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"Pain. Joints. Spine." 1 (21) 2016

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Results of evaluation an overall well-being in children with juvenile rheumatoid arthritis

Authors: Pavlishin H., Kovalchuk T., Boyarchuk O. - SHEE «Ternopil State Medical University named after I.Ya. Horbachevsky of the Ministry of Health of Ukraine», Ternopil, Ukraine

Categories: Rheumatology, Traumatology and orthopedics

Sections: Medical forums

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The article was published on p. 80

 

In recent years, there has been growing interest in the parent-reported and child-reported assessment of overall well-being in patients with juvenile rheumatoid arthritis (JRA). Integration of these measures in clinical evaluation is considered important as they reflect the parent’s and child’s perception of the disease course and effectiveness of therapeutic interventions. As parents and children are asked with increasing frequency to actively participate in shared decision-making, integration of their perspective in clinical assessment may facilitate concordance with physician’s choices and improve adherence to treatment.

The aim of the research was to determine overall well-being in children with JRA by the results of parents and children assessment.
The 99 children were examined — 60 sick by JRA patients and 39 healthy children. Selected groups were matched by the sex, age, and nationality. Overall well-being was evaluated by the using of visual analogue scale (VAS) in parents and their children. 
It was established that overall well-being in patients with JRA was much worse than in healthy children by the results of the parent-reported assessment (3.7 ± 0.2 cm, 0.7 ± 0.2 cm; p < 0.05), and the patient-reported assessment (3.5 ± 0.3 cm, 0.5 ± 0.1 cm; p < 0.05). In general overall well-being in patients with JRA survey by the various applicants didn’t differ (p > 0.05). 
The results of correlation analysis between an overall well-being, some clinical and laboratory parameters of JRA by the parent- and child-reported assessment are present in table 1.
For standardization of diagnostic approach to evaluation an overall well-being by the parent and child a diagnostic value coefficient by Zemskov A.M. formula was calculated. The most informative was founded the parent-reported evaluation of overall well-being (diagnostic value coefficient equal 2.91), something less the child-reported evaluation of overall well-being (diagnostic value coefficient equal 3.15). 
The results of research helps to conclude that overall well-being in children with JRA are much worse in comparing with healthy one. The results of parent-reported and child-reported evaluation an overall well-being are associated with some clinical peculiarities of JRA and didn’t depend on laboratory markers of disease activity. The parent-reported evaluation of overall well-being is more informative than child-reported and should be primary considered in physician assessment of further management of patient with JRA.   

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