Quantitative pain assessment for routine care of rheumatoid arthritis patients, using a pain scale based on activities of daily living and a visual analog pain scale

Abstract

Pain was assessed quantitatively as a component of routine visits of 385 outpatients with rheumatoid arthritis, using a pain scale based on activities of daily living (ADL) and a visual analog scale. The ADL pain scale met psychometric criteria for validity and reliability. Scores on the 2 pain scales were correlated significantly with one another and with other measures of disease status, including joint count, grip strength, walking time, button test, morning stiffness, erythrocyte sedimentation rate, global self-assessment, ADL difficulty, and ADL dissatisfaction scales. Correlations of ADL pain scale scores with other measures were higher than were correlations of visual analog scale scores with other measures, in both unadjusted and adjusted analyses. Significantly more patients completed the ADL pain scale without assistance than the number of those who completed the visual analog pain scale. The ADL pain scale was more sensitive to problems in ADL than were the ADL scales for difficulty and dissatisfaction. The ADL and visual analog pain scales appear to

Learned helplessness in systemic lupus erythematosus: analysis using the rheumatology attitudes index

“…The MHAQ provides data similar to the HAQ in patients with RA (13,19), and the HAQ has previously been indicated to be valid in patients with SLE (5,7). The RAI has been shown to be significantly correlated with ADL difficulty, dissatisfaction, and pain scores after controlling for age, duration of disease, and years of formal education in patients with RA (1 1).…”

A clue from a self‐report questionnaire to distinguish rheumatoid arthritis from noninflammatory diffuse musculoskeletal pain

“…This questionnaire has involved several versions, but all versions have included a Modified Health Assessment Questionnaire, with scales to assess difficulty in 8 activities of daily living (D-ADL) (7,9), as well as a 10-cm pain visual analog scale (P-VAS) (19) (Figure 1). In addition, most versions of the 2-page self-report questionnaire have included scales to assess dissatisfaction (9) and pain (20) in the same 8 activities of daily living, a global self-report of health status (20), and a rheumatology attitudes index (RAI) designed to assess the psychological construct of learned helplessness (21,22). All 6 of these scales with the exception of the P-VAS are scored on a scale of 1 4 , in which 1 = optimal health status and 4 = poorest health status.…”

Measures of activity and damage in rheumatoid arthritis: Depiction of changes and prediction of mortality over five years

“…The evaluation included, on the same day: a complete joint count according to the ACR glossary, with 70 joints scored for swelling, tenderness, pain on motion, limited motion, and deformity (33); a radiograph scored quantitatively at a later date for joint space narrowing, erosion, and malalignment according to the Kaye-modified Sharp method (45); laboratory assessments of ESR and rheumatoid factor (35); ACR Functional Class (41,46); grip strength (47), walk time (47), and button time (47); and a self-report questionnaire that included difficulty in performing 8 activities of daily living (ADL) according to a modified Health Assessment Questionnaire (MHACZ) (36), pain according to a 10-cm visual analog scale (48,49), and the psychological construct of helplessness (3840). Patients were also asked to indicate a global self-assessment of their overall functional status by selecting 1 of 4 statements in response to the question, "Which of the following best describes you today?…”

“…Cross-sectional data from the baseline evaluation of these patients have been presented in previous reports concerning the joint count (50,51); radiographs (34,35,50,52,53); rheumatoid factor (35); grip strength, walk time, and button time (47); and self-report questionnaire data concerning ADL difficulty (36), pain (49), and helplessness (39,40). These reports include further details concerning methods used for data collection and data management.…”