Objective

To assess the clinimetric properties of a new health-related quality of life (HRQOL) instrument, the World Health Organization Disability Assessment Schedule II (WHODAS II), in patients with early inflammatory arthritis.



Methods

Internal consistency as well as criterion, construct, and discriminative validity of the WHODAS II were assessed in 172 patients with early inflammatory arthritis who completed the WHODAS II, the Medical Outcomes Study Short Form 36 (SF-36), and other measures of disease severity, functioning, pain, depression, and resource use. Test–retest reliability of the WHODAS II was assessed by having a subset of 20 patients complete the WHODAS II a second time, 1 week after the first assessment.



Results

The WHODAS II had high internal consistency (Cronbach's α = 0.96 for patients working or in school and 0.93 for patients not working or in school). Test–retest intraclass correlation coefficients of the WHODAS II total score and subscales ranged from 0.82–0.96. The WHODAS II total score was strongly correlated with the SF-36 physical component score (Kendall's tau-b 0.51, P < 0.001) and moderately correlated with the SF-36 mental component score (tau-b 0.43, P < 0.001). WHODAS II correlations with disease outcomes ranged from Kendall's tau-b 0.15–0.55. The WHODAS II significantly differentiated between every aspect of disease severity assessed with the exception of measures of health resource use.



Conclusion

The WHODAS II is a valid and reliable measure of HRQOL in cross-sectional studies of patients with early inflammatory arthritis. Research is still required to investigate potential item redundancy and determine its usefulness in longitudinal studies.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/art.23314

The clinimetric properties of the World Health Organization Disability Assessment Schedule II in early inflammatory arthritis.

Objective:To explore feasibility and potential efficacy of on-line interventions for sleep quality following a traumatic brain injury (TBI).Design:A two parallel-group, randomized controlled pilot ...

A pilot randomized controlled trial of on-line interventions to improve sleep quality in adults after mild or moderate traumatic brain injury.

Background: Emotional disorders are considered to contribute to persistent difficulties after mild traumatic brain injury (TBI). Few studies have examined anxiety after mild TBI, and fewer have exa...

Depression and anxiety across the first 4 years after mild traumatic brain injury: findings from a community-based study

Primary objective: To explore the way clinicians talk about the value and purpose of goal planning in rehabilitation for people with brain injuryResearch design: Grounded theoryMethods and procedures: Nine clinicians from a range of professional backgrounds were interviewed. The interview data were analysed using the constant comparative method of grounded theory.Main outcomes and results: While the clinicians considered goal planning important, the expressed reasons for valuing goal planning were at times unclear. The term ‘goal’ referred to not one but many concepts within the rehabilitation environment; goal planning was used to serve a range of different purposes. Different reasons for undertaking goal planning were interrelated but at times conflicted, potentially creating tensions within the rehabilitation environment.Conclusions: Discussions around goal planning terminology should progress from service-level agreements towards more evidenced-based international consensus. Individual services might ...

How clinicians talk about the application of goal planning to rehabilitation for people with brain injury–variable interpretations of value and purpose

Knowledge about the impacts of traumatic brain injury (TBI) and aspects that influence recovery and adaptation are key to understanding how best to provide appropriate services. Whilst injury exper...

https://www.tandfonline.com/doi/pdf/10.1080/09602011.2017.1364653

Recovery and adaptation after traumatic brain injury in New Zealand: Longitudinal qualitative findings over the first two years*

Illness and injury can lead to complex problems for patients and clinicians. A new approach from the World Health Organization (WHO), the International Classification of Functioning, Disability and Health (ICF), may help manage such patients, and evaluate the success of the interventions used. The authors discuss the application of the ICF model.

A new classification for outcomes in illness and injury.

Background People who experience health conditions and/or disability often also have difficulty accessing employment due to a number of complex factors. These factors are very often associated with broader societal issues. They include stigma, poorly-informed judgements about what makes somebody ‘work-able’, fear of negatively affecting health and safety in the workplace and/or making the workplace vulnerable to higher costs, and challenges in negotiating work arrangements that are outside the norm when needed (Fadyl & Payne, 2016; Harlan & Robert, 1998; Louvet, 2007; Pacheco, Page, & Webber, 2014; Schur, Kruse, Blasi, & Blanck, 2009). Case management, vocational rehabilitation and employment support can all help to address these challenges and improve work outcomes for people experiencing health conditions and/or disability, and various approaches exist within these broad categories that have been tested in research (e.g. Fadyl, McPherson, & Nicholls, 2015; Fleming, Del Valle, Kim, & Leahy, 2013; Trexler, Trexler, Malec, Klyce, & Parrott, 2010).

Protocol: Support for Gaining Employment For People With Long-term Conditions – Qualitative Systematic Review

For peer review only Establishing a person -centred framework of self -identity after traumatic brain injury: a grounded theory study to inform measure development

OBJECTIVE: To explore what helps and hinders recovery and adaptation after disabling traumatic brain injury (TBI) and make recommendations for improving service responsiveness DESIGN: A longitudinal qualitative descriptive study across all TBI severities SETTING: Community PARTICIPANTS: Forty people with TBI, and 22 significant others, 6 to 9 months following a TBI MAIN MEASURES: Semistructured interviews, analyzed using qualitative description, focused on (a) key areas of importance or concern and (b) strategies or actions that people found helpful or that hindered recovery RESULTS: Traumatic brain injury produced a complex set of challenges in keeping up with life, and understanding what having a TBI means for, and to, me This period encompassed a tangled fit and misfit in life as brain injury did not occur in isolation People had to actively change some aspects of life and yet allow other changes to happen Valued supports from others included being looked out for and having someone to help drive the process CONCLUSION: Improved services delivery and better outcomes may result if we respond to the person within his or her context; listen, believe, and acknowledge the person's story through our actions; and avoid assumptions about aspects of life that mean most to people and who/what may help best Language: en

Living Life After Traumatic Brain Injury: Phase 1 of a Longitudinal Qualitative Study

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A new classification for outcomes in illness and injury.

Protocol: Support for Gaining Employment For People With Long-term Conditions – Qualitative Systematic Review

For peer review only Establishing a person -centred framework of self -identity after traumatic brain injury: a grounded theory study to inform measure development

Living Life After Traumatic Brain Injury: Phase 1 of a Longitudinal Qualitative Study