Functioning and Disability in Leprosy.

This study has been carried out to investigate the frequency of musculoskeletal symptoms in people affected by leprosy and correlate this to their functional capacity to perform daily living and working activities and to their degree of disability. This cross-sectional study was performed on 100 clients who answered a questionnaire on personal and clinical data, the Nordic Musculoskeletal (QNSO), and the shoulder, arm and hand dysfunction (DASH) questionnaires. The mean age was 53.63 years and there was a predominance of men (67%), low education (53%), and multibacillary disease (84%). Physical impairment affected 95% of respondents and 92% indicated pain and/or paresthesia in the arms that interfered in functional capacity.Respondents with musculoskeletal symptoms have more difficulty to perform daily living and working activities compared to those without musculoskeletal symptoms (p-value<0.05). The presence of physical disabilities was not associated with difficulties to perform daily living (p-value=0.29) and labor activities (p-value=0.87). The majority of patients experienced pain and/or paresthesia of the arms, and this was associated with difficulties to perform daily living and working activities. However, the presence of physical disability does not seem to cause major impediments or limitations to perform these activities.

Characterization of the profession/occupation of individuals affected by leprosy and the relationship with limitations in professional activities.

People who had leprosy stay away from work and have difficulty of employability and to perform their functions or retire early. This study aimed at determining whether there is a relationship between profession/occupation and limitations in activities. This was a cross-sectional study that used the SALSA scale (Screening of Activity Limitation and Safety Awareness) to assess limitations and to classify professions/occupations as low, medium or high risk. Of the 277 people surveyed, 50.2% were men, the mean age was 53.8 years (SD = 16.3), 62.7% had multibacillary, 59.7% had family incomes of 3 minimum wages or less, 58.5% had up to 6 years schooling and 57% did not have paid jobs. As for occupations, 45.8% were considered low, 39.7% medium and 12.3% high risk. Of thetotal, 49.1% had mild/moderate, 8.7% severe/very severe and 42.2% did not have any limitations. The relationship between limitations in activities and occupational risk indicated that people with severe limitations tend to have low risk occupations (p value < 0.05). The limitations associated with employability showed that most active individuals have no limitations (p value < 0.05). Hence, most people who had leprosy have low risk professions/occupations; the limitations favor a shift from high-risk activities and interfere with employability.

Development and structural validation of a shortened version of the Participation Scale.

PURPOSE: To validate a shortened version of the Participation Scale (P-scale) that will be quicker to use and to describe the factor structure found in the P-scale data in various study samples. METHODS: A large multi-country and multi-cultural database was compiled consisting of 5125 respondents. Item analysis, explanatory factor analysis and confirmatory factor analysis were applied to identify items for deletion and investigate the factor structure of the P-scale. RESULTS: The multi-country database included 11 databases from six different countries. Respondents were affected by a range of health conditions, including leprosy, HIV/AIDS, dermatological conditions and various disabilities. Of the respondents included 57% were male. The P-scale Short (PSS) contains 13 items. A two-factor structure, with factors named "work-related participation" (three items) and "general participation" (10 items), showed the best model fit (Comparative Fit Index = 0.983, Tucker Lewis Index = 0.979, Rooted Mean Square Error of Approximation = 0.061). The Cronbach's alphas were very good for both the whole scale and the subscales, 0.91, 0.83 and 0.90, respectively. Correlation between the two factors was high (r = 0.75) indicating that interpreting the P-scale as measuring an overall factor "participation" is still valid. A very high correlation (r = 0.99) was found between the full P-scale and the PSS. CONCLUSIONS: The findings suggest good validity of the P-scale across a range of languages and cultures. However, field testing needs to confirm the validity of the PSS to measure the level of social participation restrictions across cultures and health conditions.