mean difficulty. Subscale scores were also

calculated, corresponding to obligatory, committed, and discretionary

activities, as defined in the disablement model. Disease status measures

were examined as predictors of VLA disability using multiple regression

analyses. RESULTS: Half the subjects were unable to do at least one VLA.

Approximately 2%, 31.3%, and 40.2% were unable to do at least one

obligatory, committed, and discretionary activity, respectively. Almost all

(95%) reported at least one VLA affected by rheumatoid arthritis; 68.4%,

91.4%, and 92.5% reported at least one obligatory, committed, and

discretionary activity, respectively, affected. Disease status measures were

robust predictors of VLA disability, accounting for 22-47% of the variation

in VLA disability (with one exception). Adding the health assessment

questionnaire (HAQ) to these models increased (p<0.0001) all model R2

values. HAQ score mediated the effects of many disease measures, consistent

with the disablement model.

CONCLUSION: VLA disability was common, with more disability noted in

committed and discretionary than obligatory activities. Because VLA

disability has been linked to psychological wellbeing in previous studies,

identification of factors that may protect against such disability is

important.

PMID: 16249225

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Retrieve & dopt=Abstra\

ct & list_uids=16249225

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