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Measuring the impact and distress of osteoarthritis from the patients' perspective


Pallant, Julie F.; Keenan, Anne-Maree; Misajon, Roseanne; Conaghan, Philip G.; Tennant, Alan


BioMed Central


Health and Quality of Life Outcomes, 2009, 7:37, Seite 37, London: BioMed Central, ISSN: 1477-7525 (online)




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To assess the internal construct validity of the Perceived Impact of Problem Profile (PIPP), a patient based outcome measure based on the International Classification of Functioning, Disability and Health (ICF), which assesses impact and distress, in an osteoarthritis (OA) cohort.


A questionnaire comprising the 23-item PIPP, which assesses five domains (mobility, participation, self care, psychological well being and relationships), the Western Ontario McMasters University Osteoarthritis Index (WOMAC), the General Well-Being Index (GWBI), and the Hospital Anxiety and Depression Scale (HADS) was posted to people with clinician diagnosed OA. Assessment of the internal construct validity of the PIPP was undertaken using Rasch analysis performed with RUMM2020 software and concurrent validity through comparator measures.


Two hundred and fifty-nine participants with OA responded. Analysis of the five individual domains of the PIPP indicated that there was good fit to the Rasch model, with high person separation reliability. One item required removal from the Mobility subscale and the Participation subscale. There were strong correlations between the PIPP Mobility scores and the WOMAC disability and pain subscales (rho equal .73 and rho equal .68), and between the PIPP Psychological well-being and HADS Depression (rho equal .71) and GWBI (rho equal -.69). High inter-correlations between the impact and distress subscales for each domain (range rho equal .85 to .96), suggested redundancy of the latter.


This study demonstrates that the PIPP has good psychometric properties in an OA population. The PIPP, using just the impact subscales, provides a brief, reliable and valid means of assessing the impact of OA from the individual's perspective and operationalizing the bio-psychosocial model by the application of a single multi-domain questionnaire.

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Health and Quality of Life Outcomes
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Informationsstand: 08.09.2011

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