Functioning and preferences for improvement of health among patients with juvenile idiopathic arthritis in early adulthood using the WHO ICF model.
OBJECTIVE
To evaluate functioning and preferences for health among young adult patients with juvenile idiopathic arthritis (JIA) and controls. The WHO International Classification of Functioning, Disability and Health (ICF) was used as a framework.


METHODS
The patient files of a rheumatology hospital were screened to identify patients with juvenile arthritis born 1976 to 1980. Functioning was measured by the Finnish version of the Multidimensional Health Assessment Questionnaire (MDHAQ) within the framework of the ICF. Preferences in improvement of health were measured by the Finnish version of the Arthritis Impact Measurement Scales 2. Age and sex matched controls from the community were selected from the Finnish population registry.


RESULTS
In all, 123 patients with a mean age of 23 (SD 21-26) years participated in the followup study. The mean time from diagnosis to followup was 16.2 years. Among them, 35% (n = 43) were in remission at followup. Lower levels of functioning for 3 ICF components were found in patients with active disease compared to controls. JIA patients with active disease had more pain and lower levels of mobility, self-care, and domestic and social life compared to controls. Patients with active disease differed from those in remission with pain in preferences for improvement of health.


CONCLUSIONS
Patients with active disease need active treatment and rehabilitation to maintain functioning and decrease pain. The ICF offers a promising model to examine the outcomes of adult patients with JIA. Application of the MDHAQ is supported by our evaluation studies in young adults with JIA.
Arkela-Kautiainen
Marja
M
Rheumatism Foundation Hospital, Heinola, Finland. marja.arkela-kautiainen@medcare.fi
Haapasaari
Jarkko
J
Kautiainen
Hannu
H
Leppänen
Leena
L
Vilkkumaa
Ilpo
I
Mälkiä
Esko
E
Leirisalo-Repo
Marjatta
M
D000203:Activities of Daily Living; D001171:Arthritis, Juvenile / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D002648:Child; D004185:Disability Evaluation; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D011788:Quality of Life; D012720:Severity of Illness Index; D018434:Sickness Impact Profile