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HP0007 The haq index – relations to difficulty in daily activities
  1. KU Nordh1,
  2. U Nordenskiöld2
  1. 1Department of Occupational Therapy, Division of Rheumatology, Karolinska Hospital, Stockholm, Sweden
  2. 2Department of Occupational Therapy and Rehabilitation Medicine, Sahlgrenska Universitetssjukhuset, Gothenburg, Sweden

Abstract

The objectives were to make an analysis of the HAQ disability index concerning if the patients marked their difficulty in the answere alternatives “no, any or much difficulty” and “using assistive devices” as well as if their assistive devices were in use at home.

The methods One hundred and eighteen patients, with rheumatoid arthritis have attended in the program “Early Arthritis” which all have been at their two year control at Karolinska hospital. One hundred and eighteen of 124 patients were included in this study, 30 male and 88 female with the mean age of 53 years. The patients have marked their perceived difficulty in the HAQ seven times during two years and filled in a checklist with assistive devices. In the HAQ the scale steps are 0 = no difficulty, 1 = with any difficulty, 2 = with much difficulty, 2 = with assistive devices and 3 = unable to do. Both “much difficulty” and “using assistive devices” are scored with the scale step 2.

The results showed that 99 of 118 patients had assistive devices at home, 20 men had 4.6 assistive devices and 79 women had 10 assistive devices per person. In spite of that 97% of the devices were in use by the men and 95% were in use by the women, seventeen men and 57 women had never filled in the answere alternative “with assistive devices” in the HAQ, even though they were using the devices. If the men and the women had filled in the alternative “with assistive devices”, an increased HAQ index should have been identified. The mean value had increased from 0,28 to 0,5 for the men and for the women the mean value had increased from 0,56 to 0,89.

The conclusion The HAQ index is not reliable enough to show the level of patients perceived difficulty in daily activities in relation to using assistive devices. The scale step 2 is used for both “much difficulty” and for “with assistive devices” and the patients in this study had not filled in the alternative “with assistive devices”. The HAQ index mixes two different aspects of disability, dependence in terms of use of assistive devices and perceived difficulty.

References

  1. Fries JF. The assessment of disability; from first to future principles. Br J Rheumatol. 1983; 22(3 Suppl):48–58

  2. Guillemin F, Briacon S, Pourel J. Validity and discriminant ability of HAQ Functional Index in early rheumatoid arthritis. Disabil Rehabil.1992;14:71–7

  3. Tennant A, Hillman M, Fear J. Are we making the most of The Stanford Health Assessment Questionnaire? Br J Rheumatol. 1996;35:574–8

  4. Nordenskiöld U, Grimby G. Assessment of disability in women with rheumatoid arthritis in relation to grip force and pain. Disabil Rehabil. 1997;19:13–9

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