TY - JOUR A1 - Prodinger, Birgit A1 - Salzberger, T. A1 - Stucki, G. A1 - Stamm, T. A1 - Cieza, A. T1 - Measuring Functioning in People with Fibromyalgia (FM) Based on the International Classification of Functioning, Disability and Health (ICF)—A Psychometric Analysis JF - Pain Practice N2 - Objectives: Instruments to assess functioning in patients with FM vary considerably in their content and are often symptom‐specific. This study aimed to examine whether it is feasible to construct a psychometric‐sound clinical instrument to measure functioning in FM based on the Brief ICF‐Core‐Set for chronic widespread pain (CWP). Methods: Two hundred and fifty six people with FM completed the Brief ICF‐Core‐Set. The Rasch model was used for analysis. Once ordering of response options of ICF categories was ensured, the following properties were studied: fit of the ICF categories to the Rasch model, the targeting between ICF categories and a person’s abilities, unidimensionality, and reliability. Results: Six ICF categories were rescored due to disordered thresholds. Five ICF categories were removed due to high model‐misfit and differential item functioning (DIF) for gender. Scores from 46 participants were excluded due to extreme scores. The ICF categories included display consistency with an underlying unidimensional construct, are free of DIF for age, disease duration and gender, display excellent overall reliability, and cover a range of functioning difficulties. Conclusions: This study illustrates that it is possible to measure functioning as a unidimensional construct based on selected ICF categories from the components body functions, as well as activities and participation of the Brief ICF‐Core‐Set for CWP in patients with FM. KW - Fibromyalgia KW - ICF KW - Psychometric Analysis Y1 - 2011 UR - https://doi.org/10.1111/j.1533-2500.2011.00488.x VL - 12 IS - 4 SP - 255 EP - 265 ER - TY - JOUR A1 - Bauernfeind, B. A1 - Aringer, M. A1 - Prodinger, Birgit A1 - Kirchberger, I. A1 - Machold, K. A1 - Smolen, J. A1 - Stamm, T. T1 - Identification of relevant concepts of functioning in daily life in people with systematic Lupus Erythematosus: A patient Delphi exercise JF - Arthritis Care & Research N2 - Objective To identify the most important and relevant concepts of daily functioning from the perspective of patients with systemic lupus erythematosus (SLE). Methods We conducted a consensus‐building, 3‐round, electronic mail survey with SLE patients using the Delphi technique. The Delphi technique is a structured communication process with 4 key characteristics: anonymity, iteration with controlled feedback, statistical group response, and informed input. The concepts contained in the answers of the patients were extracted and linked to the International Classification of Functioning, Disability and Health (ICF). Results Of the total 225 participants, 194 (86.2%) completed the questionnaires from all 3 Delphi rounds. In total, after the third Delphi round, 307 concepts were identified. Ninety concepts (55 in the domain body functions and structures, 16 in activities and participation, and 19 in environmental factors) were considered relevant by at least 50% of the participants in the third round and linked to the ICF. Twelve concepts were considered important by at least 75% of the participants. Conclusion The high number of concepts resulting from this large‐scale patient Delphi approach underlines the great variety of SLE patients' problems in daily functioning. The results of this patient Delphi project supplement the findings of our focus‐group study in establishing a comprehensive overview of the patient perspective in SLE. KW - Systemic lupus erythematosus KW - Patient Delphi exercise KW - Functioning in daily life Y1 - 2009 UR - https://doi.org/10.1002/art.24165 VL - 61 IS - 1 SP - 21 EP - 28 ER - TY - JOUR A1 - Stamm, T. A1 - Van der Giesen, F. A1 - Thorstensson, C. A1 - Steen, E. A1 - Birrell, F. A1 - Bauernfeind, B. A1 - Marshall, N. A1 - Prodinger, Birgit A1 - Machold, K. A1 - Smolen, J. A1 - Kloppenburg, M. T1 - Patient perspective of hand osteoarthritis in relation to concepts covered by instruments measuring functioning: a qualitative European multicentre study JF - Annals of the Rheumatic Diseases N2 - Objective: To explore whether the concepts important to patients with hand osteoarthritis (OA) are covered by the most commonly used instruments measuring functioning. Method: A qualitative multicentre study using a focus group technique was performed in five European countries: Austria, The Netherlands, Norway, Sweden and the United Kingdom. The qualitative data analysis followed a modified form of “meaning condensation” and used the International Classification of Functioning, Disability and Health (ICF) as a theoretical framework. Finally, the concepts from the focus groups were compared with the content of the most commonly used instruments which had been identified in an earlier theoretical analysis. Results: Fifty-six people (51 women, mean (SD) age 62.7 (7.9) years) with hand OA participated in this study in two focus groups per centre. 63 concepts were extracted from the focus groups. Twenty-one (33%) of the 63 concepts were covered by at least one instrument. Psychological consequences, different qualities of pain, aesthetic changes and leisure activities are important concepts from the focus groups which were not covered by the instruments. The qualitative analysis revealed detailed descriptions of pain-concerning sensations, levels and a certain relation to activity, none of which were fully represented in the instruments routinely used. Conclusion: It was possible to combine the concepts of the focus groups from each centre into a common qualitative analysis. The concepts important to people with hand OA are not fully represented in the most commonly used instruments. KW - Hand osteoarthritis KW - Measuring functioning KW - Qualitative multicentre study Y1 - 2009 UR - http://dx.doi.org/10.1136/ard.2008.096776 VL - 68 IS - 9 SP - 1453 EP - 1460 ER - TY - JOUR A1 - Dür, M. A1 - Steiner, G. A1 - Stoffer, M.A. A1 - Fialka-Moser, V. A1 - Kautky-Willer, A. A1 - Dejaco, C. A1 - Ekmekcioglu, C. A1 - Prodinger, Birgit A1 - Binder, A. A1 - Smolen, J. A1 - Stamm, T. A. T1 - Initial evidence for the link between activities and health: Associations between a balance of activities, functioning and serum levels of cytokines and C-reactive protein JF - Psychoneuroendocrinology N2 - Growing evidence shows interrelations of psychological factors, neurological and immunological processes. Therefore, constructs like a balance of activities, the so called “occupational balance”, could also have biological correlates. The aim of this study was to investigate potential associations between occupational balance, functioning, cytokines and C-reactive protein (CRP) in patients suffering from a chronic inflammatory disease like rheumatoid arthritis (RA) and healthy people. Moreover, we wanted to explore potential differences in gender and employment status. A descriptive study in patients with RA and healthy people was conducted using the Occupational Balance-Questionnaire (OB-Quest) and the Short-Form 36 Health Survey (SF-36). Serum levels of cytokines, such as interleukin 6 (IL-6) and 8 (IL-8), interferon alpha (INFα), tumour necrosis factor alpha (TNFα), rheumatoid factor (RF) and of CRP were measured. Descriptive statistics, as well as Mann-Whitney U tests and Spearmen's rank correlation coefficients (rs) were calculated. One-hundred-thirty-two patients with RA and 76 healthy people participated. Occupational balance was associated with functioning, cytokines and CRP. The strongest associations were identified in the unemployed healthy-people sample with cytokines and CRP being within the normal range. For example, the OB-Quest item challenging activities was associated with IL-8 (rs = − 0.63, p = 0.04) and the SF-36 sub-scale bodily pain was associated with IFNα (rs = − 0.69, p = 0.02). The items rest and sleep (rs = − 0.71, p = 0.01) and variety of different activities (rs = − 0.74, p < 0.01) correlated with the SF-36 sub-scale social functioning. Employed and unemployed people differed in their age and CRP levels. Additionally, gender differences were found in two OB-Quest items in that fewer women were able to adapt their activities to changing living conditions and fewer men were overstressed. In conclusion, we found preliminary biological evidence for the link between occupation and health in that the concepts encompassed in the construct of occupational balance were associated with functioning, cytokines and CRP. KW - Autoimmune disease KW - Psychoneuroendocrinology KW - Inflammatory markers KW - Occupational balance KW - Measure KW - Immunology Y1 - 2016 UR - https://doi.org/10.1016/j.psyneuen.2015.12.015 VL - 65 SP - 138 EP - 148 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Ndosi, M. A1 - Nordenskiöld, U. A1 - Stamm, T. A1 - Persson, G. A1 - Andreasson, I. A1 - Lundgren-Nilsson, A. T1 - Rehabilitation provided to patients with rheumatoid arthritis: A comparison of three different Rheumatology clinics in Austria, Sweden and the UK from the perspectives of patients and health professionals JF - Journal of Rehabilitation Medicine N2 - Objective: To explore patients’ and health professionals’ views of outpatient rehabilitation services for patients with rheumatoid arthritis in 3 different rheumatology sites across Europe. Methods: A qualitative multi-method study was conducted with patients and health professionals in Vienna (Austria), Gothenburg (Sweden) and Leeds (UK). Data collection was carried out during focus groups with patients and health professionals. Patients’ hospital records were integrated into the analysis. Data were analysed for site and findings were compared across sites. Results: A total of 20 patients and 20 health professionals participated in 12 focus groups. Although the 3 sites were all publicly funded university clinics, there were differences between sites regarding the structure and content of rehabilitation services. The themes that emerged in the focus groups were: referrals; continuity in rehabilitation; information provided to patients; patients’ organizations; documentation and communication amongst health professionals; interface between primary and specialist care; and prescription practices. Most themes were addressed at all 3 sites, but there were variations in the specifics within themes. Conclusion: Integration of patients’ and health professionals’ views on how rehabilitation services are coordinated and how (parts of) processes are set up elsewhere provide valuable information for the further optimization of rehabilitation services. KW - Delivery of Healthcare KW - Interdisciplinary Communication KW - Multi-centre study KW - Patient perspective KW - Rehabilitation Y1 - 2015 UR - https://doi.org/10.2340/16501977-1914 VL - 47 IS - 2 SP - 174 EP - 182 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Shaw, L. A1 - Rudman, D. L. A1 - Stamm, T. T1 - Negotiating disability in everyday life: Ethnographical accounts of women with rheumatoid arthritis JF - Disability and Rehabilitation N2 - Purpose: Drawing on data from a larger study, the aim of this paper is to illuminate how the everyday doings of women with disabilities are coordinated to and shaped by organizational processes and social context, particularly as these relate to the potential of being labelled disabled. Methods: An institutional ethnography was conducted with seven Austrian women diagnosed with rheumatoid arthritis (RA). Interviews and participant observations were conducted, and texts about the historical development of disability policies were identified. Data analysis included grouping similar doings of participants together to subsequently explore links between what the women did and how their doings are shaped by disability policies and the social context. Results: The women, who participated in this study, spent time and effort to keep the disease invisible, resist disability and negotiate a disability pass. By drawing upon the historical development of Austrian disability policies, the interpretation reveals how this development infiltrates into participants’ lives and shapes their everyday doing. Conclusion: This study furthers understanding of how broader policies and practices, shaped over historical time, infiltrate into the daily lives of women with disabilities. It illustrates how full participation may not necessarily be a lived reality for people with disabilities at this point in Austria. Implications for Rehabilitation Maximising full participation for people with rheumatoid arthritis is important. This requires focusing not only on the bodily health of people with rheumatoid arthritis but also on their interaction with the social, cultural and political context in their daily lives. This requires also understanding how knowledge about disability is passed on from previous generations. KW - Employment KW - Policies KW - Rheumatoid arthritis KW - Women Y1 - 2014 UR - https://doi.org/10.3109/09638288.2013.800594 VL - 36 IS - 6 SP - 497 EP - 503 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Stamm, T. A. T1 - The emergence of Occupational Science in Austria: An insider perspective JF - Journal of Occupational Science N2 - Occupational science has been discussed in terms of its relation to occupational therapy, its philosophical and theoretical foundations, and its international and interdisciplinary character over the past years. The disciplinary identity of occupational science in non-English speaking countries has not yet been debated in the literature. The aim of this article is to discuss occupational science as an emergent discipline in Austria, a German-speaking country. The discussion is divided into two parts. In the first part we engage in critical reflexivity to explicate the current development of occupational science in Austria by reviewing the disciplinary and historical context of occupational science and the related profession of occupational therapy, the educational and institutional influences as well as the influence of language. In the second part, we illustrate that occupational science is an emerging discipline in Austria by drawing on an ongoing research project: the Gender, Occupational Balance, and Immunology Study. By making explicit how occupational science has emerged, from our insider perspective, we aim to contribute to the further development of the disciplinary identity of occupational science nationally and internationally. KW - Critical reflexivity KW - Knowledge generation KW - Occupational balance KW - Occupational science Y1 - 2012 UR - https://doi.org/10.1080/14427591.2011.582833 VL - 19 IS - 2 SP - 127 EP - 137 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Stamm, T. A. T1 - Self-reflection as a means for personal transformation: An analysis of women's life stories living with a chronic disease JF - Forum Qualitative Sozialforschung / Forum: Qualitative Social Research N2 - The aim of this secondary analysis is to explicate taken-for-granted practices in the health care system in which the life stories of six women with rheumatoid arthritis (RA) are embedded. A secondary analysis of life stories of six women with RA, which were assigned to a typology named "rheumatoid arthritis as a source for new challenges" (STAMM et al., 2008) in the primary narrative study, was conducted. The theoretical framework applied for the analysis was informed by feminist standpoint theory and feminist philosophy. In the present analysis, each of the women challenged established health care practices and the cognitive authority of medicine at a certain point in their life story reflections. Becoming more conscious about health care practices enabled the women to acknowledge their own knowledge and to make choices about their health. The findings challenge health care providers to engage in critical reflexivity to become conscious about and to transform taken-for-granted practices as embedded in larger systems and to create health care environments that enable dialogue between clients and health care providers. KW - Secondary analysis KW - Narratives KW - Feminist critiques on health care KW - Standpoint theory KW - Gender KW - Rheumatiod arthritis Y1 - 2010 UR - http://dx.doi.org/10.17169/fqs-11.3.1379 VL - 11 IS - 4 ER - TY - JOUR A1 - Stamm, T. A. A1 - Machold, K. P. A1 - Smolen, J. A1 - Prodinger, Birgit T1 - Life stories of people with rheumatoid arthritis who retired early: how gender and other contextual factors shaped their everyday activities, including paid work JF - Musculoskeletal Care N2 - Objective: The aim of the present study was to explore how contextual factors affect the everyday activities of women and men with rheumatoid arthritis (RA), as evident in their life stories. Methods: Fifteen people with RA, who had retired early due to the disease, were interviewed up to three times, according to a narrative biographic interview style. The life stories of the participants, which were reconstructed from the biographical data and from the transcribed ‘told story’ were analysed from the perspective of contextual factors, including personal and environmental factors. The rigour and accuracy of the analysis were enhanced by reflexivity and peer‐review of the results. Results: The life stories of the participants in this study reflected how contextual factors (such as gender, the healthcare system, the support of families and social and cultural values) shaped their everyday activities. In a society such as in Austria, which is based on traditional patriarchal values, men were presented with difficulties in developing a non‐paid‐work‐related role. For women, if paid work had to be given up, they were more likely to engage in alternative challenging activities which enabled them to develop reflective skills, which in turn contributed to a positive and enriching perspective on their life stories. Health professionals may thus use some of the women's strategies to help men. Conclusion: Interventions by health professionals in people with RA may benefit from an approach sensitive to personal and environmental factors. KW - Rheumatoid arthritis KW - Gender KW - Everyday activities Y1 - 2010 UR - https://doi.org/10.1002/msc.168 VL - 8 IS - 2 SP - 78 EP - 86 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Weise, A. P. A1 - Shaw, L. A1 - Stamm, T. A. T1 - A Delphi study on Environmental Factors that impact work and social life participation of individuals with Multiple Sclerosis in Austria and Switzerland JF - Disability and Rehabilitation N2 - Purpose: This study aimed to gain knowledge about environmental factors (EFs) that impact work and social life participation of people with multiple sclerosis (MS) in Austria and Switzerland to extend the knowledge of participation and to identify key areas for measuring participation. Method: A three-round Delphi study was conducted defining patients as experts. In the 1st round, qualitative data was gathered through questionnaires, analyzed with content analysis, and factors were assigned to EFs as classified in the ICF. In the 2nd and 3rd round, experts judged EFs according to its relevance to obtain consensus (cut-off 75%). Categories were ranked on a scale from mostly important to important. Results: One hundred and twelve Austrian and 109 Swiss experts were recruited. The content analysis revealed 768 EFs. The study resulted in a list of 176 consensus factors for Austria and 177 Switzerland. Five categories revealed to be highly important, 12 moderately important, 6 fairly important, and 10 important. Conclusions: This study indicates that participation in work or social life is influenced by physical, social, attitudinal, and policy factors. Consensus factors afford insights into areas for consideration in the development of participation outcome measurements and support a comprehensive and inclusive rehabilitation approach. KW - Contextual factors KW - Patient perspective KW - Consensus method KW - ICF KW - Disability and health Y1 - 2010 UR - https://doi.org/10.3109/09638280903071883 VL - 32 IS - 3 SP - 183 EP - 195 ER -