DEVELOPMENT AND VALIDATION OF A RHEUMATOID HAND FUNCTIONAL DISABILITYSCALE THAT ASSESSES FUNCTIONAL HANDICAP

Objective. To construct a functional disability scale for the rheumato id hand and to determine if this scale also assesses functional handic ap. Methods. Outpatients and inpatients with rheumatoid arthritis (RA) according to the ACR criteria, answered a set of questions on their d aily hand activities. Intrarater and interrater reliability were exami ned. Criterion referenced validity, and convergent and divergent valid ities were investigated. Factor analysis followed by varimax rotation was performed. Spearman's (r(S)) correlation coefficients between 2 qu antitative variables were examined. The level of significance was p < 0.05. Results. 96 patients with RA were recruited. The provisional sca le had 41 questions, The elimination process left 18 hand activity que stions with 6 levels of answers, The intrarater and interrater reliabi lities of the scale were 0.97 and 0.96, respectively. Correlation of t he scale's total score with visual analog scale (VAS) measure of funct ional handicap (r(S) = 0.78) showed good criterion referenced validity . The scale had good convergence with Revel's Functional Index (r(S) = 0.91) and a moderate relation to the Hand Functional Index (HFI) (r(S ) = 0.58), The scale had a moderate, fair, or no relation to age, morn ing stiffness, pain measures, and hand swelling, The scale had 3 main factors by factor analysis. An English translation of the scale was va lidated. Conclusion. We have developed a practical functional disabili ty scale for rheumatoid hands that also assesses functional handicap. It has 18 hand activity questions and has been validated in a French p opulation.