OBJECTIVES. The Groningen Activity Restriction Scale (GARS) is a non-disease-specific instrument to measure disability in activities of daily living (ADL) and instrumental activities of daily living (IADL). It was developed in studies of Dutch samples consisting of elderly or chronically ill people. The psychometric properties of the GARS demonstrated in these studies were highly satisfactory. This paper addresses the psychometric properties of the GARS across countries. METHODS. Data of 623 patients with recently diagnosed rheumatoid arthritis from four European countries were analyzed by means of a principal components analysis and a Mokken scale analysis for polychotomous items. RESULTS. The results of the analyses were highly satisfactory: there was one strong and reliable general factor representing one underlying dimension of disability in ADL and IADL, and there was a clear hierarchical ordering of the items included in the GARS. The validity of the GARS was strongly suggested by the pattern of associations of the GARS with age, sex, and other existing health status measures. CONCLUSIONS. The psychometric characteristics of the GARS, which measures disability in ADL and IADL simultaneously, make this instrument very useful for comparative research across countries.

No abstract

No abstract

Considering the key position of patients' global assessment in clinical practice and research, we wanted to examine the relationships between patients' global assessment and biological, functional, and mental variables, and to explore the relative contribution of these variables on patients' assessment of arthritis impact. Patients with RA of < or = 4 yrs duration were examined at baseline (n = 238) and after 12 and 24 months (n = 216). Study variables were tender joints, ESR, CRP, hand X-ray abnormalities and self-reported global arthritis impact, pain, disability, and symptoms of depression. 2-yr mean scores were computed for all variables. Strong correlations were found between patients' global assessment and pain (r = .73), depression (r = .68), disability (r = .64), and tender joints (r = .51), while ESR, CRP, and X-ray abnormalities correlated weakly with the global assessment. Using a multivariate approach, however, the relative effects of disability and tender joints were no longer statistically significant, whereas pain and depression still had significant impact on patients' global assessments.

A partially-controlled intervention study was performed. Female patients with rheumatoid arthritis (RA) were allocated to three groups: the network intervention group (n = 104), the attention control group (n = 85), and the no-treatment control group (n = 75). The network intervention consisted of an assessment session and a network meeting. Patients were assessed at baseline and approximately 10 and 18 months after the intervention. The network intervention group reported an increase in network size. Daily emotional support increased for the intervention patients compared with patients in the attention control group. The degree of social dysfunction was reduced for patients in the intervention group compared to patients in the no-treatment control group. Furthermore, for single patients, the intervention significantly increased the social network size and improved both social functioning, and perceived overall health, compared to both control groups. The results suggest that the social needs of single patients should be given special attention in clinical settings.