Session: (1405–1433) Spondyloarthritis Including Psoriatic Arthritis – Diagnosis, Manifestations, & Outcomes Poster II
1422: Assessment of Difficulties, Modifications and Use of Work Adaptations in Patients with Axial Spondyloarthritis: Validation of the Dificultax and Modal Questionnaires
sanatorio Mendez CABA, Ciudad Autonoma de Buenos Aires, Argentina
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Background/Purpose: DificuLtAR and ModAL, two spanish-language questionnaires that assess work difficulties and workplace adaptations, were originally developed and validated for rheumatoid arthritis (RA). Their performance in axial spondyloarthritis (axSpA) remains unknown.
Objective: (1) to validate DificuLtAR and ModAL in axSpA (2) Identify factors associated with work difficulties and the use of workplace modifications and adaptations reported by employed patients with axSpA. Methods: An adaptation of the DificuLtAR for EspAax (DificuLtAx) questionnaire was made, Both questionnaires were applied to patients ≥18 years old, both genders, with a diagnosis of axSpA (ASAS-2009) and actively working. Cronbach's alpha (DifficuLtAx=0.92 and ModAL=0.83) and construct validity were explored through factor analysis. The Eigenvalue values for a single factor (DificuLtAx=0.89 and ModAL=0.81) and correlation coefficients greater than 0.40 for all questions of both questionnaires after varimax rotation were aceptable. Spearman correlation coefficients, Mann-Whitney or Kruskal-Wallis tests, were calculated. (p < 0.05). Results: 72 patients were included, 72% men, median age 42 years (IQR 37-53), disease duration 97 months (IQR 40-156), 54% B27positive, and 67% radiographic. The median ASDAS-PCR 2 (IQR 1-3) and BASFI 3.5 (IQR 2-5). 58% were in formal salaried employment and the median WPAI (labor productivity) was 0 (IQR 0-44). The greatest difficulties were sitting or standing for prolonged periods of time (75%) and working crouched (84%) and the most frequent modifications were taking breaks (78%) and furniture changes (45%). The median DificuLtAx 5 (IQR 2-9) and ModAL 3.5 (IQR 2-6), with a correlation between both of rho: 0.67 (p 0.001). See correlations Table 1. Female gender 5.5 vs 3.5 (p 0.001) and boss's knowledge of the disease 4 vs 3 (p 0.05), were associated with greater modifications.
Conclusion: DificuLtAx and ModAL showed good reliability and construct validity. The main work difficulties were to remain seated or standing and to work crouching/kneeling, and the most frequent modifications were to take breaks and modify the furniture; these were more common in women and in those in whom the boss was aware of the disease.
