Background Despite important improvements in pharmacological care for patients with rheumatoid arthritis (RA), many patients with RA need additional care to achieve and maintain an optimal level of functioning (1). Delivery of comprehensive multidisciplinary care in a rehabilitation setting may be required if treatment by other health professionals has failed (2).
Objectives This study aimed to explore whether RA patients’ perspectives on rehabilitation are covered by current rehabilitation instruments.
Methods A qualitative focus group study with RA patients about their experiences with rehabilitation was conducted. Meaningful units were derived from the recorded and transcribed texts, and concepts regarding essential aspects of rehabilitation contained in these meaningful units were extracted and were linked to the International Classification of Functioning, Disability and Health (ICF). Rehabilitation tools which have been validated among RA patients were identified using a structured literature search. Using the ICF as a common framework, we determined for each concept identified in the focus groups whether it was covered by each of the rehabilitation instruments.
Results 19 patients participated in 4 focus groups. Fifty-one concepts were identified in the 368 meaningful units derived from the transcribed data. Four rehabilitation tools were selected from the literature: The ICF Core Sets for RA, the Canadian Occupational Performance Measure, the Rehabilitation Activities Profile and the WHO Disability Assessment Schedule II. The concepts from the focus groups were best covered by the ICF-CSRA 44 out of 51 (86%), followed by WHODAS-II (39%), RAP (35%) and COPM (16%). Concepts from the focus group within the ICF-component Activities and Participation showed the best coverage by the rehabilitation tools. Overall, the patient perspective regarding important concepts of rehabilitation was best covered by the ICF-CSRA (fig. 1).
Conclusions Besides Activities and participation, current rehabilitation tools poorly cover the concepts that patients find essential during rehabilitation. The ICF-CSRA outstands and could serve as a checklist to guide multidisciplinary assessments and goal-setting in the rehabilitation of RA patients.
 Hallert E et al. Rheumatology 2006; 45(3):325-31.
 Vliet Vlieland T. Rheumatology 2007; 46(9):1397-404
Disclosure of Interest None Declared
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