title: Personal factors in systemic sclerosis and their coverage by patient-reported outcome measures. A multicentre European qualitative study and literature review.
abstract: BACKGROUND
  Systemic sclerosis (SSc) is an autoimmune disease where thickening of the skin can lead to reduced body function and limitations in activities. Severe forms can also affect and seriously damage inner organs. Patient-centred rehabilitation emphasises considerations of patients' background, experience and behavior which highlights the need to know if patient-reported outcome measures (PROMs) include such personal factors.
  
  
  OBJECTIVE
  To identify and describe personal factors in the experiences of functioning and health of persons with SSc and to examine if and to what extent PROMs in SSc research cover these factors.
  
  
  METHODS
  Data from a qualitative study with focus group interviews were analysed. PROMs in SSc research were identified in a literature review between 2008-2013.
  
  
  METHODS
  Participants were recruited from outpatient clinics at rheumatology department.
  
  
  METHODS
  Sixty-three patients with SSc from four European countries participated.
  
  
  METHODS
  Data from interviews were analysed using a structure of personal factors developed by Geyh et al. Identified PROMs were analysed and linked to main concepts, related to the personal factors, found in the interview data.
  
  
  RESULTS
  Nineteen main concepts were related to the area "patterns of experience and behaviour" in the personal factor structure, 16 to "thoughts and beliefs", nine to "feelings", one to "motives" and one to "personal history and biography", respectively. Among the 35 PROMs identified, 15 did not cover any of the identified concepts. Concepts within the area "feelings" were mostly covered by the PROMs. Five of the PROMs covered "patterns of experience and behaviour", while "motives" and "personal history and biography" were not covered at all. Four of the identified PROMs covered concepts within the areas "feelings", "thoughts and beliefs" and "patterns of experience and behaviour" in the same instrument. The Illness Cognition Questionnaire and Illness Behaviour Questionnaire were such PROMs.
  
  
  CONCLUSIONS
  Patterns of experience and behaviour had the highest number of concepts related to personal factors, but few of the PROMs in SSc research covered these factors. Only a few PROMs covered several personal factors areas in the same instrument.
  
  
  CONCLUSIONS
  The results would be of value when developing core sets for outcome measurements in SSc.
authors.affiliation: Department of Health Sciences, Luleå University of Technology, Luleå, Sweden - malin.mattsson@nll.se.
authors.forename: M
authors.initials: M
authors.lastname: Mattsson
authors.forename: C
authors.initials: C
authors.lastname: Boström
authors.forename: C
authors.initials: C
authors.lastname: Mihai
authors.forename: J
authors.initials: J
authors.lastname: Stöcker
authors.forename: S
authors.initials: S
authors.lastname: Geyh
authors.forename: G
authors.initials: G
authors.lastname: Stummvoll
authors.forename: G
authors.initials: G
authors.lastname: Gard
authors.forename: B
authors.initials: B
authors.lastname: Möller
authors.forename: R
authors.initials: R
authors.lastname: Hesselstrand
authors.forename: G
authors.initials: G
authors.lastname: Sandqvist
authors.forename: O
authors.initials: O
authors.lastname: Draghicescu
authors.forename: A M
authors.initials: AM
authors.lastname: Gherghe
authors.forename: M
authors.initials: M
authors.lastname: Voicu
authors.forename: O
authors.initials: O
authors.lastname: Distler
authors.forename: J S
authors.initials: JS
authors.lastname: Smolen
authors.forename: T A
authors.initials: TA
authors.lastname: Stamm
mesh_terms: D004185:Disability Evaluation; D005060:Europe; D006801:Humans; D015337:Multicenter Studies as Topic; D063868:Patient Outcome Assessment; D036301:Qualitative Research; D012595:Scleroderma, Systemic / Q000534:rehabilitation*