Development and validation of a short form of the valued life activities disability questionnaire for rheumatoid arthritis

Abstract

Objective Develop and validate a shortened version of the Valued Life Activities disability and accommodations scale (VLA) for individuals with rheumatoid arthritis (RA). Methods To shorten the existing VLA measure, item response theory analyses were conducted using data from 449 patients with RA. Next, the resulting 14-item shortened version of the VLA scale (S-VLA) was evaluated by structured interviews among 20 RA patients. Lastly, the S-VLA was administered to 150 RA patients along with other measures including the Health Assessment Questionnaire (HAQ) and SF-36. A random sample of 50 patients completed the S-VLA two weeks later to assess reliability. Item statistics were calculated to evaluate correlations between individual items and S-VLA total score. Correlations between the S-VLA and other measures were used to evaluate validity. Results Test–retest reliability was 0.91, while Cronbach’s alpha for the S-VLA was 0.95. None of the 14 items were associated with improved alpha coefficients when omitted. All items were strongly correlated with the S-VLA total score. S-VLA scores were highly positively correlated with HAQ (r=0.81; p≤0.001), patient-reported disease activity (r=0.71; p≤0.001), satisfaction with abilities (r=0.82; p≤0.001), and number of days with activity limitations (r=0.65; p≤0.001). In addition, as hypothesized, the S-VLA was inversely correlated with SF-36 Physical Component Summary score (r=−0.78; p≤0.001) and subscales: Physical Functioning (r=−0.80; p≤0.001), Role Physical (r=−0.67; p≤0.001) and Social Functioning (r=−0.72; p≤0.001). Conclusions The S-VLA is a short, valid, and reliable instrument that may prove useful for monitoring disability among individuals with RA.

Participation in work in early rheumatoid arthritis: a qualitative interview study interpreted in terms of the ICF

“…In RA patients, declines in the ability to engage in recreational activities and social interactions are related to the onset of depressive symptoms [39], which may in its turn influence participation in work. Measures of work ability will probably correlate positively with measures of the ability to perform the described issues of self-care, social relationships, and recreation and leisure [25][26], but the results regarding participation priorities suggest that the performance of work in early RA will not necessarily show high positive correlations with the actual performance of other valued domains of participation.…”

“…sick leave or a high HAQ score [3,21,25]. Regarding each kind of embedded action, the general ability to participate in work may be facilitated by interventions supporting the ability of the individual as well as interventions on environmental factors [36].…”

“…In addition to individual aspects of functioning such as body functions and an individual's ability to perform certain activities, the ICF model includes participation which is the actual performance of activities in a social context. Regarding the ability of the individual, several assessment instruments have been developed and within a psychometric perspective it has been possible to make selections of items because many abilities correlate fairly well with each other [21,[23][24][25][26]. However, it is more difficult to know how participation in work should be assessed in order to understand and prevent work disability; it is not clear what categories within the ICF activity/participation component that have to be considered when relating participation to e.g.…”

Item Development and Face Validity of the Rheumatoid Arthritis Patient Priorities in Pharmacological Interventions Outcome Measures

“…Not all scales or items identified in the literature were included. For example, items from the Valued Life Activities (VLA) were not used because they were too specific, but were discussed in the consultation meeting as extra examples of wording [42]. Limited existing scales were identified for the eight priorities (Table 3): six for pain; ADL six; mobility two; life enjoyment three; independence four; fatigue five; and valued activities five.…”

Development and Validation of a Lung Transplant-Specific Disability Questionnaire

“…17 18 LT-VLA item reduction and validation An initial LT-VLA version was modelled on a shortened VLA measure (S-VLA) developed for RA. 19 For the S-VLA, item response theory analyses were used to eliminate items while preserving the range of activity 'difficulty' to ensure that a range of activities, from low-physical demand activities such as self-care to higher-demand activities such as physical recreation, was included. The S-VLA correlated strongly (0.97) with the original version; internal consistency and validity estimates for the S-VLA were excellent and closely corresponded to the original.…”