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Evaluation of the Multidimensional Health Assessment Questionnaire in Finnish Patients with Rheumatoid Arthritis
MARJA ARKELA-KAUTIAINEN, HANNU KAUTIAINEN, TOINI UUTELA, KARI LAIHO, HARRI BLÅFIELD, MARJATTA LEIRISALO-REPO, and MARKKU HAKALA
ABSTRACT. Methods. The reliability of the questionnaire was tested by test-retest procedure. Construct validity was studied by factor analysis and convergent validity by calculating correlations between the Finnish MDHAQ (Finn-MDHAQ) scales and the Finnish Health Assessment Questionnaire (HAQ) and the Finnish Arthritis Impact Measurement Scales (Finn-AIMS2). Correlations between Finn-MDHAQ and measures of clinical characteristics, disease activity, and functional class were also measured. An item analysis was made of the Finn-MDHAQ scales Function (FN) and Psychological (PS). Results. Internal consistency on the FN scale was 0.92 (95% lower limit 0.89) and 0.66 (0.56) on the PS scale. Reproducibility (95% CI) on FN was 0.93 (0.82 to 0.97) and on PS 0.84 (0.70 to 0.92). Factor analysis identified 2 factors, mobility of upper extremities and trunk, and mobility of lower extremities. Strong correlations were found between the FN scale and HAQ and physical subscales of Finn-AIMS2 and between PS and the psychological subscales of Finn-AIMS2. In item analysis corrected item correlation was high on the Finn-MDHAQ scales, except in one item on the PS scale. Conclusion. The Finn-MDHAQ is an applicable, reliable, and valid instrument for the part of the FN scale measuring functional ability in Finnish rheumatic patients. The incongruity in the PS scale structure that produced moderate internal consistency can be overcome with minor modifications. (J Rheumatol 2005;32:1426-31) Key Indexing Terms:
EVALUATION
From the Rheumatism Foundation Hospital, Heinola; Central Hospital of Lapland, Rovaniemi; Central Hospital of South Ostrobothnia, Seinäjoki; and Department of Medicine, Division of Rheumatology, Helsinki University Central Hospital, Helsinki, Finland. Supported by the Rheumatism Foundation Hospital Research Fund, Heinola, Finland. M. Arkela-Kautiainen, MSc, PT; H. Kautiainen, BA, Statistician; K. Laiho, MD, PhD; M. Hakala, MD, PhD, Rheumatism Foundation Hospital, Heinola; T. Uutela, MD, Central Hospital of Lapland, Rovaniemi; H. Blåfield, MD, Central Hospital of South Ostrobothnia, Seinäjoki; M. Leirisalo-Repo, MD, PhD, Professor, Helsinki University Central Hospital. Address reprint requests to M. Arkela-Kautiainen, Likolahdenkatu 43, FIN-44150 Äänekoski, Finland. E-mail: marja.arkela-kautiainen@medcare.fi Accepted for publication February 7, 2005. |