Fibromiyalji Sendromu Hastalarının İşlevsellik, Yetiyitimi ve Sağlığın Uluslararası Sınıflandırılması ICF Kapsamında Değerlendirilmesi: Pilot Çalışma

Amaç: Bu çalışmanın amacı, kronik yaygın ağrı KYA için geliştirilmiş olan İşlevsellik, Yetiyitimi ve Sağlığın Uluslararası Sınıflandırılması ICF çekirdek dizisinin fibromiyalji sendromu FMS hastalarındaki sağlık sorunlarının etkinlikler ve katılım ile çevresel faktörler bileşeninde değerlendirilmesidir. Hastalar ve Yöntemler: Bu çalışma prospektif, kesitsel bir pilot çalışma olarak planlandı ve 2017 Haziran-2018 Mart ayları arasında yürütüldü. Çalışmada KYA için Kısa ICF Çekirdek Dizisi ICF kullanıldı. Bu ICF çekirdek dizisinde yer alan 24 kategori, 254 FMS hastası üzerinde değerlendirildi. Vücut işlevleri, etkinlikler ve katılım alanlarındaki kategoriler 0–4 arası puanlama ile değerlendirildi. Bulgular: Hastaların %97,6’sı kadın iken n=248 , %2,4’ü erkekti n=6 . Vücut işlevlerinde yapılan değerlendirmeye göre özellikle enerji, uyku, psikomotor fonksiyon, emosyonel durum, düşünce içeriği, ağrı, egzersiz tolerans, ve kas kuvveti kategorilerinde orta veya ciddi düzeyde bozukluk tespit edildi. Etkinlikler ve katılım alanında yapılan değerlendirmeye göre ise, problem çözme, günlük yaşam aktivitelerini yerine getirme, stresle baş etme, cisimleri kaldırma-taşıma, yürüme, ev işi yapma, aile ilişkileri, yakın ilişkiler, işe başlama-devam ettirme, boş zamanlarını değerlendirme kategorilerinde orta veya ciddi düzeyde sorun tespit edildi. Çevresel faktörler alanı incelendiğinde ilaç kullanımı, aile ilişkileri, sağlık profesyonellerinin tutumu, yakın aile ilişkileri, ve sosyal sistemlerin ve politikalarının genel olarak orta düzeyde kolaylaştırıcı olduğu tespit edilmiştir. Sonuç: FMS, sadece hasta olan bireyi değil, bireyin yaşadığı alanda bireyle etkileşim halinde olan diğer toplumsal bireyleri ve grupları da etkileyen ve geniş çaplı sistemik etkilerin ortaya çıkmasına neden olan kronik bir hastalıktır. ICF sistemi ile FMS gibi hastalıklarda, sadece hastalığın etkileri değil, hastalığın direk veya dolaylı olarak oluşturduğu çevresel etkiler de ayrıntılı olarak incelenebilir.

Evaluation of Fibromyalgia Syndrome Patients With International Classification of Functioning, Disability and Health Icf : a Pilot Study

Objectives: The objective of this study was the evaluation of the International Classification of Functioning, Disability and Health ICF core set which was developed for chronic widespread pain CWP in patients with fibromyalgia syndrome FMS in terms of activities and participation, and environmental factors. Patients and Methods: This study was designed as a prospective, cross-sectional pilot study and conducted between June 2017 and March 2018. A brief ICF core set for CWP was applied to patients. A total of 24 categories of the brief ICF core were applied to 254 FMS patients. Categories of body functions and activities and participation were scored between 0 and 4. Results: Among enrolled patients, 96.7% n=248 were females and 2.4% n=6 were males. Among body function evaluations, mild and severe disturbances were observed in energy, sleep, psychomotor function, emotional function, content of thought, pain, exercise tolerance, and muscle power categories. In activities and participation, mild and severe disturbances were determined in problem-solving, carrying out a daily routine, handling stress, lifting and carrying objects, doing housework, family relationships, intimate relationships, acquiring and keeping a job, recreation and leisure categories. Among environmental factors, individual attitudes of health professionals, family relationships, and social services, systems and policies were considered moderately facilitating factors. Conclusion: FMS is a chronic disease that affects not only the patient but also the individuals or groups who are in contact with the patient. With the use of ICF, environmental effects caused directly or indirectly by the disease may be evaluated in chronic diseases such as FMS.

Keywords:

Fibromyalgia, chronic widespread pain, ICF, functioning disability,

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Cieza A, Ewert T, Ustun TB, Chatterji S, Kostanjsek N, Stucki G. Development of ICF Core Sets for patients with chronic conditions. J Rehabil Med 2004;36:9–11. [CrossRef]

World Health Organization (WHO). International classification of functioning, disability, and health: ICF. Version 1.0. Geneva: World Health Organization; 2001. https://apps.who.int/iris/bitstream/ handle/10665/42407/9241545429.pdf;jsessionid=B56F33947DC15 1536AFCCA7543827ACD?sequence=1

Dernek B, Esmaeilzadeh S, Oral A. The utility of the International Classification of Functioning, Disability and Health checklist for evaluating disability in a community-dwelling geriatric population sample. Int J Rehabil Res 2015;38:144–55. [CrossRef]

Hieblinger R, Coenen M, Stucki G, Winkelmann A, Cieza A. Validation of the International Classification of Functioning, Disability and Health Core Set for chronic widespread pain from the perspective of fibromyalgia patients. Arthritis Res Ther 2009;11:R67. [CrossRef]

Guyatt GH, Feeny DH, Patrick DL. Measuring health-related quality of life. Ann Intern Med 1993;118:622–9. [CrossRef]

Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Hauser W, Katz RL, et al 2016 Revisions to the 2010/2011 fibromyalgia diagnostic criteria. Semin Arthritis Rheum 2016;46:319–29. [CrossRef]

Wolfe F, Ross K, Anderson J, Russell IJ, Hebert L. The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheum 1995;38:19–28. [CrossRef]

Clauw DJ, Crofford LJ. Chronic widespread pain and fibromyalgia: what we know, and what we need to know. Best Pract Res Clin Rheumatol 2003;17:685–701. [CrossRef]

Richardson JC, Ong BN, Sim J. Experiencing chronic widespread pain in a family context: giving and receiving practical and emotional support. Sociol Health Illn 2007;29:347–65. [CrossRef]

Gupta A, Silman AJ, Ray D, Morriss R, Dickens C, MacFarlane GJ, et al. The role of psychosocial factors in predicting the onset of chronic widespread pain: results from a prospective population-based study. Rheumatology (Oxford) 2007;46:666–71. [CrossRef]

Sylvain H, Talbot LR. Synergy towards health: a nursing intervention model for women living with fibromyalgia, and their spouses. J Adv Nurs 2002;38:264–73. [CrossRef]

Stucki G, Boonen A, Tugwell P, Cieza A, Boers M. The World Health Organisation International Classification of Functioning, Disability and Health: a conceptual model and interface for the OMERACT process. J Rheumatol 2007;34:600–6.

Mease P. Fibromyalgia syndrome: review of clinical presentation, pathogenesis, outcome measures, and treatment. J Rheumatol Suppl 2005;75:6–21.

Mease P, Arnold LM, Bennett R, Boonen A, Buskila D, Carville S, et al. Fibromyalgia syndrome. J Rheumatol 2007;34:1415–25.

Lofgren M, Ekholm J, Broman L, Njoo P, Schult ML. Using a profile of a modified Brief ICF Core Set for chronic widespread musculoskeletal pain with qualifiers for baseline assessment in interdisciplinary pain rehabilitation. J Multidiscip Healthc 2013;6:311–21. [CrossRef]

Bautz-Holter E, Sveen U, Cieza A, Geyh S, Roe C. Does the International Classification of Functioning, Disability and Health (ICF) core set for low back pain cover the patients’ problems? A cross- sectional content-validity study with a Norwegian population. Eur J Phys Rehabil Med 2008;44:387–97. https://www.minervamedica.it/ en/getfreepdf/xUJXGmDZrMxupGFw5%252FV1lmYVHCdlrsR8HNQ AbCFGf39IjlxeChCcOb%252Bq84iN8APBlVHcXXDuP9ySxiYJhgj2BQ %253D%253D/R33Y2008N04A0387.pdf

Amris K, Waehrens EE, Stockmarr A, Bliddal H, Danneskiold-Samsoe B. Factors influencing observed and self-reported functional ability in women with chronic widespread pain: a cross-sectional study. J Rehabil Med 2014;46:1014–21. [CrossRef]

Finger ME, Selb M, De Bie R, Escorpizo R. Using the International Classification of Functioning, Disability and Health in Physiotherapy in Multidisciplinary Vocational Rehabilitation: A Case Study of Low Back Pain. Physiother Res Int 2015;20:231–41. [CrossRef]