Background Joint Protection Behavior Assessment was developed to evaluate the patient's use of behaviors in daily activities with hand using in patients with rheumatoid arthritis. A short version of the JPBA (JPBA-S) consisting of 10 tasks for the activity of preparing instant coffee has been found to be reliable compare with the full-length JPBA.
Objectives To adapt the original JPBA-S to a Turkish version (TUR-JPBA-S) and to develop assessment manual and to investigate the reliability of assessment in patients with RA.
Methods 15 participants with RA were videotaped while they were doing tasks in original version for manual development and face validity (phase 1). The video recordings were analyzed by two therapists. TUR-JPBA-S was developed with the consensus of four therapists who were working on occupational therapy. 22 participants with RA and 21 healthy people were videotaped while doing TUR-JPBA-S for the second part of the study (phase 2). Two raters were analyzed the records and gave a rate to strictly follow the manual (inter-reliability). One rater were re-analyzed the recordings at different time point (intra-rater reliability). Participants with RA were re-recorded after three to four weeks period. One rater analyzed the re-records (test-retest reliability). The evaluators' composite results were compared between and within raters using the kappa coefficient and ICC's for categorical scoring respectively.
Results There were some differences in TUR-JPBA-S. For example; (i) therapists decided with consensus to videotape the participants while they were making tea in Turkish style teapot with using cattle for heating up the water; (ii) the task “holding milk” were changed as “carrying tray”. Internal consistency (Cronbach α value) was found to be high (0.89) for participants with RA. There was a significant difference in JPBA scores between patients with RA and healthy participants (p<0,001). Our results demonstrated excellent intra-rater (ICC: 0.99, SEM: 1.2) inter-rater (ICC: 0.99, SEM: 1.7) reliability. Also excellent test retest reliability was found (ICC2:1, 0.96). There was a 100% agreement in 5 tasks in intra-rater agreement while there was 100% agreement in 4 tasks in inter-rater agreement.
Conclusions The TUR-JPBA-S provides valid and reliable instrument for assessing JP behavior of patients with RA in Turkey.
Hammond A and Lincoln N. Development of the Joint Protection Behavior Assessment. Arthritis Care Res. 1999 Jun;12(3):200-7.
Niedermann et. al. Development and validation of a German version of the joint protection behavior assessment in patients with rheumatoid arthritis. Arthritis Rheum. 2007 Mar 15;57(2):249-55
Niedermann et. al. Effectiveness of individual resource-oriented joint protection education in people with rheumatoid arthritis. A randomized controlled trial Patient Education and Counseling 82 (2011) 42–48.
Acknowledgements We want to thank to Prof. Alison Hammond to give permission for using assessment and support our research.
Disclosure of Interest None declared