General symptom reporting in female fibromyalgia patients and referents: a population-based case-referent study

<p>Abstract</p> <p>Background</p> <p>Fibromyalgia is characterized by widespread musculoskeletal pain and palpation tenderness. In addition to these classic symptoms, fibromyalgia patients tend to report a number of other complaints. What these other complaints are and how often they are reported as compared with related referents from the general population is not very well known. We therefore hypothesized that subjects with fibromyalgia report more of a wide range of symptoms as compared with referents of the same sex and age from the general population.</p> <p>Methods</p> <p>138 women with diagnosed fibromyalgia in primary health care and 401 referents from the general population matched to the cases by sex, age and residential area responded to a postal questionnaire where information on marital status, education, occupational status, income level, immigrant status, smoking habits physical activity, height and weight history and the prevalence of 42 defined symptoms was sought.</p> <p>Results</p> <p>The cases had lower educational and income levels, were more often unemployed, on sick leave or on disability pension and were more often first generation immigrants than the referents. They were also heavier, shorter and more often had a history of excessive food intake and excessive weight loss. When these differences were taken into account, cases reported not only significantly more presumed fibromyalgia symptoms but also significantly more of general symptoms than the referents. The distribution of symptoms was similar in subjects with fibromyalgia and referents, indicating a generally higher symptom reporting level among the former.</p> <p>Conclusion</p> <p>Subjects with fibromyalgia had a high prevalence of reported general symptoms than referents. Some of these differences may be a consequence of the disorder while others may reflect etiological processes.</p

Linking self-determined functional problems of patients with neck pain to the International Classification of Functioning, Disability, and Health (ICF)

Nada Andelic,1 Jan Borre Johansen,1 Erik Bautz-Holter,1,2 Anne Marit Mengshoel,3 Eva Bakke,3 Cecilie Roe1,21Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway; 2Faculty of Medicine, University of Oslo, Oslo, Norway; 3Department of Health Sciences, Institute of Health and Society, University of Oslo, Oslo, NorwayObjective: To describe commonly reported self-determined functional problems in patients with neck pain and to evaluate their fit to the components of the International Classification of Functioning, Disability, and Health (ICF).Methods: Overall, 249 patients were included in this cross-sectional study that comprised patients with neck pain referred to the outpatient clinic at Oslo University Hospital (2007&amp;ndash;2009). Patients were asked to report their three most significant functional problems on the Patient-Specific Functional Scale, a self-determined measure of function. The ICF was used as a tool for analysis. Meaningful concepts within the functional problems were identified, coded, and linked to second-level categories within the components of &amp;ldquo;body functions,&amp;rdquo; and &amp;ldquo;activities and participation.&amp;rdquo; Two researchers performed coding and linking independently. The ICF categories were presented by percentage of the total number of functional problems linked to the ICF.Results: Of 628 reported functional problems, 13 meaningful ICF domains were identified: four domains belonging to the body functions component (b) and nine domains belonging to activities and participation components (d). Within the 88 second-level ICF classification categories of body functions, the most frequently reported items were sleep function (b134; 27%) and mobility of joint functions (b710; 26%). Within the 538 second-level categories of activities and participation, remunerative employment was reported as the most frequent item (d850; 15%), closely followed by doing housework (d640; 14%), and recreation and leisure activities (d920; 13%). Only two meaningful concepts, described as &amp;ldquo;be active&amp;rdquo; and &amp;ldquo;to function after activities,&amp;rdquo; were not assigned to a specific ICF category.Conclusion: The majority of the specific functional problems presented by patients in this study showed a good fit with the ICF model. The substantial number of links to the activities and participation categories, such as mobility, domestic life, employment, and social and civic life, suggests that a comprehensive approach, as well as the involvement of a multidisciplinary team, should be present in the rehabilitation of neck pain-related disability.Keywords: neck pain disability, self-determined functional problems, PSFS, IC