The Mexican Spanish version of the Juvenile Arthritis Multidimensional Assessment Report (JAMAR).

The Juvenile Arthritis Multidimensional Assessment Report (JAMAR) is a new parent/patient reported outcome measure that enables a thorough assessment of the disease status in children with juvenile idiopathic arthritis (JIA). We report the results of the cross-cultural adaptation and validation of the parent and patient versions of the JAMAR in the Mexican Spanish language. The reading comprehension of the questionnaire was tested in 10 JIA parents and patients. Each participating centre was asked to collect demographic, clinical data and the JAMAR in 100 consecutive JIA patients or all consecutive patients seen in a 6-month period and to administer the JAMAR to 100 healthy children and their parents. The statistical validation phase explored descriptive statistics and the psychometric issues of the JAMAR: the 3 Likert assumptions, floor/ceiling effects, internal consistency, Cronbach's alpha, interscale correlations, test-retest reliability, and construct validity (convergent and discriminant validity). A total of 100 JIA patients (16% systemic, 16% oligoarticular, 30% RF positive polyarthritis, 38% other categories) and 99 healthy children, were enrolled at the paediatric rheumatology department of the Hospital General de Mexico. The JAMAR components discriminated well healthy subjects from JIA patients. However, there was no significant difference between healthy subjects and their affected peers in school related problem variable. All JAMAR components revealed good psychometric performances. In conclusion, the Mexican Spanish version of the JAMAR is a valid tool for the assessment of children with JIA and is suitable for use both in routine clinical practice and clinical research.

Self-management interventions for chronic disease: a systematic scoping review.

OBJECTIVE: To investigate the contributions of physiotherapy and occupational therapy to self-management interventions and the theoretical models used to support these interventions in chronic disease. DATA SOURCES: We conducted two literature searches to identify studies that evaluated self-management interventions involving physiotherapists and occupational therapists in MEDLINE, the Cochrane Library, CINAHL, EMBASE, AMED (Allied and Complementary Medicine), SPORTdiscus, and REHABDATA databases. STUDY SELECTION: Four investigator pairs screened article title and abstract, then full text with inclusion criteria. Selected articles (n = 57) included adults who received a chronic disease self-management intervention, developed or delivered by a physiotherapist and/or an occupational therapist compared with a control group. DATA EXTRACTION: Four pairs of investigators performed independent reviews of each article and data extraction included: (a) participant characteristics, (b) the self-management intervention, (c) the comparison intervention, (d) outcome measures, construct measured and results. DATA SYNTHESIS: A total of 47 articles reported the involvement of physiotherapy in self-management compared with 10 occupational therapy articles. The type of chronic condition produced different yields: arthritis n = 21 articles; chronic obstructive pulmonary disease and chronic pain n = 9 articles each. The theoretical frameworks most frequently cited were social cognitive theory and self-efficacy theory. Physical activity was the predominant focus of the self-management interventions. Physiotherapy programmes included disease-specific education, fatigue, posture, and pain management, while occupational therapists concentrated on joint protection, fatigue, and stress management. CONCLUSIONS: Physiotherapists and occupational therapists make moderate contributions to self-management interventions. Most of these interventions are disease-specific and are most frequently based on the principles of behaviour change theories.

[Measurement of health-related quality of life and functional capacity in patients with chronic tophaceous gout]. / Medición de la calidad de vida asociada a la salud y a la capacidad funcional en pacientes con gota crónica tofácea.

INTRODUCTION: In gout there are few instruments validated for the evaluation of activity, functional capacity or quality of life. It is not known if generic instruments such as the MOS-20, or specific for other illnesses, such as the AIMS, can be applied to patients with Gout. OBJECTIVE: To evaluate the clinimetric characteristic of the MOS-20 and AIMS questionnaires, and their correlation with HAQ-DI, as well as with clinical variables in patient with tophaceous gout (TG). METHODS: 49 patients with TG were included. Demographic and clinical variables were obtained. The 3 questionnaires were applied at the basal evaluation. A second evaluation was applied to 20 patients, 8 weeks later. RESULTS: All patients were male. The time of since onset of the illness was 14.9±8.3 years. The HAQ-DI was 0.43±0.56 with an alpha of Cronbach (αC) of 0.95 and the intraclass correlation coefficient (ICC) was 0.86. The MOS-20 had an αC of 0.68 to 1.0 and a ICC of 0.27 to 0.61 between the several components. The AIMS had an αC of 0.66 to 0.96, and a ICC of 0.11 to 0.79 between the several components. Reliability was better between the physical components in MOS-20 and AIMS. The MOS-20, AIMS and the HAQ-DI correlated with the presence of joints with functional limitation. There weren't any significant differences among the patients with inflamed joints, nor in those with tophi. The HAQ-DI was best correlated with the physical component than with the mental component of the AIMS and the MOS-20. CONCLUSION: The AIMS, the MOS-20 and the HAQ-DI are useful in measuring the functional capacity and the quality of life in patient with TG.