The SHAQ also has utility in sculpting treatment. By allowing patients to assess their own pain and functional level, practitioners can then tweak therapies to decrease the overall symptom burden, thus allowing patients to have more normal routines. The chronicity of autoimmune disease should not be forgotten here. Pain takes many forms leading to loss of independence and self-image issues that can add to a sense of depression and even hopelessness. Exploring the issues of functional assessment from a sexual, mental, and physical dynamic is truly the “art” we all bring to patient care.
As a nurse practitioner working in rheumatology for 10 years, I couldn’t have stumbled into a more rewarding field. Being able to diagnose, apply effective treatments, and monitor disease progression all the while employing this model of patient-centered care and looking at the patient in their entirety, treating their various pain syndromes, and addressing psychosocial aspects of their day-to-day experiences has been a fulfilling calling.
References
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- Clements PJ, Wong WK, Hurwitz EL, et al. Correlates of the disability index of the health assessment questionnaire: A measure of functional impairment in systemic sclerosis. Arthritis Rheum. 1999;42:2372-2380.
- Johnson SR, Hawker GA, Davis AM. The health assessment questionnaire disability index and scleroderma health assessment questionnaire in scleroderma trials: An evaluation of their measurement properties. Arthritis Care & Research. 2005; 53:256-262.
- Merkel PA, Clements PJ, Reveille JD, et al. Current status of outcome measure development for clinical trials in systemic sclerosis: Report from OMERACT 6. J Rheumatol. 2003;30:1630-1647.
- Li SC, Liebling MS. The use of doppler ultrasound to evaluate lesions of localized scleroderma. Current Rheumatology Rep. 2009;11:205-211.
- Steen VD, Medsger TA. The value of the health assessment questionnaire and special patient-generated scales to demonstrate change in systemic sclerosis patients over time. Arthritis Rheum. 1997;40:1984-1991.