Skip to main content
Top
Published in: Health and Quality of Life Outcomes 1/2009

Open Access 01-12-2009 | Research

Measuring the impact and distress of osteoarthritis from the patients' perspective

Authors: Julie F Pallant, Anne-Maree Keenan, Roseanne Misajon, Philip G Conaghan, Alan Tennant

Published in: Health and Quality of Life Outcomes | Issue 1/2009

Login to get access

Abstract

Background

To assess the internal construct validity of the Perceived Impact of Problem Profile (PIPP), a patient based outcome measure based on the International Classification of Functioning, Disability and Health (ICF), which assesses impact and distress, in an osteoarthritis (OA) cohort.

Methods

A questionnaire comprising the 23-item PIPP, which assesses five domains (mobility, participation, self care, psychological well being and relationships), the Western Ontario McMasters University Osteoarthritis Index (WOMAC), the General Well-Being Index (GWBI), and the Hospital Anxiety and Depression Scale (HADS) was posted to people with clinician diagnosed OA. Assessment of the internal construct validity of the PIPP was undertaken using Rasch analysis performed with RUMM2020 software and concurrent validity through comparator measures.

Results

Two hundred and fifty-nine participants with OA responded. Analysis of the five individual domains of the PIPP indicated that there was good fit to the Rasch model, with high person separation reliability. One item required removal from the Mobility subscale and the Participation subscale. There were strong correlations between the PIPP Mobility scores and the WOMAC disability and pain subscales (rho = .73 and rho = .68), and between the PIPP Psychological well-being and HADS Depression (rho = .71) and GWBI (rho = -.69). High inter-correlations between the impact and distress subscales for each domain (range rho = .85 to .96), suggested redundancy of the latter.

Conclusion

This study demonstrates that the PIPP has good psychometric properties in an OA population. The PIPP, using just the impact subscales, provides a brief, reliable and valid means of assessing the impact of OA from the individual's perspective and operationalizing the bio-psychosocial model by the application of a single multi-domain questionnaire.
Literature
1.
go back to reference Pendleton A, Arden N, Dougados M, Doherty M, Bannwarth B, Bijlsma J, Cluzeau F, Cooper C, Dieppe P, Gunther K-P, et al.: EULAR recommendations for the management of knee osteoarthritis: report of a task force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT). Ann Rheum Dis 2000, 59: 936–244. 10.1136/ard.59.12.936CrossRef Pendleton A, Arden N, Dougados M, Doherty M, Bannwarth B, Bijlsma J, Cluzeau F, Cooper C, Dieppe P, Gunther K-P, et al.: EULAR recommendations for the management of knee osteoarthritis: report of a task force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT). Ann Rheum Dis 2000, 59: 936–244. 10.1136/ard.59.12.936CrossRef
2.
go back to reference World Health Organisation: The burden of musculoskeletal conditions at the start of the new millennium. Geneva: World Health Organization; 2003. World Health Organisation: The burden of musculoskeletal conditions at the start of the new millennium. Geneva: World Health Organization; 2003.
3.
go back to reference American College of Rheumatologists Subcommittee on Osteoarthrtis Guidelines: Recommendations for hip and knee OA management. Arthritis Rheum 2000,43(9):1905–1915. 10.1002/1529-0131(200009)43:9<1905::AID-ANR1>3.0.CO;2-PCrossRef American College of Rheumatologists Subcommittee on Osteoarthrtis Guidelines: Recommendations for hip and knee OA management. Arthritis Rheum 2000,43(9):1905–1915. 10.1002/1529-0131(200009)43:9<1905::AID-ANR1>3.0.CO;2-PCrossRef
4.
go back to reference Arokoski MH, Haara M, Helminen HJ, Arokoski JP: Physical function in men with and without hip osteoarthritis. Arch Phys Med & Rehabil 2004,85(4):574–581. 10.1016/j.apmr.2003.07.011CrossRef Arokoski MH, Haara M, Helminen HJ, Arokoski JP: Physical function in men with and without hip osteoarthritis. Arch Phys Med & Rehabil 2004,85(4):574–581. 10.1016/j.apmr.2003.07.011CrossRef
5.
go back to reference Mili F, Helmick CG, Moriarty DG: Health related quality of life among adults reporting arthritis: analysis of data from the Behavioral Risk Factor Surveillance System, US, 1996–99. J Rheumatol 2003,30(1):160–166. Mili F, Helmick CG, Moriarty DG: Health related quality of life among adults reporting arthritis: analysis of data from the Behavioral Risk Factor Surveillance System, US, 1996–99. J Rheumatol 2003,30(1):160–166.
7.
go back to reference MacLean C, Knight K, Paulus R, Brook P, Sheckelle : Costs attributable to osteoarthritis. J Rheumatol 1998,25(11):2213–2218. MacLean C, Knight K, Paulus R, Brook P, Sheckelle : Costs attributable to osteoarthritis. J Rheumatol 1998,25(11):2213–2218.
8.
go back to reference World Health Organisation: Ageing and Health: A Global Challenge for the 21st Century. WHO Symposium: Kobe, Japan; 1998:479. World Health Organisation: Ageing and Health: A Global Challenge for the 21st Century. WHO Symposium: Kobe, Japan; 1998:479.
9.
go back to reference Mannoni A, Briganti M, Di Bari M, Ferrucci L, Costanzo S, Serni U, Masotti G: Epidemiological profile of symptomatic osteoarthritis in older adults: a population based study in Dicomano, Italy. Ann Rheum Dis 2003, 62: 576–578. 10.1136/ard.62.6.576CrossRef Mannoni A, Briganti M, Di Bari M, Ferrucci L, Costanzo S, Serni U, Masotti G: Epidemiological profile of symptomatic osteoarthritis in older adults: a population based study in Dicomano, Italy. Ann Rheum Dis 2003, 62: 576–578. 10.1136/ard.62.6.576CrossRef
10.
go back to reference Peat G, McCarney R, Croft P: Knee pain and osteoarthritis in older adults: a review of community burden and current use of primary health care. Ann Rheum Dis 2000, 60: 91–97. 10.1136/ard.60.2.91CrossRef Peat G, McCarney R, Croft P: Knee pain and osteoarthritis in older adults: a review of community burden and current use of primary health care. Ann Rheum Dis 2000, 60: 91–97. 10.1136/ard.60.2.91CrossRef
11.
go back to reference Ehrich E, Davies G, Watson D, Bolognese J, Seidenberg B, Bellamy N: Minimal perceptible clinical improvement with the Western Ontario and McMaster Universities osteoarthritis index questionnaire and global assessments in patients with osteoarthritis. J Rheumatol 2000,27(11):2635–2641. Ehrich E, Davies G, Watson D, Bolognese J, Seidenberg B, Bellamy N: Minimal perceptible clinical improvement with the Western Ontario and McMaster Universities osteoarthritis index questionnaire and global assessments in patients with osteoarthritis. J Rheumatol 2000,27(11):2635–2641.
12.
go back to reference Leeb B, Schweitzer H, Montag K, Smolen J: A metaanalysis of chondroitin sulfate in the treatment of osteoarthritis. J Rheumatol 2000,27(1):205–211. Leeb B, Schweitzer H, Montag K, Smolen J: A metaanalysis of chondroitin sulfate in the treatment of osteoarthritis. J Rheumatol 2000,27(1):205–211.
13.
go back to reference Rosemann T, Joos S, Koerner T, Szechseny J, Laux G: Comparison of AIMS2-SF, WOMAC, x-ray and a global physician assessment in order to approach quality of life in patients suffering from osteoarthritis. BMC Musculoskelet Disord 2006.,7(6): Rosemann T, Joos S, Koerner T, Szechseny J, Laux G: Comparison of AIMS2-SF, WOMAC, x-ray and a global physician assessment in order to approach quality of life in patients suffering from osteoarthritis. BMC Musculoskelet Disord 2006.,7(6):
14.
go back to reference Janse AJ, Gemke RJB, Uiterwaal CSPM, Tweel I, Kimpen JLL, Sinnema G: Quality of life: patients and doctors don't always agree: a meta-analysis. J Clin Epidemiol 2004, 57: 653–661. 10.1016/j.jclinepi.2003.11.013CrossRef Janse AJ, Gemke RJB, Uiterwaal CSPM, Tweel I, Kimpen JLL, Sinnema G: Quality of life: patients and doctors don't always agree: a meta-analysis. J Clin Epidemiol 2004, 57: 653–661. 10.1016/j.jclinepi.2003.11.013CrossRef
15.
go back to reference Janse AJ, Uiterwaal CS, Gemke RJ, Kimpen JL, Sinnema G: A difference in the perception of quality of life in chronically ill children was found between parents and pediatricians. J Clin Epidemiol 2005, 58: 495–502. 10.1016/j.jclinepi.2004.09.010CrossRef Janse AJ, Uiterwaal CS, Gemke RJ, Kimpen JL, Sinnema G: A difference in the perception of quality of life in chronically ill children was found between parents and pediatricians. J Clin Epidemiol 2005, 58: 495–502. 10.1016/j.jclinepi.2004.09.010CrossRef
16.
go back to reference Carr A: Beyond disability: measuring the social and personal consequences of osteoarthritis. Osteoarthritis Cartilage 1999,7(2):230–238. 10.1053/joca.1998.0154CrossRef Carr A: Beyond disability: measuring the social and personal consequences of osteoarthritis. Osteoarthritis Cartilage 1999,7(2):230–238. 10.1053/joca.1998.0154CrossRef
17.
go back to reference World Health Organization: International Classification of Functioning, Disability and Health. Geneva: World Health Organization; 2001. World Health Organization: International Classification of Functioning, Disability and Health. Geneva: World Health Organization; 2001.
18.
go back to reference Pallant JF, Misajon R, Bennett E, Manderson L: Measuring the impact and distress of health problems from the individual's perspective: development of the Perceived Impact of Problem Profile (PIPP). Health Qual Life Outcomes 2006,4(1):36. 10.1186/1477-7525-4-36CrossRef Pallant JF, Misajon R, Bennett E, Manderson L: Measuring the impact and distress of health problems from the individual's perspective: development of the Perceived Impact of Problem Profile (PIPP). Health Qual Life Outcomes 2006,4(1):36. 10.1186/1477-7525-4-36CrossRef
19.
go back to reference WHO: International Classification of Functioning, Disability and Health. Geneva: World Health Organization; 2001. WHO: International Classification of Functioning, Disability and Health. Geneva: World Health Organization; 2001.
20.
go back to reference Altman R, Alarcon G, Appelrouth D, Bloch D, Borenstein D, Brandt K, et al.: The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip. Arthritis Rheum 1991, 34: 505–514. 10.1002/art.1780340502CrossRef Altman R, Alarcon G, Appelrouth D, Bloch D, Borenstein D, Brandt K, et al.: The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip. Arthritis Rheum 1991, 34: 505–514. 10.1002/art.1780340502CrossRef
21.
go back to reference Altman R, Asch D, Bloch D, Bole G, Borenstein D, Brandt K, W C, Cooke T, Greenwald R, Hochberg M, et al.: Development of criteria for the classification and reporting of osteoarthritis: classification of OA of the knee. Arthritis Rheum 1986,29(8):1039–1049. 10.1002/art.1780290816CrossRef Altman R, Asch D, Bloch D, Bole G, Borenstein D, Brandt K, W C, Cooke T, Greenwald R, Hochberg M, et al.: Development of criteria for the classification and reporting of osteoarthritis: classification of OA of the knee. Arthritis Rheum 1986,29(8):1039–1049. 10.1002/art.1780290816CrossRef
22.
go back to reference Altman R, Alarcon G, Appelrouth D, Bloch D, Borenstein D, Brandt K, Brown C, Cooke T, Daniel W, Gray R, et al.: The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand. Arthritis Rheum 1990,33(11):1601–1610. 10.1002/art.1780331101CrossRef Altman R, Alarcon G, Appelrouth D, Bloch D, Borenstein D, Brandt K, Brown C, Cooke T, Daniel W, Gray R, et al.: The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand. Arthritis Rheum 1990,33(11):1601–1610. 10.1002/art.1780331101CrossRef
23.
go back to reference Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt L: Validation study of WOMAC: a health status instrument for measuring clinically-important patient-relevant outcomes following total hip or knee arthroplasty in osteoarthritis. Journal of Orthopaedic Rheumatology 1988, 1: 95–108. Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt L: Validation study of WOMAC: a health status instrument for measuring clinically-important patient-relevant outcomes following total hip or knee arthroplasty in osteoarthritis. Journal of Orthopaedic Rheumatology 1988, 1: 95–108.
24.
go back to reference Lingard EA, Katx JN, Wright RJ, Wright EA, Sledge CB: Validity and responsiveness of the Knees Society Clinical Rating System in Comparison with the SF-36 and WOMAC. J Bone Joint Surg 2001,83-A(12):1856–1864. Lingard EA, Katx JN, Wright RJ, Wright EA, Sledge CB: Validity and responsiveness of the Knees Society Clinical Rating System in Comparison with the SF-36 and WOMAC. J Bone Joint Surg 2001,83-A(12):1856–1864.
25.
go back to reference Theiler R, Sangha O, Schaeren S, Michel BA, Tyndall A, Dick W, Stucki G: Superior responsiveness of the pain and function sections of the Western Ontario and McMasters Universities Osteoarthritis Index in patients with osteoarthritis of the lower extremities. Osteoarthritis Cartilage 1999, 7: 515–519. 10.1053/joca.1999.0262CrossRef Theiler R, Sangha O, Schaeren S, Michel BA, Tyndall A, Dick W, Stucki G: Superior responsiveness of the pain and function sections of the Western Ontario and McMasters Universities Osteoarthritis Index in patients with osteoarthritis of the lower extremities. Osteoarthritis Cartilage 1999, 7: 515–519. 10.1053/joca.1999.0262CrossRef
26.
go back to reference Jinks C, Jordan K, Croft P: Measuring the population impact of knee pain and disability with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Pain 2002,100(1–2):55–64. 10.1016/S0304-3959(02)00239-7CrossRef Jinks C, Jordan K, Croft P: Measuring the population impact of knee pain and disability with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Pain 2002,100(1–2):55–64. 10.1016/S0304-3959(02)00239-7CrossRef
27.
go back to reference Domsic RT, Saltzman CL: The Ankle Osteoarthritis Scale. Foot Ankle Int 1998,19(7):466–471.CrossRef Domsic RT, Saltzman CL: The Ankle Osteoarthritis Scale. Foot Ankle Int 1998,19(7):466–471.CrossRef
28.
go back to reference Johanson NA, Liang MH, Daltroy L, Rudicel S, Richmond J, Johanson NA, Liang MH, Daltroy L, Rudicel S, Richmond J: American Academy of Orthopaedic Surgeons lower limb outcomes assessment instruments. Reliability, validity, and sensitivity to change. J Bone Joint Surg Am 2004,86-A(5):902–909. Johanson NA, Liang MH, Daltroy L, Rudicel S, Richmond J, Johanson NA, Liang MH, Daltroy L, Rudicel S, Richmond J: American Academy of Orthopaedic Surgeons lower limb outcomes assessment instruments. Reliability, validity, and sensitivity to change. J Bone Joint Surg Am 2004,86-A(5):902–909.
29.
go back to reference Gaston JE, Vogl L: Psychometric properties of the general well-being index. Qual Life Res 2005,14(1):71–75. 10.1007/s11136-004-0793-zCrossRef Gaston JE, Vogl L: Psychometric properties of the general well-being index. Qual Life Res 2005,14(1):71–75. 10.1007/s11136-004-0793-zCrossRef
30.
go back to reference Gaston JE, Vogl L: Psychometric properties of the general well-being index. Qual Life Res 2005,14(1):71–75. 10.1007/s11136-004-0793-zCrossRef Gaston JE, Vogl L: Psychometric properties of the general well-being index. Qual Life Res 2005,14(1):71–75. 10.1007/s11136-004-0793-zCrossRef
31.
go back to reference Revicki DA, Leidy NK, Howland L: Evaluating the psychometric characteristics of the Psychological General Well-Being Index with a new response scale. Qual Life Res 1996,5(4):419–425. 10.1007/BF00449916CrossRef Revicki DA, Leidy NK, Howland L: Evaluating the psychometric characteristics of the Psychological General Well-Being Index with a new response scale. Qual Life Res 1996,5(4):419–425. 10.1007/BF00449916CrossRef
32.
go back to reference Hunt S, McKenna S: A British adaptation of well-being, the General Well-Being Index: a new tool for clinical research. British Journal of Medical Economics 1992, 2: 49–60. Hunt S, McKenna S: A British adaptation of well-being, the General Well-Being Index: a new tool for clinical research. British Journal of Medical Economics 1992, 2: 49–60.
33.
go back to reference Zigmond AS, Snaith RP: The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 1983, 67: 361–370. 10.1111/j.1600-0447.1983.tb09716.xCrossRef Zigmond AS, Snaith RP: The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 1983, 67: 361–370. 10.1111/j.1600-0447.1983.tb09716.xCrossRef
34.
go back to reference Pallant JF, Tennant A: An introduction to the Rasch measurement model: An example using the Hospital Anxiety and Depression Scale (HADS). B J Clin Psychol 2007, 46: 1–18. 10.1348/014466506X96931CrossRef Pallant JF, Tennant A: An introduction to the Rasch measurement model: An example using the Hospital Anxiety and Depression Scale (HADS). B J Clin Psychol 2007, 46: 1–18. 10.1348/014466506X96931CrossRef
35.
go back to reference Tennant A, Conaghan PG: Rasch measurement model in rheumatology: What is it and why use it? When should it be applied, and what should one look for in a Rasch paper? Arthritis Rheum. 2007,57(8):1358–1362. 10.1002/art.23108CrossRef Tennant A, Conaghan PG: Rasch measurement model in rheumatology: What is it and why use it? When should it be applied, and what should one look for in a Rasch paper? Arthritis Rheum. 2007,57(8):1358–1362. 10.1002/art.23108CrossRef
36.
go back to reference Rasch G: Probabilistic models for some intelligence and attainment tests. Chicago: University of Chicago Press; 1960. Rasch G: Probabilistic models for some intelligence and attainment tests. Chicago: University of Chicago Press; 1960.
37.
go back to reference Masters G: A Rasch model for partial credit scoring. Psychometrika 1982, 47: 149–174. 10.1007/BF02296272CrossRef Masters G: A Rasch model for partial credit scoring. Psychometrika 1982, 47: 149–174. 10.1007/BF02296272CrossRef
38.
go back to reference Smith RM: Fit analysis in latent trait measurement models. Journal of Applied Measurement 2000, 2: 199–218. Smith RM: Fit analysis in latent trait measurement models. Journal of Applied Measurement 2000, 2: 199–218.
39.
go back to reference Teresi JA: Different approaches to differential item functioning in health applications. Med Care 2006, 44: S152-S170. 10.1097/01.mlr.0000245142.74628.abCrossRef Teresi JA: Different approaches to differential item functioning in health applications. Med Care 2006, 44: S152-S170. 10.1097/01.mlr.0000245142.74628.abCrossRef
40.
go back to reference Andrich D, Sheridan B, Luo G: RUMM2020. Perth, Australia: RUMM Laboratory; 2007. Andrich D, Sheridan B, Luo G: RUMM2020. Perth, Australia: RUMM Laboratory; 2007.
41.
go back to reference Linacre JM: Sample size and item calibration stability. Rasch Measurement Transactions 1994, 7: 28. Linacre JM: Sample size and item calibration stability. Rasch Measurement Transactions 1994, 7: 28.
42.
go back to reference Andrich D: Models for measurement, precision, and the non-dichotomization of graded responses. Psychometrika 1995, 60: 17–26. Andrich D: Models for measurement, precision, and the non-dichotomization of graded responses. Psychometrika 1995, 60: 17–26.
43.
go back to reference Davis AM, Badley EM, Beaton DE, Kopec J, Wright JG, Young NL, Williams JI: Rasch analysis of the Western Ontario McMaster (WOMAC) Osteoarthritis Index: results from community and arthroplasty samples. J Clin Epidemiol 2003, 56: 1076–1083. 10.1016/S0895-4356(03)00179-3CrossRef Davis AM, Badley EM, Beaton DE, Kopec J, Wright JG, Young NL, Williams JI: Rasch analysis of the Western Ontario McMaster (WOMAC) Osteoarthritis Index: results from community and arthroplasty samples. J Clin Epidemiol 2003, 56: 1076–1083. 10.1016/S0895-4356(03)00179-3CrossRef
44.
go back to reference Wolfe F, Kong SX: Rasch analysis of the Western Ontario MacMaster questionnaire (WOMAC) in 2205 patients with osteoarthritis, rheumatoid arthritis, and fibromyalgia. Ann Rheum Dis 1999,58(9):563–568. 10.1136/ard.58.9.563CrossRef Wolfe F, Kong SX: Rasch analysis of the Western Ontario MacMaster questionnaire (WOMAC) in 2205 patients with osteoarthritis, rheumatoid arthritis, and fibromyalgia. Ann Rheum Dis 1999,58(9):563–568. 10.1136/ard.58.9.563CrossRef
45.
go back to reference Luce RD, Tukey JW: Simultaneous conjoint measurement: A new type of fundamental measurement. J Math Psychol 1964, 1: 1–27. 10.1016/0022-2496(64)90015-XCrossRef Luce RD, Tukey JW: Simultaneous conjoint measurement: A new type of fundamental measurement. J Math Psychol 1964, 1: 1–27. 10.1016/0022-2496(64)90015-XCrossRef
Metadata
Title
Measuring the impact and distress of osteoarthritis from the patients' perspective
Authors
Julie F Pallant
Anne-Maree Keenan
Roseanne Misajon
Philip G Conaghan
Alan Tennant
Publication date
01-12-2009
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2009
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-7-37

Other articles of this Issue 1/2009

Health and Quality of Life Outcomes 1/2009 Go to the issue