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PubMed2000

Assessing health status and quality of life in idiopathic pulmonary fibrosis: which measure should be used?

Many studies conducted on the health status and quality of life (QOL) of patients with certain chronic diseases have demonstrated that their disease had an impact on their lives. However, less is known about the QOL and health status of patients suffering from idiopathic pulmonary fibrosis (IPF). In the present study, three focus groups of IPF patients (n=10) were run to identify the aspects of QOL or health status that are relevant to this population and to establish which measure is preferable to assess these aspects. The patients completed and discussed the St. George's Respiratory Questionnaire (SGRQ) and the World Health Organization Quality of Life assessment instrument (WHOQOL-100). Results indicated that hobbies/leisure activities, mobility, transport, social relationships, working capacity, energy and doing things slower were aspects relevant to IPF patients' QOL. The WHOQOL-100, with an additional social support questionnaire, appeared to be preferable.

Activities of Daily Living↗
PubMed2005

[Changes of general and oral health status of elderly patients receiving home-visit dental services].

This study investigated the changes of general and oral health status of elderly patients who received home-visit dental services. The subjects were 51 patients (male: 19, female: 32, age: 83.0+/-9.1). The results of initial and re-examination (5.4 months later) by questionnaire survey, oral status and oral microbes were compared. The following results were obtained. 1. More than half of the subjects were bedridden and about 70% were affected by dementia. Three-quarters needed special care for daily activities. 2. The general health condition of the subjects became worse after 5.4 months. Moreover, 11 subjects died within 6 months after re-examination. However, oral health status, such as status of oral hygiene (p < 0.01), inflammation of gingiva (p < 0.01), tongue coating (p < 0.05) and oral malodor (p < 0.01) improved significantly. 3. There was a significant difference in the rate of people with dysphagic problems between the living and dead groups (p < 0.05). 4. The initial general and oral health status of the people with dysphagic problems was significantly worse than that of those without it. After receiving home-visit dental services, general condition became worse. However oral status, such as status of oral hygiene, inflammation of gingiva, oral malodor, and lactobacillus count significantly improved in both groups. These results suggest that dysphagic problems of elderly patients may affect their general health condition and might increase the risk of death. It is recommended to judge dysphagic problems accurately when performing certification of need for long-term care and to provide professional oral care periodically for the dependent elderly needing care.

Aged↗
PubMed2005

Long-term exercise therapy resolves ethnic differences in baseline health status in older adults with knee osteoarthritis.

OBJECTIVES: To determine whether ethnicity was associated with baseline and 18-month health status within a merged sample of older adults with knee osteoarthritis (OA) from the Fitness Arthritis in Seniors Trial and the Arthritis, Diet, and Activity Promotion Trial. DESIGN: Cross-sectional and prospective study. SETTING: Center-based exercise therapy at two universities. PARTICIPANTS: A total of 584 African-American (n=143) and Caucasian-American (n=441) adults aged 60 and older with knee OA were examined for baseline and 18-month health status. MEASUREMENTS: Six-minute-walk distance, 36-item Short Form General Health Scale (SF-36 GHS), and Physical Functioning Questionnaire index score. Ethnicity was obtained via self-report. RESULTS: Analyses of covariance testing the effect of ethnicity, adjusted for demographic and health status covariates, revealed significant effects for ethnicity upon baseline 6-minute-walk distance and SF-36 GHS, with Caucasian Americans reporting better scores (P=.001), although these differences were not significant after 18 months of exercise therapy. CONCLUSION: Ethnicity and baseline function are important factors that should not be overlooked in knee OA research involving exercise interventions. Moreover, not only should physical activity be recommended to improve functional outcomes, it may also be a useful strategy in reducing health disparities.

Black or African American↗
PubMed2006

Health status of individuals with serious mental illness.

We examined indices of the health of persons with serious mental illness. A sample of 100 adults with schizophrenia and 100 with major mood disorder were recruited from randomly selected outpatients who were receiving community-based psychiatric treatment. Participants were surveyed about health indicators using items from the National Health and Nutrition Examination Study III and the National Health Interview Survey. Their responses were compared with those of matched samples from the general population surveys. A total of 1% of persons with serious mental illness, compared with 10% from the general population sample, met criteria for all 5 of selected health indicators: nonsmoker, exercise that meets recommended standards, good dentition, absence of obesity, and absence of serious medical co-occurring illness. Within the mentally ill group, educational level, but not a diagnosis of schizophrenia versus mood disorder, was independently associated with a composite measure of health behaviors. We conclude that an examination of multiple health indicators may be used to measure overall health status in persons with serious mental illness.

Adolescent↗
PubMedDate not supplied

Development of a Spanish (Castillian) version of the Childhood Health Assessment Questionnaire. Measurement of health status in children with juvenile chronic arthritis.

OBJECTIVE: To demonstrate that the Spanish (Castillian) version of the Childhood Health Assessment Questionnaire (cHAQ-S) is a valid and reliable instrument for measuring the health status of children with juvenile chronic (or rheumatoid) arthritis (JCA) and is sensitive to change. METHODS: A conceptual translation of the original questionnaire into Spanish and two back-translations were performed. The cHAQ-S was completed by the parents of young children (aged 1 to 19 years) affected by JCA, and additionally by those children aged over 9. A second cHAQ-S was administered at least 15 months after the first one. RESULTS: The cHAQ-S was administered to 79 patients of patients affected by JCA. The test-retest reliability was evaluated among 16 patients, and no significant differences between the first and second administration were found (0.88 versus 0.84; p > 0.6; intraclass correlation coefficient R = 0.94). The Cronbach's alpha coefficient was 0.948, indicating an excellent internal reliability with a mean correlation between the different components of the questionnaire varying from 0.3557 to 0.7831. For the between-observer reliability, an intraclass correlation coefficient of 0.96 was obtained. Correlations between DI (Disability Index) and several measures of disease activity were all statistically significant (Spearman's R ranged from 0.42 to 0.87; p < 0.005). Patients who improved showed similar improvement in the DI (p = 0.015), while patients who worsened showed a worsening of the DI (p = 0.1) and patients whose condition was stable showed no change in DI (p = 0.6). CONCLUSION: The cHAQ-S is a feasible, reliable and valid instrument for the determination of the health status of Spanish children suffering from JCA. It is also sensitive to changes in the child's health status.

Arthritis, Juvenile↗
PubMed2005

Risk factors for rehospitalisation in COPD: role of health status, anxiety and depression.

The aim of the present study was to analyse the risk of rehospitalisation in patients with chronic obstructive pulmonary disease and associated risk factors. This prospective study included 416 patients from a university hospital in each of the five Nordic countries. Data included demographic information, spirometry, comorbidity and 12 month follow-up for 406 patients. The hospital anxiety and depression scale and St. George's Respiratory Questionnaire (SGRQ) were applied to all patients. The number of patients that had a re-admission within 12 months was 246 (60.6%). Patients that had a re-admission had lower lung function and health status. A low forced expiratory volume in one second (FEV1) and health status were independent predictors for re-admission. Hazard ratio (HR; 95% CI) was 0.82 (0.74-0.90) per 10% increase of the predicted FEV1 and 1.06 (1.02-1.10) per 4 units increase in total SGRQ score. The risk of rehospitalisation was also increased in subjects with anxiety (HR 1.76 (1.16-2.68)) and in subjects with low health status (total SGRQ score >60 units). When comparing the different subscales in the SGRQ, the closest relation between the risk of rehospitalisation was seen with the activity scale (HR 1.07 (1.03-1.11) per 4 unit increase). In patients with low health status, anxiety is an important risk factor for rehospitalisation. This may be important for patient treatment and warrants further studies.

Aged↗
PubMed2000

Health status as geneologic burden in aging process.

UNLABELLED: Knowledge of modern molecular biology is leading to the idea that aging and diseases of the aged are two different entities. Healthy life is relatively limited by the specific number of chronic conditions which are present more in old age. Up to now the idea of aging as a process in relation to the individual, organ, tissue, cell or a molecule. There are only few studies on the influence of aging within a single family and even less of aging within several generations of the same family. Genealogic level is one way of getting into the process of family system and aging throughout time. The aim of the study was to determine the significance of genealogical burden with regard to the health status in examinees with different cognitive capabilities. The difference according to sex and age was not significant between the two groups. Health status of the examinees proband in both groups showed 34.4% healthy examinees in the group D and 65.3% in group G. The difference between the two groups was statistically significant. The difference of health status of parents (II. generation) was statistically significant in both groups. Morbidity of diseases was not statistically significant. Most of the ancestors from the grandmothers and grandfathers (III generation) died. (group G--97.5%, group D--100%). Statistically significant difference is present among the diseases of the circulatory system and those of digestive system in this generation. Data on the ancestors of the IV. generation showed that all the relatives died in both groups. CONCLUSION: The health status of the examinees with higher impairment in the test of cognitive capabilities is worse and they come from the families with worse health status.

Adult↗
PubMed2002

Health status of children after admission for injury.

OBJECTIVE: Injury is the major cause of death in children ages 1 to 19 in the United States and is a leading cause of morbidity. Few studies have described the impact of injuries on the health status of affected children over time or used newer, child-specific measures in this population. The objective of this study was to describe the health status of children in the 6 months after admission for injury using child-specific health status measures. METHODS: Injured children who were ages 3 to 18 years and admitted to an academic children's hospital were evaluated at discharge and at 1 and 6 months after discharge with a battery of outcome measures. The Child Health Questionnaire (CHQ) measured health status. The scores on the Functional Independence Measure (FIM) or pediatric version of the FIM tracked physical function. RESULTS: A total of 195 children were enrolled. Boys outnumbered girls (67% vs 33%). Injury mechanisms and severity scores were typical of pediatric injury populations reported in other studies. Most (90%) children had at least 1 area of functional limitation by FIM at discharge, and 57% had some impairment at 1 month. By 6 months, 28% reported some limitation. At discharge, CHQ summary scores for the injury group were markedly depressed compared with normative populations. Differences in both physical health and psychosocial health summary scores between the injured and normal children persisted through 6 months of follow-up. Scores on 11 of 12 subscales were significantly below the normal population at discharge. This was particularly evident for bodily pain (injury group mean 49.1 vs normative mean 81.7) and parental impact-emotional (43.9 vs 80.3), and physical functioning (50.9 vs 96.1). Significant differences persisted in all subscales at 1 month and in 6 subscales at 6 months. CONCLUSIONS: The CHQ provided useful information about the impact of injuries on children and their families over time. Significantly reduced scores in several domains of the CHQ highlight problem areas for injury patients, several of which persist through 6 months of follow-up. Low scores in areas of bodily pain and parental emotional burden suggest that improved management of these problems is required. Additional study of risk factors for persistent problems after injury may suggest ways to improve functional outcomes of injured children and reduce the impact on their families.

Adolescent↗
PubMedDate not supplied

International standards and guidelines on education and training for the multi-disciplinary health response to major events that threaten the health status of a community.

UNLABELLED: The 13th World Congress on Disaster and Emergency Medicine, convened in Melbourne, Australia in May 2003, requested the World Association for Disaster and Emergency Medicine (WADEM) to lead the development of "International Standards and Guidelines on Education and Training for "Disaster Medicine". This Paper has been developed by a Working Group of the WADEM Education Committee ("the Working Group") in response to that request from the international "Disaster Medicine" and emergency health community. The main focus of the Working Group is to develop standards and guidelines for education and training in the multi-disciplinary health response to major events that threaten the health status of a community. The contemporary view is that of a multi-disciplinary health response to major events which threaten the health status of a community, including the prevention and mitigation of future events, and taking account of the broader context in which these events occur. It is the vision of the Working Group that evidence-based standards and guidelines for education and training must be developed in a broad sense, for all members of the healthcare community. Rather than purely describing isolated performance indicators, the Working Group agreed that priority be given to explaining the general approach, presenting the conceptual framework, clarifying important principles, and describing the educational needs and training requirements for situations for which there exist a major threat to the health status of a community. It is not the intent to produce an updated educational curriculum for special courses in "Disaster Medicine" by listing levels of theoretical knowledge and clinical skills required for medical doctors, nurses, and paramedics. Nor, does the Working Group think it is useful to repeat requirements and learning outcomes that are part of the normal basic education and training for the various health professionals. The purpose of this Issues Paper is to present an initial summary of current issues relating to an international perspective of "Disaster Medicine" education and training. This summary has been prepared following discussions within the Working Group of the WADEM Education Committee. The paper aims to stimulate debate and form the basis of further of discussion at an international meeting scheduled to be held in Brussels (Belgium) on 29-31 October 2004. The Working Group has structured this Issues Paper into five parts and has identified several key issues for discussion. Part 1: Understanding the contemporary interpretation of the multi-disciplinary health response to major events that threaten the health status of a community. Issue 1: Definitions and terminology in "Disaster Medicine"; Issue 2: Getting to grips with the contemporary concepts and international trends in 'Disaster Medicine"; and, Issue 3: Valuing personal attributes in "Disaster Medicine" practitioners. Part 2: Developing an underlying scientific framework for linking theory to practice in "Disaster Medicine". Issue 4: Creating a scientific framework(s) for "Disaster Medicine". Part 3: Defining a conceptual framework and general principals to develop "International Standards and Guidelines on Education and Training for the Multi-disciplinary Health Response to Major Events that Threaten the Health Status of a Community". Issue 5.: Where are we now? Getting to grips with the contemporary concepts and international trends in "Disaster Medicine" education and training. Issue 6: Where do we want to get to? Identifying contemporary, evidence-based education and training standards and guidelines for 'Disaster Medicine" education and training programs. Issue 7: How do we get there? Overcoming barriers to introducing the International Standards and Guidelines. Part 4: Maintaining the momentum--improving international collaboration. Issue 8: Exploring the feasibility of an ongoing, international, collaborative network of "Centres of Excellence" in "Disaster Medicine" research and/or education. Part 5: Additional input. Issue 9: What other issues would you like to bring to the attention of the Working Group? CONCLUSIONS: The results of the consultation will lead to the development of international standards and guidelines that will be presented and consensus sought during the 14th World Congress on Disaster and Emergency Medicine (WCDEM-14) to be convened in Edinburgh in May, 2005.

Civil Defense↗
PubMed2002

Obesity and health status in rural, urban, and suburban southern women.

BACKGROUND: Obesity has reached epidemic proportions over the past 20 years. METHODS: This study investigated the differences in rates of obesity and perceptions of health status between rural, urban, and suburban Southern women based on selected socioeconomic factors. Using data from a national health survey, the reports from 4,391 women aged 40 to 64 years were included in the study. RESULTS: Significantly more rural women lived in poverty, reported a poorer health status, and had a greater prevalence of obesity. Urban women had the next highest obesity rate and a moderate health status. The healthiest group with the lowest obesity and poverty rates were suburban women. CONCLUSION: Obesity and poor overall health are closely related in rural women. The greatest challenge to health care providers is to provide appropriate community-based weight-management programs.

Adult↗
PubMed2006

Misinterpretation with norm-based scoring of health status in adults with type 1 diabetes.

BACKGROUND: Interpretations of profile and preference based measure scores can differ. Profile measures often use a norm-based scoring algorithm where each scale is scored to have a standardized mean and standard deviation, relative to the general population scores/norms (i.e., norm-based). Preference-based index measures generate an overall scores on the conventional scale in which 0.00 is assigned to dead and 1.00 is assigned to perfect health. Our objective was to investigate the interpretation of norm-based scoring of generic health status measures in a population of adults with type 1 diabetes by comparing norm-based health status scores and preference-based health-related quality of life (HRQL) scores. METHODS: Data were collected through self-complete questionnaires sent to patients with type 1 diabetes. The RAND-36 and the Health Utilities Index Mark 3 (HUI3) were included. RESULTS: A total of 216 (61%) questionnaires were returned. The respondent sample was predominantly female (58.8%); had a mean (SD) age of 37.1 (14.3) years and a mean duration of diabetes of 20.9 (12.4) years. Mean (SD) health status scores were: RAND-36 PHC 47.9 (9.4), RAND-36 MHC 47.2 (11.8), and HUI3 0.78 (0.23). Histograms of these scores show substantial left skew. HUI3 scores were similar to those previously reported for diabetes in the general Canadian population. Physical and mental health summary scores of the RAND-36 suggest that this population is as healthy as the general adult population. CONCLUSION: In this sample, a preference-based measure indicated poorer health, consistent with clinical evidence, whereas a norm-based measure indicated health similar to the average for the general population. Norm-based scoring measure may provide misleading interpretations in populations when health status is not normally distributed.

Adult↗
PubMed1993

Characteristics, health status and service needs of sheltered homeless families.

To describe the characteristics, health status, needs and utilization of health services of sheltered homelessness families, we performed a population-based, cross-sectional survey of a probability sample of 103 parents and 260 children in the District of Columbia. Data from parents were gathered by a semi-structured interview and from children by standard validated instruments. The parents were: single (72%), women (95%), poorly educated (54% less than high school), unemployed (85%), on AFDC (91%); and had minimum support persons (30% not any), medical (27%), psychiatric (46%), and substance abuse problems (45%). Based on the Denver Developmental Screening Test, 61% of the children under five had at least one developmental lag and 44% had two or more lags; 60% of the children over five required further medical and psychiatric evaluation and 55% were performing below average in school. The findings have implications for the delivery of health services to homeless families in shelters.

Adult↗
PubMed1995

The outcomes movement and health status measures.

The outcomes movement is exemplified by clinical effectiveness studies incorporating patient-centered outcomes measures. Findings from these studies are used to base payment decisions and improve the structure and process of clinical practices. The usefulness of these studies is dependent upon the selection of appropriate outcomes measures. Typically, clinical measures used by health professionals are narrowly focused and assess physiologic, other biomedical, or limited functional dimensions of health. On the other hand, patient-centered outcome measures are more broadly defined and capture health status as perceived by the patient in areas of health identified to be of value to the patient. An introduction to multidimensional general and disease-specific health status measures is presented. Health status and other outcomes assessments should be part of a continuous quality improvement cycle which begins with measuring patient status and developing treatment plans, proceeds to monitoring patient progress, evaluates the clinical effectiveness of the service, and concludes with outcomes information being fed back to improve the structure and process of future health care services before the cycle can begin again.

Attitude to Health↗
PubMed2001

The effects of postpartum stress and social support on postpartum women's health status.

BACKGROUND: Eastern sociocultural systems differ in many ways from Western ones, and these differences influence many aspects of the postpartum period. AIM: The purpose of this study was to determine postpartum women's health status in the wider social context of the Taiwanese family after women return home from the hospital or clinic. METHOD: A longitudinal study was conducted with data collected at the first, the third, and the fifth weeks of the postpartum period. Five hundred and twenty-six postpartum women were included in the study using stratified sampling from clinics and hospitals in Kaohsiung City in the southern part of Taiwan. The Hung Postpartum Stress Scale (HPSS), Smilkstein's Social Support Scale, and the Chinese Health Questionnaire were used to obtain information about the women's postpartum stress, social support, and health status at each time point. Data were analysed with factor analysis, repeated measures MANOVA, and multiple logistic regression. RESULTS: Three factors associated with postpartum stress were identified by factor analysis: (1) maternity role attainment, (2) lack of social support, and (3) body changes. Furthermore, the level of postpartum stress at the third and the fifth postnatal weeks was higher than at the first. Social support scores at this postnatal week were the highest among the three points in time. In addition, 29%, 41% and 41% of the women at the first, third, and fifth weeks, respectively, had minor psychiatric morbidity. CONCLUSIONS: Because the postpartum women's self-reported stress is relatively low whereas the social support is relatively high, especially from the family, this confirms Pillsbury's conclusion regarding the significance of social support during the Chinese women's postpartum period. The study also showed that the three factors associated with postpartum stress were important predictors of postpartum women's health status. Future studies should compare the level of postpartum stress, social support, and women's health status in both Western and Eastern cultures.

Adult↗
PubMed1996

Race and self assessed health status: the role of socioeconomic factors in the USA.

STUDY OBJECTIVE: To estimate relative odds ratios and to ascertain the relative contribution of each socioeconomic covariate in explaining racial disparities in self assessed health status (for example, global health perceptions and functional limitations of daily activities). DESIGN: National representative data from the 1987-88 national survey of families and households, a multistage, stratified probability sample of non-institutionalised American adults age 19 and older, were used. Logistic regression models enabled a multistage building strategy to be used in the analyses. PARTICIPANTS AND SETTING: The study included three racial groups: whites (n = 9419), blacks (n = 2391), and Hispanics (n = 1004). While face to face interviews were carried out with each respondent, some portions of the interview were self administered to collect sensitive information. MAIN RESULTS: Compared with whites, blacks and Hispanics were more likely to assess health as poor and report having functional limitations of daily activities. Socioeconomic factors tended to play a different role in explaining racial disparities in self assessed health status. In global health, education tended to play a significant role in accounting for health disparities between whites and Hispanics. In functional limitations, none of the covariates explained racial differences for blacks, whereas for Hispanics, education and marital status explained racial differences. CONCLUSIONS: The debate over whether race is a proxy for socioeconomic conditions or race influences health independent of socioeconomic factors depends on the measure of health and racial group included in the study. Future studies should examine separately the differential impacts of various socioeconomic factors on varying domains of health.

Activities of Daily Living↗
PubMed2005

Travel and health status: a survey follow-up study.

BACKGROUND: To date there is little sound knowledge on the relationship between travel and health status as perceived by the traveller. Our aim was to investigate the frequency and risk factors of travel-associated illnesses and injuries and identify potential protective factors. METHODS: All adults enrolled in a health insurance scheme who planned to travel in 2002 were eligible for participation in a baseline survey. Pre-travel written questionnaires and post-travel telephone interviews were conducted with responders. We analysed travel-associated health problems using descriptive methods and multivariate logistic regression. RESULTS: From 8316 persons who returned a pre-travel questionnaire, a sample of 2384 were chosen, of whom 1471 completed post-travel interviews. 10.1% of all travellers reported travel-associated illnesses, and 1.8% suffered from injuries during travel. Among travellers to European destinations, 6.0% reported an illness as opposed to 16.2% of travellers to overseas destinations. Predictors for travel-associated illness were age <30 years (OR 1.48), duration of travel >4 weeks (OR 3.35) and travel destination. Perceived health status as scored by the travellers improved after travel. The frequency of medical consultations and personal health-related expenses decreased significantly shortly after travel. CONCLUSIONS: In this study, travel had a positive effect on the perceived health status of the traveller. The positive effects of travel seemed to outweigh the impact of health problems. Travel did not lead to increased health-related costs, neither in individual health expenses nor indirectly through increased medical consultation rates.

Adult↗
PubMed2005

Reliability, effect size, and responsiveness of health status measures in the design of randomized and cluster-randomized trials.

BACKGROUND: New health status survey instruments are often described by their psychometric (measurement) properties, such as Validity, Reliability, Effect Size, and Responsiveness. For cluster-randomized trials, another important statistic is the Intraclass Correlation (ICC) for the instrument within clusters. Studies using better instruments can be performed with smaller sample sizes, but better instruments may be more expensive in terms of dollars, opportunity cost, or poorer data quality due to the response burden of longer instruments. METHODS: We defined the psychometric statistics in terms of a mathematical model, and examined the power of a two-sample test as a function of the test-retest Reliability, Effect Size, Responsiveness, and Intraclass Correlation of the instrument. We examined the "cost-effectiveness" of using a one-item versus a five-item measure of mental health status. FINDINGS: Under the standard model for measurement error, the psychometric statistics are all functions of the same error term. They are also functions of the setting in which they were estimated. In randomized trials, power is a function of Reliability and sample size, and a less reliable instrument can achieve the desired power if N is increased. In cluster-randomized trials, adequate power may be obtained by increasing the number of clusters per treatment group (and often the number of persons per cluster), as well as by choosing a more reliable instrument. The one-item measure of mental health status may be more cost-effective than the five-item measure in some situations. CONCLUSION: If the goal is to diagnose or refer individual patients, an instrument with high Validity and Reliability is needed. In settings where the sample sizes are large or can be increased easily, any valid instrument may be cost-effective. It is likely that many published values of psychometric statistics are accurate only in settings similar to that in which they were estimated.

Cost-Benefit Analysis↗
PubMedDate not supplied

Gender and age differences in pain, coping and health status among children with chronic arthritis.

OBJECTIVE: To investigate pain, coping and health status in children with chronic arthritis. Additional aims were to explore gender variations in pain, coping and health status, and the same factors in children under 16 years versus children 16 years or older. METHODS: For 125 children (43 boys) with a median age of 14.1 years (range 10.3-17.8) disability and discomfort were assessed (Childhood Health Assessment Questionnaire, CHAQ). Pain, coping, fatigue, sleeping and satisfaction with life were evaluated (Visual Analogue Scales). The Pain Intensity Scale was used to assess the variation in pain intensity during one week. RESULTS: The CHAQ disability index (DI) was 0.63. In the total sample, girls had larger numbers of affected joints in upper extremities (p = 0.028) and more days with morning pain (p = 0.025) than boys. Boys reported greater perceived ability to reduce pain than girls (p = 0.020). Compliance with treatment was more frequent in girls than in boys (p = 0.029). In children 16 years of age and older, boys reported greater perceived ability to control pain (p = 0.032) and to reduce pain than girls (p = 0.001) and fewer days with worst pain in the mornings (p = 0.013), as well as less pain variations over the period of a day (p = 0.014) and over a period of a week (p = 0.035). CONCLUSIONS: As a group, the children were clearly affected by their arthritis. Pain was related to the severity of disease. Some significant gender and age differences were highlighted, which should be considered in clinical pain management.

Adaptation, Psychological↗