Validity of the Developed Arabic Multidimensional Health Assessment Questionnaire for use in standard clinical care of patients with rheumatic diseases

Authors


: Yasser El Miedany, Professor of Rheumatology and Rehabilitation, 2 Italian Hospital St. Abbassia, Cairo, 11381, Egypt. Email: yasser_elmiedany@yahoo.com

Abstract

Objective:  To assess the validity, reliability and comprehensibility of the Developed Arabic Multidimensional Health Assessment Questionnaire (Arabic-MDHAQ) for use in standard clinical care of patients with rheumatic diseases.

Methods:  The multidimensional questionnaire was developed on a one-page sheet. One side includes 10 activities of daily living (Arabic HAQII), four items to assess psychological distress, duration of morning stiffness as well as visual analogue scales for pain, global status, and fatigue. The other side includes review of the systems, falls and cardiovascular risk assessment, the rheumatology attitudes index to assess the psychological construct of helplessness and self-report of joint counts. The questionnaire was completed by consecutive patients with various rheumatic diseases including 85 with rheumatoid arthritis, 57 with fibromyalgia, 57 with osteoarthritis, 18 with psoriatic arthritis and 11 with ulcerative colitis.

Results:  The test was reliable as demonstrated by a high standardized alpha-value and minimal changes recorded in the second from the first test. The Developed Arabic-MDHAQ correlated significantly with clinical parameters of disease activity as well as inflammatory markers. Changes in both functional and psychological assessment scores showed variation with diseases. The Arabic health assessment questionnaire II (functional disability) was significantly correlated with the original Arabic-HAQ. The psychological assessment items in the Arabic-MDHAQ were significantly correlated with depression as well as anxiety scores as demonstrated by Hamilton scales for depression and anxiety (P < 0.001). The Arabic-MDHAQ showed also a high degree of comprehensibility (92.9%).

Conclusion:  The Developed Arabic-MDHAQ is a reliable and valid instrument for assessment of Arabic patients suffering from rheumatic diseases. Being short, rapid and comprehensive, this adds more to its applicability. The data support the value of completion of the simple 2-page patient questionnaire, which provides a quantitative written documented record by the patient, at each visit to a rheumatologist.

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