Persons with rheumatoid arthritis challenge the relevance of the health assessment questionnaire: a qualitative study of patient perception

BMC Musculoskeletal Disorders
David EbbeviHelena Hvitfeldt Forsberg

Abstract

The Stanford Health Assessment Questionnaire-Disability Index (HAQ) is widely used to measure functional ability in persons with Rheumatoid Arthritis (RA). The instrument was developed with limited involvement from persons with RA, and their perception of the instrument has not been studied in depth. The aim of this study was to explore how persons with RA experience the use of the HAQ in care. The study used secondary data analysis. Persons with RA participated in semi-structured interviews in previous research projects. Thirty-nine interviews were included based on data fit, and thematic analysis applied. The participants questioned the relevance of the HAQ but nevertheless experienced that the instrument had a profound effect on their understanding of health and how care is delivered. The analysis resulted in three themes: Problems with individual items, meaning of the summative score, and effects on care and health perceptions. To make the HAQ relevant to persons with RA, it needs to be revised or to include an option to select items most meaningful to the respondent. To ensure relevance, the HAQ update should preferably be co-created by researchers, clinicians and persons with RA.

References

Aug 1, 1983·British Journal of Rheumatology·J F Fries
Feb 1, 1980·Arthritis and Rheumatism·J F FriesH R Holman
Sep 15, 2001·Annals of the Rheumatic Diseases·S HewlettJ R Kirwan
Jul 2, 2003·Health and Quality of Life Outcomes·Bonnie Bruce, James F Fries
Jul 6, 2004·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·Charlotte Paterson
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Oct 2, 2012·Social Science & Medicine·Anna Essén, Staffan Lindblad
Nov 6, 2012·British Journal of Nursing : BJN·Tessa SandersonKanta Kumar
Jan 18, 2013·Journal of Mental Health·Joan TrujolsJosé Pérez de Los Cobos
Feb 19, 2016·Health Expectations : an International Journal of Public Participation in Health Care and Health Policy·Bianca WieringDiana Delnoij
Oct 18, 2016·Quality Management in Health Care·David EbbeviSofia Ernestam

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