bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hip fracture in older persons does self‐efficacy‐based intervention have a role in rehabilitation?
Authors: Allegrante John P. , Ronald MacKenzie C. , Robbins Laura , Cornell Charles N. 
Published: February 2007

AbstractOver 250,000 patients are hospitalized each year in the United States for treatment of a fractured hip, resulting in considerable medical, social, and economic costs to society. Most hip fractures occur among older persons who have fallen. The consequences of hip fractures due to falls by older persons include loss of confidence and the accompanying deterioration in global functional capacity for independent living. This article reviews the problem of hip fracture in the elderly and suggests that intervention approaches designed to enhance personal self‐efficacy through patient education may have an important role to play in rehabilitation after hip fracture.
Psychosocial effects of juvenile rheumatic disease the family and peer systems as a context for coping
Authors: Harris Jennifer A. , Newcomb Andrew F. , Gewanter Harry L. 
Published: February 2007

AbstractThe psychosocial effects of juvenile rheumatic diseases and disease activity were examined among 24 children and their families (12 children with a rheumatic disease and 12 children with no chronic illness). Each child with rheumatic illness was paired with a healthy control child nominated by their classroom teacher. Family and child functioning was assessed through measures of competence, coping, and adjustment and through direct observation of social functioning with peers at school. Multivariate and univariate analyses were performed to examine scores on the assessment measures, percentages of time spent in peer activities, and frequency scores for types of peer interactions. The results of these analyses indicated that juvenile rheumatic disease (JRD) is not associated with detrimental psychosocial outcomes. Instead, the results indicated that JRD children and their families actively utilize multiple coping strategies. These findings stress the importance of including and examining the family and peer systems as contexts for coping in future research.
Immediate and short‐term effects of three commercial wrist extensor orthoses on grip strength and function in patients with rheumatoid arthritis
Authors: Stern Erica B. , Ytterberg Steven R. , Krug Hollis E. , Mullin Gerald T. , Mahowald Maren L. 
Published: February 2007

AbstractObjective. To investigate the immediate and shortterm effects of 3 commercial wrist orthoses on grip strength and function.Methods. Thirty‐six patients with definite rheumatoid arthritis participated in the randomized, controlled, cross‐over design study of 3 commercial wrist extensor orthoses. Dominant‐hand dynamometric grip strength was assessed at both initial and followup sessions while splinted and nonsplinted. Functional impact was assessed using a written questionnaire.Results. All 3 commercial orthoses reduced grip strength when first donned. After a 1‐week adjustment period, one orthosis, the Smith and Nephew Roylan D‐Ring® (Roylan), afforded splinted grip strength equal to that of the nonsplinted grip strength. The other 2 orthoses continued to reduce grip strength, and afforded splinted grip strength significantly below that of the Roylan. The Roylan was deemed comfortable by more subjects than the other orthoses.Conclusions. The belief that commercial orthotic use increases grip strength, either immediately or after 1 week, is not supported by this study's data. Different styles of commercial wrist orthoses appear to have differing influence on splinted grip strength.
The effect of person‐centered counseling on the psychological status of persons with systemic lupus erythematosus or rheumatoid arthritis. A randomized, controlled trial
Authors: Maisiak Richard , Austin Janet , West Susan , Heck Louis 
Published: February 2007

AbstractObjective. We tested the effectiveness of a 6‐month person‐centered (PC), nondirective, telephone‐based counseling intervention for improving the psychological status of persons with systemic lupus erythematosus (SLE) or rheumatoid arthritis (RA).Methods. The design was a parallel‐group, randomized, controlled study comparing a PC counseling intervention (8 SLE, 28 RA patients) with usual care (7 SLE, 30 RA patients). The Arthritis Impact Measurement Scales was used to measure psychological dysfunction, physical dysfunction, and pain at baseline and at followup.Results. The main finding was that the PC counseling intervention significantly improved the psychological status of the SLE patients (P < 0.05, effect size = 1.13, responsiveness = 0.77) in comparison to usual care. There was no evidence of a benefit for persons with RA or of improvements in physical function or pain for persons with either disease.Conclusions. PC counseling may be an effective intervention for improving the psychological status of persons with SLE, but may not be for those with RA.
Differences in symptom reports between men and women with rheumatoid arthritis
Authors: Katz Patricia P. , Criswell Lindsey A. 
Published: February 2007

AbstractObjective. To determine if differences exist between men and women in their reports and evaluations of rheumatoid arthritis (RA) symptoms, and, if so, to identify explanations for those differences.Method. Data from a longitudinal panel study of persons with RA were used. Symptom reports were defined as individuals' evaluations of body states, e.g., evaluations of the severity of pain. Analyses were controlled for sociodemographic, clinical, and psychological characteristics.Results. In unadjusted analyses, women were more likely to evaluate their symptoms as severe. Adjustment for sociodemographic and clinical characteristics changed these results very little. Controlling for depressive symptoms decreased the magnitude of associations somewhat. Analyses controlling for additional respondent‐reported clinical characteristics (Health Assessment Questionnaire score, number of painful joints) yielded dramatically different results; in no case did women evaluate their symptoms significantly more severely than men.Conclusion. Our analyses suggest that women reported more severe symptoms, but that these differences may be due to more severe disease rather than a tendency by women to over‐report symptoms or overrate symptom severity. Future research should examine whether physicians respond to reports or prescribe treatments differently for men and women.
Racial aspects of comorbidity in systemic lupus erythematosus
Authors: Walsh Stephen J. , Algert Charles , Rothfield Naomi F. 
Published: February 2007

AbstractObjective. To investigate racial differences in the expression of systemic lupus erythematosus (SLE) by comparing comorbidity at death among individuals with SLE.Methods. Proportional mortality rates were estimated for common contributing causes of death among white and black females in the United States, 1989–1991, whose death certificates listed SLE as an underlying or contributing cause. Logistic regression analysis was used to assess the effects of SLE and race on variation in proportional mortality using rates from non SLE deaths as a comparison baseline.Results. Common contributing causes of death listed with SLE included conditions that are known sequelae of the disease. Proportional mortality rates for these conditions varied with race and age. However, among black deaths that listed SLE, the rates of renal disease surpassed those of all other conditions regardless of age. When rates of renal disease among black SLE deaths or among white SLE deaths in any age group were compared to those among white non‐SLE deaths, proportional mortality ratios were significantly greater than 1. This also held when rates of renal disease among black non‐SLE deaths were compared to rates among white non‐SLE deaths. However, across all ages, the proportional mortality ratios for renal disease in black SLE deaths significantly exceeded corresponding ratios for white SLE deaths and for black non‐SLE deaths.Conclusion. Black females who die with SLE appear to experience a combination of the excess renal disease reported for persons with SLE and for all blacks. This combination may be a source of the elevated SLE mortality rates observed among US blacks.
Nutrient intake patterns, body mass index, and vitamin levels in patients with rheumatoid arthritis
Authors: Morgan Sarah L. , Anderson Ashley M. , Hood Sara M. , Matthews Patricia A. , Lee Jeannette Y. , Alarcón Graciela S. 
Published: February 2007

AbstractObjective. To assess nutrient intakes and vitamin levels in 79 patients with rheumatoid arthritis participating in a trial and to determine whether changes in body mass index were associated with changes in disease activity.Methods. This study evaluated baseline vitamin levels, 1‐day dietary intakes, and weight every 3 months for 1 year. Linear regression analysis was used to evaluate the relationship of time to body mass index. Analysis of covariance was used to determine if body mass index, time, or treatment had an effect on disease activity.Results. Deficient vitamin levels and poor nutrient intake patterns were prevalent in the study population. Changes in body mass index over time did not correlate with changes in disease activity.Conclusions. Rheumatoid arthritis patients are at high risk of obesity, abnormal vitamin levels, and poor nutrient intakes. Changes in body mass index failed to correlate with changes in disease activity.
The importance of enhancing self‐efficacy in rheumatoid arthritis
Authors: Smarr Karen L. , Parker Jerry C. , Wright Gail E. , Stucky‐Ropp Renée C. , Buckelew Susan P. , Hoffman Robert W. , O'Sullivan Frank X. , Hewett John E. 
Published: February 2007

AbstractObjective. To examine relationships among changes in self‐efficacy and changes in other clinically relevant outcome measures.Method. Subjects (n = 44) were participants in a prospective, randomized stress‐management study followed over 15 months. Outcome measures included self‐efficacy, depression, pain, health status, and disease activity.Results. Correlational analyses revealed significant associations between changes in self‐efficacy (particularly total self‐efficacy) and changes in selected measures of depression, pain, health status, and disease activity. The observed associations were not due to changes in medication regimen or to nonadherence to the stress‐management program.Conclusions. Evidence is provided that induced changes in self‐efficacy following a stress‐management program were significantly related to other clinically important outcome measures.
Correlates of fear of falling and activity limitation among persons with rheumatoid arthritis
Authors: Fessel Karen D. , Nevitt Michael C. 
Published: February 2007

AbstractObjectives. To examine factors associated with fear of falling, activity limitation due to fear of falling, and how persons modified their activities in response to fear of falling, among older persons with rheumatoid arthritis (RA).Methods. Participants in a panel study of RA who were over age 50 (n = 570) were questioned about whether they experienced fear of falling and whether and how they limited activities due to fear of falling.Results. Fifty percent reported fear of falling, and 38% modified activities due to fear of falling. Correlates of fear of falling included female gender, depressive symptoms, poor physical functioning, minor fall‐related injuries, and a greater number of painful joints. Correlates of limiting activities due to fear of falling included worse self‐rated health, poor physical functioning, and high painful joint count. Activities commonly affected included stair climbing, walking, and outings.Conclusions. Fear of falling and limiting activities are common problems for persons with RA. Persons at risk should be targeted for appropriate interventions.
Illness behavior in rheumatoid arthritis
Authors: Sakalys Jurate A. 
Published: February 2007

AbstractObjective. To explore prediagnostic illness behavior in rheumatoid arthritis (RA).Method. In this descriptive study, interview and medical records data from 50 female patients were analyzed using quantitative and qualitative techniques.Results. Findings revealed a high incidence of symptom normalization, self‐treatment, symptom comparison, and prolonged time to diagnosis with multiple misdiagnoses and physicians consulted. Most subjects reported invalidation of initial symptoms, multifaceted emotional distress, and relief upon accurate diagnosis. Significant associations were found between (a) illness‐related symptom attributions and fewer physicians consulted (P < 0.05) and less invalidation (P < 0.05); (b) life stress events and fewer physicians consulted (P < 0.05) and shorter time to diagnosis (P < 0.05); (c) remissions and time to diagnosis (P < 0.05), number of physicians consulted (P < 0.001), and number of misdiagnoses (P < 0.001).Conclusion. Illness behavior in RA is prolonged, convoluted, and accompanied by personal and social stress. Invalidation of reported symptoms and relief upon definitive diagnosis are prominent features of the process.
Coordinated individual education with an arthritis passport for patients with rheumatoid arthritis
Authors: Riemsma Robert P. , Taal Erik , Brus Herman L. M. , Rasker Johannes J. , Wiegman Oene 
Published: February 2007

AbstractObjective. To evaluate the effects of a program for individual education in combination with the use of an arthritis passport.Methods. We studied 3 groups of patients with rheumatoid arthritis. The first experimental group received educational materials and followed the program under the guidance of their regular providers of health care whose activities were coordinated through arthritis passports. The second experimental group only received education materials; the control group received only usual care.Results. There were no effects on self‐efficacy expectations, knowledge, health status, or behavior in either experimental group. Opinions of general practitioners, physiotherapists, and visiting nurses concerning the arthritis passport were very positive, but rheumatologists' opinions were not. Opinions on coordination of care were more positive among the physiotherapists of the experimental group.Conclusions. Individual education for patients with rheumatoid arthritis by health care providers during routine consultations, as implemented in this program, had no effect on self‐efficacy expectations, knowledge, health status, or health behavior. Likewise, the distribution of educational materials by itself without the involvement of health care providers had no effect. The use of the arthritis passport improved coordination of care, especially for physiotherapists.
Measures of activity and damage in rheumatoid arthritis: Depiction of changes and prediction of mortality over five years
Authors: Callahan Leigh F. , Pincus Theodore , Huston Joseph W. , Brooks Raye H. , Nance E. Paul , Kaye Jeremy J. 
Published: February 2007

AbstractObjective. To analyze various quantitative measures of inflammatory activity and joint damage, including articular, radiographic, laboratory, questionnaire, and physical function measures, in regard to changes in status in surviving patients and prediction of mortality in non‐survivors over 5 years in a cohort of patients with rheumatoid arthritis (RA) monitored in the mid‐1980s and early 1990s.Methods. A comprehensive evaluation, which included a complete joint count, radiograph, laboratory tests, physical measures of function, and self‐report questionnaire scales, was performed at baseline and 5 years later in 210 consecutive patients with RA.Results. Five years after baseline, 206 of the 210 patients were accounted for: 37 had died, 130 had a comprehensive repeat assessment, and 39 had a more limited repeat assessment. In surviving patients, most measures of activity were generally unchanged or somewhat better, including joint tenderness, pain on motion, and swelling; erythrocyte sedimentation rate and rheumatoid factor; as well as questionnaire scores for pain, global status, helplessness, and difficulty in performing 8 activities of daily living (ADL) according to a modified Health Assessment Questionnaire (MHAQ). By contrast, measures of damage, including joint deformity, grip strength, walk time, and radiographic scores, indicated worse status. Mortality over 5 years was predicted significantly in univariable analyses by American College of Rheumatology (formerly the American Rheumatism Association) Functional Class, limited joint motion, scores for MHAQ, global status, helplessness, grip strength, walk time, button time, and number of comorbidities and duration of diseases, as well as the sociodemographic measures of age and formal education. In multivariable Cox regressions, age, comorbidities, MHAQ, and other measures of functional status were the most effective predictors of 5‐year mortality.Conclusion. In patients with RA, most measures of inflammatory activity were unchanged and sometimes better, while measures of damage indicated worse status in the same patients over 5 years. Measures indicating functional disability, as well as age and comorbidities, predict 5‐year mortality more effectively than radiographic and laboratory data. Measures of inflammatory activity may underestimate long‐term outcomes in RA, and long‐term studies should include measures of damage.
The stresses of rheumatoid arthritis: Appraisals of perceived impact and coping efficacy
Authors: Katz Partricia P. 
Published: February 2007

AbstractObjective. This study examined appraisals of the impact of 7 stressors associated with rheumatoid arthritis (RA) and the perceived ability to cope With those stressors.Methods. Subjects were 446 participants in a panel study of persons with RA. Data were derived from the 1994 annual interview.Results. There were significant differences among mean ratings of the stressors. Taking care of RA, fatigue, pain, and functional impairment were rated as having the greatest impact; perceived coping efficacy was highest for medication side effects and taking care of RA. Appraisals of impact and coping efficacy were negatively correlated. Clinical factors were the strongest predictors of both appraisals. Depressive symptoms and instrumental support were also independently associated with both appraisals for most stressors.Conclusions. All of the stressors were problematic to some degree, suggesting that coping research should include stressors other than pain and function. Most subjects rated the effects of these stressors as moderate, however. Future examination of the coping responses of these individuals may shed light on adaptation to RA.
Treating disability in knee osteoarthritis with exercise therapy: A central role for self‐efficacy and pain
Authors: Rejeski W Jack , Martin Kathleen , Ettinger Walter H. , Morgan Timothy 
Published: February 2007

AbstractObjective. To examine the effects of aerobic and resistance exercise on self‐efficacy beliefs in older adults with knee osteoarthritis [OA] and to determine whether self‐efficacy and knee pain mediated the effects of the treatments on stair time performance and health perceptions.Methods. Measures of self‐efficacy knee pain, stair climbing performance, and health perceptions were collected prior to randomization and again at an 18‐month follow up in older adults with knee OA who were assigned to 1 of 3 treatment conditions: aerobic exercise, resistance training, or health education control. All analyses were conducted on the intention‐to‐treat principle.Results. Both exercise treatments increased self‐efficacy for stair climbing in comparison to the health education control group. Both knee pain and self‐efficacy mediated the effect of the treatments on stair climb time, whereas only knee pain mediated health perceptions.Conclusions. The findings suggest that control beliefs and changes in physical symptoms such as knee pain are important outcomes in physical activity programs with patients who have OA of the knee. Moreover, these variables mediate the effects that such programs have on disability and health perceptions.
One‐year followup of patients with osteoarthritis of the knee who participated in a program of supervised fitness walking and supportive patient education
Authors: Sullivan Theresa , Allegrante John P. , Peterson Margaret G. E. , Kovar Pamela A. , MacKenzie C. Ronald 
Published: February 2007

AbstractObjective. To determine whether gains in functioning observed immediately following participation in an 8‐week program of supervised fitness walking for patients with knee osteoarthritis were sustained at 1‐year followup.Methods. Twenty‐nine (61.1%) of 47 original intervention program patients and 23 (51.1%) of 45 original control patients were interviewed by telephone at 1‐year followup. Patients completed the Arthritis Impact Measurement Scales physical activity, arthritis impact, pain, medication use, and general health perceptions subscales, as well as a separate visual analog pain scale and measures of perceived self‐efficacy to cope with arthritis pain and other symptoms.Results. Adherence to walking was low, and there were no statistically significant differences between intervention and control patients at one year.Conclusions. The failure of intervention patients to maintain regular walking resulted in loss of functional benefits that were observed at 8 weeks in the original study. Long‐term adherence to walking is critical to maintenance of initial gains in functional outcomes.
What do self‐administered joint counts tell us about patients with rheumatoid arthritis?
Authors: Escalante Agustín 
Published: February 2007

AbstractObjective. This report presents data from two sources showing that a self‐administered joint count (SAJC) suitable for use in clinical settings provides information comparable with that of observerassessed joint counts.Methods. Patients were tested with a 1‐page form containing a 40‐joint mannequin on which they could mark their painful or swollen joints. The first sample of 110 patients was used to compare the SAJC with the tender or swollen joint counts (TJC or SJC) performed by a rheumatologist and to a battery of clinical and laboratory measurements. The second sample consisted of 240 rheumatoid arthritis (RA) patients enrolled in a cohort study of RA outcomes, in whom the relationship between the SAJC and health‐related quality of life measures was examined.Results. Test‐retest reliability of the SAJC was excellent (ri = 0.89), as was its agreement with the observer‐assessed TJC (ri = 0.78). The SAJC was significantly correlated (P ≤ 0.01) to pain on a 10‐point scale (r = 0.33), the McGill Pain Questionnaire (r = 0.27), the pain subscale of the Arthritis Impact Measurement Scales (AIMS) (r = 0.32), the duration of morning stiffness (r = 0.27), and to the AIMS subscales of physical function (r = 0.20), impact (r = 0.31), and global health (r = 0.29). The SAJC was inversely related to formal education (r = −0.32), but did not correlate significantly with the modified Health Assessment Questionnaire, walking velocity, grip strength, or erythrocyte sedimentation rate. The responsiveness of the SAJC was comparable with that of other measures commonly employed to assess RA outcomes. Either the SAJC or the TJC could be included alternatively in multivariate models to explain 7 of the 8 subscales of the Medical Outcomes Study Short Form‐36 (SF‐36) questionnaire.Conclusion. The SAJC is a reliable and responsive measure that agrees highly with the observer‐assessed TJC and is significantly associated to the health‐related quality of life of patients with RA. Given its low cost and ease of administration, it is suggested that SAJC be included in future studies of RA outcome in routine clinical practice.