BackgroundJuvenile idiopathic arthritis (JIA) is a chronic inflammatory childhood disease with symptoms such as joint inflammation, pain and loss of quality of life.1 Types of disease and the presence of pain can impact the child psychosocially, as well as affecting functional activity.2 ObjectivesThe aim of this study is to examine the results of functional and psychosocial status according to the disease type and the presence of pain symptoms in children with JIA.MethodsThe study included 71 children diagnosed with JIA who applied to the Hacettepe University İhsan Doğramacı Children’s Hospital Rheumatology Department. Following the collection of demographic information, functional status was assessed with the Child Health Assessment Questionnaire (CHAQ) and psychosocial and functional status was assessed with the scale developed in Hacettepe University Faculty of Health Sciences Department of Physiotherapy and Rehabilitation for functional and psychosocial status of children with rheumatism by Edibe Ünal.3 Children were divided into groups according to disease type as oligoarthritis or polyarthritis and the presence or absence of pain.ResultsTable 1 shows the mean age and numbers of children. There was no difference between the groups according to disease type (p>0,05). On the other hand, comparing scores for the CHAQ total, CHAQ general VAS assessment, functional and psychosocial status according to the presence or absence of pain revealed significant differences (p<0,05).Abstract AB1452HPR – Table 1Assessment values and comparison statisticsDisease TypePain Oligoarthritis(n=51)Polyarthritis(n=20) pPresent(n=21)Absent(n=50) p Age (years)10,88±3,8113,50±3,92001611,71±3,7711,58±4,120885CHAQ Total0,28±0,290,46±0,4101270,51±0,40,26±0,270012CHAQ (General VAS)2,49±2,433,93±300684,46±2,862,24±2,30002Function (range 0–30)4,72±4,855,05±6,3207667,85±6,63,54±4,020004Psychosocial (range 0–30)23±5,6714,5±5,82036316±5,7412,34±5,40012Function; Psychosocial; Functional and Psychosocial subscales of Ünal’s scale.3 ConclusionsWe conclude that pain has a greater effect on functional, psychosocial and overall disease assessment in children with JIA when compared to the disease type. Thus, it must be taken into consideration that child’s ability to cope with pain should be improved.References[1] Angelo Ravelli, Alberto Martini. Juvenile idiopathic arthritis.The Lancet2007, 369(9563); 767–778.[2] Laura E Schanberga, John C Lefebvreb, et al. Pain coping and the pain experience in children with juvenile chronic arthritis. Pain1997, 73(2); 181–189.[3] Kısacık Pınar,Ünal Edibe, et al. Juvenil İdiyopatik Artritli Hastalarda Çok Yönlü Bir Değerlendirme Sistemi Oluşturulması Delphi Çalışması. 2016, Annals Of Paediatric Rheumatology Disclosure of InterestNone declared
BackgroundRheumatic diseases have biopsychosocial effects on individiuals.1 This affection includes the combination of anxiety, depression, and participation in daily living activities. It can be thought that individuals can be affected from different diseases in different ways.ObjectivesThe aim of this study is to compare the biopsychosocial status of patients with Rheumatoid Arthritis (RA) and Fibromyalgia (FMS).MethodsIndividuals diagnosed with Rheumatoid Arthritis (RA) and Fibromyalgia (FMS) who applied to the Rheumatology Department of the Medical Faculty of Hacettepe University were included in the study. After the demographic characteristics of the individuals were recorded; daily living activities were assessed with the Health Assessment Questionnaire (HAQ), quality of life with Short Form 36 (SF-36) scale, anxiety and depression levels with Hospital Anxiety and Depression Scale (HADS) and disease related biopsychosocial status with the Cognitive Exercise Therapy Approach Scale (BETY) which is a newly developed scale in rheumatic patients (the authors request that the abbreviation stay as “BETY” as the original in Turkish).2 Results120 RA and 99 FMS patients were included in the study. The scores of individuals on scales are shown in Table 1. When analysed in terms of differences according to RA and FMS, the anxiety and depression scores of the HADS scale and the SF-36 quality of life scale of the individuals were found to differ between the Physical Functioning, Social Functioning, General Mental Health, Role Limitations Due to Emotional Problems, Vitality Energy or Fatigue and General Health Perception subparametric scores.Abstract AB1450HPR – Table 1Comparison of two groups.RA (n=120)FMS (n=99)p Age51,91±11,3943,03±8,420,00BMI28,47±6,5527,46±5,670227HAQ13,48±11,8611,7±9,470229HADS-A7,07±5,49,59±4,820000HADS-D5,62±4,399,23±4,460000BETY60,64±29,7467,14±22,70075SF36-FF45,12±26,0938,44±22,450046SF36-FR28,54±43,6320,95±34,570162SF36-A39,87±25,7642,06±20,250492SF36-SI36,67±45,8250,63±25,90008SF36-RS73,15±19,8253,87±20,250000SF36-ER55,1±24,9130,03±41,830000SF36-EC70,41±30,427,27±19,990000SF36-GS50,08±24,7638,38±16,610000PF: Physical Functioning, RL: Role Limitations, RLE: Role Limitations Due to Emotioal, VEF: Vitality, Energy or Fatigue, GMH: General Mental Health, SF: Social Functioning, P: Pain, GHP: General Health PerceptionConclusionsPhysical function, mental health, emotional role strength, energy vitality and general health perception, anxiety and depression levels in RA patients were found to be better than FMS patients. The activities of daily living were thought to be unaffected by the changing parameters of pain and biopsychosocial status.References[1] van Middendorp H, Evers AWM. The role of psychological factors in inflammatory rheumatic diseases: From burden to tailored treatment. Best Practice & Research Clinical Rheumatology. 2016;30(5):932–45.[2] Ünal E, Arin G, Karaca Nb, Kiraz S, Akdoğan A, Kalyoncu U, et al. Romatizmalı hastalar için bir yaşam kalitesi ölçeğinin geliştirilmesi: madde havuzu...
JAB-Q is a valid and reliable multidimensional biopsychosocial outcome tool that can be used routinely in clinical practice of pediatric rheumatology. The main advantage of this tool is incorporation of patients' and parents' perspectives separately while providing a practical and standard setting for the clinician's evaluation. However, further validation of this tool in an independent cohort is needed to improve its applicability.
BackgroundThe Cognitive Exercise Therapy Approach is a biopsychosocial model for the patients with rheumatic diseases.1 Cognitive Exercise Therapy Approach Scale (the authors request that the abbreviation stay as “BETY” as the original in Turkish) is a scale that evaluates the biopsychosocial status of the patients with rheumatic diseases. This scale needs validation studies in different rheumatic diseases.2 ObjectivesThe aim of this study is to investigate the validation of the BETY scale in patients with Rheumatoid Arthritis (RA).Methods120 RA patients were included in this study. To determine the functional status of the patient Health Assessment Questionnaire (HAQ) was used. Rheumatoid Arthritis Quality of Life Scale (RAQoL) and 36-Item Short Form Survey (SF-36) were used to measure quality of life. Hospital Anxiety and Depression Scale (HADS) was used to determine anxiety and depression levels. BETY scale was used to in addition to this questionaires for the validation.Results120 RA patients including 13 men and 107 women were participated in the study. The average age of the participating patients was 28,47±11,39 years and the body mass index was 28.4±6,56. There was a very high correlation between the BETY scale and RAQoL (r=0,817, p<0,001). There was high correlation between the BETY scale and subscale of the HADS-Anxiety, HAQ and subscale of the SF-36 Pain (r=0,617, p<0.001; r=0,606, p<0.001; r= −0, 610, p<0.001, respectively). There was moderate correlation between the BETY scale and subscale of the HADS-Depression, subscales of the SF-36 form Physical Functioning, Role Limitations, Role Limitations Due to Emotioal and General Health Perception (r=-0,597, p<0,001; r=-0,576, p<0,001; r=-0,525, p<0,001; r=-0, 598, p<0,001; r=-0, 420, p<0,001, respectively) (Table 1–2).ConclusionsThere were high or moderate correlations between the BETY scale and valid and reliable scales that are developed for these parameters. The BETY scale can be considered as a valid scale in patients with RA.References[1] Kisacik P, Unal E, Akman U, Yapali G, Karabulut E, Akdogan A. Investigating the effects of a multidimensional exercise program on symptoms and antiinflammatory status in female patients with ankylosing spondylitis. Complementary therapies in clinical practice. 2016;22:38–43.[2] Ünal E, Arin G, Karaca Nb, Kiraz S, Akdoğan A, Kalyoncu U, et al. Romatizmalı hastalar için bir yaşam kalitesi ölçeğinin geliştirilmesi: madde havuzunun oluşturulması. Journal of Exercise Therapy and Rehabilitation. 2017;4(2):67–75.Disclosure of InterestNone declared
Background:Pain is an important symptom in rheumatic diseases. Chronic pain is strongly associated with cognition, anxiety and depression levels in these patients.1 2 Pain behavior can be related to the patient's response to the disease and the use of painkillers.Objectives:The aim of this study is to compare the pain behavior of patients with different rheumatic diseases.Methods:Patients with Ankylosing Spondylitis (AS), Fibromyalgia (FM), and Rheumatoid Arthritis (RA) were included in the study and their demographic data were recorded. The Hospital Anxiety and Depression Scale (HADS) was used to determine the anxiety and depression levels of patients. Health Assessment Questionnaire (HAQ) was used to determine functional status and Cognitive Exercise Therapy Approach Scale (the authors request that the abbreviation stays as “BETY” as the original in Turkish) was used to assess bio-psychosocial status of the patients.3 The first and fourth questions of BETY were used to investigate pain behavior.Results:The mean age of 329 patients were 45,5±11,5 years and the body mass index was 27,8±5,9. The patient’s HAQ score was 12,5±10,5, the HADS anxiety score was 8,7±5,2 and the HADS depression score was 7,50±4,6. The BETY total score was 62.6±26.3. According to BETY scale’s 1st question, although the patients felt pain, the rate of continuing activity was 42.6% and the non-continuity rate was 13.4%. According to BETY scale’s 4th question, the painkiller using rate was 27.8% and the non-painkiller rate was 25.3% (table 1).Conclusions:Although patients knew that their pain would increase, it was determined that the patients had continued their activities. It was also found that the use of painkillers was higher in AS patients compared to the others. It was concluded that these groups should be trained in regarding to restricting their activities when they felt pain.Table 1Findings related to questionnairesRA (n=126)AS (n=100)FMS (n=103)ALL (n=329)HAQ13,3±11,912,6±9,911,7±9,512,6±10,6HADS-A7,1±5,49,9±4,89,7±4,88,8±5,2HADS-D5,7±4,58±4,29,2±4,47,5±4,6BETY60,6±29,759,9±24,367,1±22,762,7±26,31st question(I can’t stop myself doing activities even though I know it will increase my pain.)Yes always (%)46503343,2Yes often (%)8,72121,416,4Yes sometimes (%)231226,220,7Yes rarely (%)4213,66,4No never (%)18,3155,813,44th question(I don’t feel comfortable unless I take painkillers.)Yes always (%)21,43829,128,9Yes often (%)9,5119,710Yes sometimes (%)22,21522,320,1Yes rarely (%)16,71319,416,4No never (%)30,22319,424,6References1. Shim EJ, Hahm BJ, Go DJ, Lee KM, Noh HL, Park SH, et al. Modeling quality of life in patients with rheumatic diseases: the role of pain catastrophizing, fear-avoidance beliefs, physical disability, and depression. Disability and rehabilitation2017:1–8.2. Edwards RR, Cahalan C, Mensing G, Smith M, Haythornthwaite JA. Pain, catastrophizing, and depression in the rheumatic diseases. Nature reviews Rheumatology2011;7(4):216–24.3. Ünal E, Arin G, Karaca Nb, Kiraz S, Akdoğan A, Kalyoncu U, et al. Romatizmalı hastalar i...
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