Use of accommodations for valued life activities: Prevalence and effects on disability scores
Use of accommodations for valued life activities: Prevalence and effects on disability scores
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DOI：
10.1002/art.22765
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发表时间：
2007-06-15
期刊：
影响因子：
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通讯作者：
Morris, Anne
中科院分区：
文献类型：
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作者：
Katz, Patricia P.;Morris, Anne
Objective.描述在有价值的生活活动（VLA）的表现中使用4种特定行为调节（辅助设备，个人协助，活动数量或种类的限制，以及花费更多时间进行活动）的流行率，并检查这些调节对VLA残疾评分的影响。数据来自一项对467名类风湿性关节炎（RA）患者的小组研究，每年通过电话采访。VLA残疾使用29项量表进行评估，评估执行每项活动的难度，并询问是否使用了4种类型的住宿。计算仅基于难度等级的未调整难度评分，以及3个调整评分，包括使用辅助或设备，使用辅助，设备或活动限制，以及使用所有4种辅助。类风湿关节炎患者广泛使用关节活动来进行日常活动。限制和更多的时间被用于更多的活动，而不是援助和设备。对住宿条件的调整使残疾评分大幅增加（例如，在调整所有4种调节后，平均总VLA难度评分增加了84%。包括在健康评估问卷，最常用的措施，为类风湿关节炎的功能，住宿只包括辅助设备和个人援助，这不是我们的样本中最常用的住宿。如果评估旨在估计总疾病负担，则应包括使用更广泛的调节，以更全面地了解日常功能如何受到影响。
Objective. To describe the prevalence of using 4 specific behavioral accommodations (assistive devices, personal assistance, limits on the amount or kind of activities, and taking more time to perform activities) in the performance of valued life activities (VLAs), and to examine the impact of accounting for these accommodations on VLA disability scores.Methods. Data were from a panel study of 467 individuals with rheumatoid arthritis (RA) interviewed annually by telephone. VLA disability was assessed using a 29-item scale, rating difficulty performing each activity and asking whether the 4 types of accommodations were used. An unadjusted difficulty score based solely on difficulty ratings was calculated, as well as 3 adjusted scores accounting for use of assistance or devices, use of assistance, devices, or limitations in activities, and use of all 4 accommodations.Results. Accommodations were widely used by individuals with RA to perform daily activities. Limits and more time were used for more activities than assistance and devices. Adjustment for accommodations produced substantial increases in disability scores (e.g., the mean total VLA difficulty score increased by 84% after adjustment for all 4 accommodations).Conclusion. The accommodations included on the Health Assessment Questionnaire, the most commonly used measure of functioning for RA, include only assistive devices and personal assistance, which were not the accommodations most frequently used in our sample. If assessments are intended to estimate total disease burden, they should include use of a broader range of accommodations to develop a more complete picture of how daily function is affected.