The Michigan Hand Outcomes Questionnaire (MHQ): Assessment of responsiveness to clinical change

被引:254
作者
Chung, KC
Hamill, JB
Walters, MR
Hayward, RA
机构
[1] Univ Michigan, Med Ctr, Dept Surg, Plast & Reconstruct Surg Sect, Ann Arbor, MI 48109 USA
[2] Vet Adm Med Ctr, VA Ctr Practice Management & Outcomes Res, Ann Arbor, MI 48105 USA
[3] Dept Vet Affairs, Ann Arbor, MI USA
[4] St Joseph Mercy Hosp, Trauma Program, Ann Arbor, MI 48104 USA
关键词
D O I
10.1097/00000637-199906000-00006
中图分类号
R61 [外科手术学];
学科分类号
摘要
Responsiveness is an important property of an outcomes questionnaire. It can be defined as the ability of an instrument to capture important changes in a patient's health status over time. The authors previously designed the Michigan Hand Outcomes Questionnaire (MHQ), a hand-specific outcomes instrument that contains six distinct scales: (1) overall hand function, (2) activities of daily living, (3) pain, (4) work performance, (5) aesthetics, and (6) patient satisfaction with hand function. In the first study, the authors demonstrated that the MHQ is a reliable and valid instrument for the hand. The purpose of this second study is to assess the responsiveness, or sensitivity, of the MHQ to clinical change in patient status. A total of 187 consecutive patients with chronic hand disorders completed a baseline MHQ prior to receiving treatment at a university plastic surgery clinic. Approximately 6 to 18 months after completing the first questionnaire, patients were sent a follow-up MHQ by mail. The second questionnaire was identical to the first, with the exception of one additional question added to each of the six MHQ scales. This additional question asked patients to rate the change in their hands since completing the last questionnaire using a seven-point response scale. Spearman's correlation coefficient was used to correlate the responses from patients' self-assessment questions with the actual score change (after score - before score). The response rate for the second administration was 49% (92 questionnaires returned)-a fairly good rate of return for mail surveys. There were no significant differences in gender, race, education, and income between responders and nonresponders. When patients' self-assessment of change was correlated with the change in the six scale scores over time, all six correlations were statistically significant, with p < 0.05. The correlations ranged from 0.25 for the aesthetics scale to 0.43 for the pain scale. The MHQ was responsive using patients' self-assessment of their clinical change. Future studies will evaluate the responsiveness of the MHQ compared with objective physiological measures such as grip strength, range of motion, and the Jebson-Taylor test. Additionally, research is underway to assess the responsiveness of the MHQ for specific procedures, including metacarpophalangeal arthroplasties for rheumatoid arthritis and microvascular toe-to-hand reconstructions.
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页码:619 / 622
页数:4
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