Validity and psychometric characteristics of the Duruöz Hand Index (DHI) with systemic sclerosis.

IF 2.9 3区医学 Q2 RHEUMATOLOGY Rheumatology International Pub Date : 2025-03-15 DOI:10.1007/s00296-025-05829-z

Mehmet Tuncay Duruöz, Nuran Öz, Yusuf Karabulut, Didem Erdem Gürsoy, Halise Hande Gezer, Sevtap Acer Kasman

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Abstract

Objective: The Duruöz Hand Index (DHI) is a self-report questionnaire originally developed to assess hand function in rheumatoid arthritis patients and validated for various rheumatic conditions. The aim of the study is to evaluate the validity and psychometric features of the DHI in patients with systemic sclerosis (SSc).

Methods: SSc patients diagnosed using EULAR/ACR 2013 criteria were included in study. Hand functionality was assessed using the DHI, Hand Functional Index (HFI) and visual analog scales (VAS) for disability and handicap. Overall disability and quality of life were measured using the Health Assessment Questionnaire (HAQ) and Short Form-36 (SF-36). Reliability (Cronbach's alpha and ICC) and validity (face, content, convergent and divergent) were also analyzed and correlations with other measures assessed for construct validity of the DHI were examined.

Results: Seventy-three patients were included in the study, 78.1% were female. The baseline mean DHI score was 31.2 (SD: 20.2). Completion and calculation of the questionnaire were easy and took 5 min and 30 s, respectively. The Cronbach's alpha coefficient for internal consistency was 0.973 and the ICC for test-retest reliability was 0.993 (95%CI 0.981-0.997), suggesting that the DHI has high internal consistency and a high degree of reliability. Cognitive debriefing showed that the DHI is clear, understandable, relevant, and covers many domains of daily life, indicating good face and content validity. The DHI demonstrated good to moderate correlations with functional measures indicating convergent validity and moderate to non-significant correlations with non-functional parameters that supported divergent validity. Cronbach's alpha was 0.973, indicating excellent internal consistency.

Conclusion: In SSc patients, specific tools for assessing hand function are lacking. The DHI is a practical, reliable and valid measurement tool for both clinical assessment and research in this disease affecting skin, tendons, subcutaneous tissue and arthritis.

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系统性硬化症患者Duruöz手部指数（DHI）的效度及心理测量特征。

目的：Duruöz手指数（DHI）是一份自我报告问卷，最初用于评估类风湿关节炎患者的手功能，并在各种风湿性疾病中得到验证。本研究的目的是评估DHI在系统性硬化症（SSc）患者中的有效性和心理测量特征。方法：采用EULAR/ACR 2013标准诊断的SSc患者为研究对象。使用DHI、手功能指数（HFI）和视觉模拟量表（VAS）评估残疾和障碍的手功能。采用健康评估问卷（HAQ）和SF-36短表（SF-36）测量总体残疾和生活质量。信度（Cronbach’s alpha和ICC）和效度（face, content， convergent和divergent）也被分析，并检验了与DHI结构效度评估的其他措施的相关性。结果：73例患者纳入研究，其中78.1%为女性。基线平均DHI评分为31.2 （SD: 20.2）。问卷的完成和计算简单，分别需要5分钟和30秒。内部一致性的Cronbach’s alpha系数为0.973，重测信度的ICC为0.993 (95%CI 0.981 ~ 0.997)，表明DHI具有较高的内部一致性和较高的信度。认知汇报表明，DHI清晰、可理解、相关，涵盖了日常生活的许多领域，表明了良好的表面和内容效度。DHI与功能测量显示出良好到中度的相关性，表明收敛效度，与支持发散效度的非功能参数显示出中度到不显著的相关性。Cronbach’s alpha为0.973，内部一致性较好。结论：在SSc患者中，缺乏评估手功能的特定工具。对于这种影响皮肤、肌腱、皮下组织和关节炎的疾病的临床评估和研究，DHI是一种实用、可靠和有效的测量工具。

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来源期刊

Rheumatology International 医学-风湿病学

CiteScore

7.30

自引率

5.00%

发文量

191

审稿时长

16. months

期刊介绍： RHEUMATOLOGY INTERNATIONAL is an independent journal reflecting world-wide progress in the research, diagnosis and treatment of the various rheumatic diseases. It is designed to serve researchers and clinicians in the field of rheumatology. RHEUMATOLOGY INTERNATIONAL will cover all modern trends in clinical research as well as in the management of rheumatic diseases. Special emphasis will be given to public health issues related to rheumatic diseases, applying rheumatology research to clinical practice, epidemiology of rheumatic diseases, diagnostic tests for rheumatic diseases, patient reported outcomes (PROs) in rheumatology and evidence on education of rheumatology. Contributions to these topics will appear in the form of original publications, short communications, editorials, and reviews. "Letters to the editor" will be welcome as an enhancement to discussion. Basic science research, including in vitro or animal studies, is discouraged to submit, as we will only review studies on humans with an epidemological or clinical perspective. Case reports without a proper review of the literatura (Case-based Reviews) will not be published. Every effort will be made to ensure speed of publication while maintaining a high standard of contents and production. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.