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European Journal of Physical and Rehabilitation Medicine 2015 August;51(4):405-21


language: English

Personal factors in systemic sclerosis and their coverage by patient-reported outcome measures. A multicentre European qualitative study and literature review

Mattsson M. 1, 2, Boström C. 3, Mihai C. 4, Stöcker J. 5, 6, Geyh S. 7, 8, Stummvoll G. 9, Gard G. 1, Möller B. 10, Hesselstrand R. 11, Sandqvist G. 11, Draghicescu O. 4, Gherghe A. M. 4, Voicu M. 12, Distler O. 13, Smolen J. S. 9, Stamm T. A. 9, 14

1 Department of Health Sciences, Luleå University of Technology, Luleå, Sweden; 2 Department of Physiotherapy, Sunderby Hospital, Luleå, Sweden; 3 Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; 4 Internal Medicine and Rheumatology Department, Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; 5 Department of Rehabilitation, Nijmegen Centre for Evidence Based Practice, Radboud University Medical Centre, Nijmegen, The Netherlands; 6 Department of Occupational Therapy, HAN University of Applied Sciences, Nijmegen, The Netherlands; 7 Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland; 8 Swiss Paraplegic Research, Nottwil, Switzerland; 9 Department of Internal Medicine 3, Division of Rheumatology, Medical University of Vienna, Vienna, Austria; 10 Department of Rheumatology, Sunderby Hospital, Luleå, Sweden; 11 Department of Rheumatology, Lund University, Lund, Sweden; 12 GESIS Leibniz Institute for the Social Sciences, Cologne, Germany; 13 Division of Rheumatology, University Hospital Zurich, Zurich, Switzerland; 14 Division of Occupational Therapy, Department of Health, FH Campus Wien, University of Applied Sciences, Vienna, Austria


BACKGROUND: Systemic sclerosis (SSc) is an autoimmune disease where thickening of the skin can lead to reduced body function and limitations in activities. Severe forms can also affect and seriously damage inner organs. Patient-centred rehabilitation emphasises considerations of patients’ background, experience and behavior which highlights the need to know if patient-reported outcome measures (PROMs) include such personal factors.
AIM: To identify and describe personal factors in the experiences of functioning and health of persons with SSc and to examine if and to what extent PROMs in SSc research cover these factors.
DESIGN: Data from a qualitative study with focus group interviews were analysed. PROMs in SSc research were identified in a literature review between 2008-2013.
SETTING: Participants were recruited from outpatient clinics at rheumatology department.
POPULATION: Sixty-three patients with SSc from four European countries participated.
METHODS: Data from interviews were analysed using a structure of personal factors developed by Geyh et al. Identified PROMs were analysed and linked to main concepts, related to the personal factors, found in the interview data.
RESULTS: Nineteen main concepts were related to the area “patterns of experience and behaviour” in the personal factor structure, 16 to “thoughts and beliefs”, nine to “feelings”, one to “motives” and one to “personal history and biography”, respectively. Among the 35 PROMs identified, 15 did not cover any of the identified concepts. Concepts within the area “feelings” were mostly covered by the PROMs. Five of the PROMs covered “patterns of experience and behaviour”, while “motives” and “personal history and biography” were not covered at all. Four of the identified PROMs covered concepts within the areas “feelings”, “thoughts and beliefs” and “patterns of experience and behaviour” in the same instrument. The Illness Cognition Questionnaire and Illness Behaviour Questionnaire were such PROMs.
CONCLUSION: Patterns of experience and behaviour had the highest number of concepts related to personal factors, but few of the PROMs in SSc research covered these factors. Only a few PROMs covered several personal factors areas in the same instrument.
CLINICAL REHABILITATION IMPACT: The results would be of value when developing core sets for outcome measurements in SSc.

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