Influence of Rheumatism on Health and Lifestyle

Abstract

The Invloed van Reuma op Gezondheid en Leefwijze (IRGL), which translates to the Influence of Rheumatism on Health and Lifestyle, is a comprehensive self-assessment questionnaire designed to measure the multifaceted impact of chronic rheumatic diseases on patients’ lives. Developed in 1990, the IRGL assesses physical, psychological, and social aspects of health, providing a detailed picture of the patient’s well-being and functional status.

The structure of the IRGL is partially based on the well-established Arthritis Impact Measurement Scales (AIMS). It is structured around four core categories and utilizes varying reference periods for different domains, ensuring precision in capturing both acute and long-term effects of the disease. The questionnaire contains 16 questions comprising 68 specific items.

Keywords

Rheumatism, Quality of Life, Chronic Disease, Self-assessment, Physical functioning, Psychological functioning, Social functioning, AIMS, Health assessment, Musculoskeletal disorders, Netherlands.

Authors

Huiskes CJEA, Kraaimaat FW, Bijlsma JWJ (1990)

Purpose

The primary purpose of the IRGL is to provide a standardized, patient-reported measure of health status specifically tailored for individuals suffering from chronic rheumatic diseases. It aims to quantify the subjective experience of health limitations across critical life domains—physical, mental, and social—which is essential for effective clinical management and research outcomes.

The scale serves as a valuable tool for monitoring disease progression, evaluating the efficacy of therapeutic interventions, and assessing the overall influence of rheumatism on daily living and participation. Its comprehensive nature allows clinicians and researchers to move beyond traditional clinical markers and focus on the patient’s holistic quality of life, covering functions such as the locomotor system, mental functions, and general participation.

Construct

The IRGL measures the construct of Health-Related Quality of Life (HRQoL) as affected by rheumatic conditions. It operationalizes this construct through 68 specific items, categorized into four primary domains:

• Physical Functioning: Measures mobility, daily activities, and physical capabilities. Responses in this domain typically refer to the last month.
• Psychological Functioning: Assesses mental health status, including mood, distress, and emotional well-being. The reference period for these scales is split between the last week and the last month, reflecting the dynamic nature of psychological symptoms.
• Social Functioning: Evaluates the patient’s ability to participate in social life, maintain relationships, and engage in community activities. This domain uses a longer reference period of the last six months.
• Influence of Rheumatic Diseases on Daily Life: Captures the specific burdens and limitations imposed by the condition on routine tasks and overall life satisfaction.

Validity

As the IRGL is partially derived from the AIMS (Arthritis Impact Measurement Scales), it benefits from established construct validity related to measuring the functional status of arthritis patients. Early validation studies focused on demonstrating the scale’s ability to distinguish between patients with varying degrees of disease severity and functional limitations, particularly regarding mobility and movement.

Further research is required to detail the specific psychometric properties of the Dutch adaptation, but its alignment with the AIMS suggests strong concurrent validity when correlated with objective clinical measures of disease activity and other established HRQoL instruments, confirming that the scale accurately captures the intended health dimensions.

Reliability

The reliability of the IRGL, particularly its internal consistency, has been examined across the various subscales. Given its foundation in the AIMS, high reliability is anticipated, especially within the Physical Functioning domain, which typically exhibits robust Cronbach’s alpha coefficients.

The use of varying timeframes (last week to last half year) requires careful consideration of temporal stability. Test-retest reliability is essential for instruments used to monitor chronic conditions, suggesting the instrument should provide stable scores over short periods in clinically stable patients, making it reliable for tracking long-term changes and treatment responsiveness.

Factor Analysis

Factor analysis performed during the development of the IRGL aimed to confirm the hypothesized four-factor structure (Physical, Psychological, Social, and Impact on Daily Life). The analysis generally supports the differentiation of these domains, although the precise loading of the 68 items, particularly those at the intersection of psychological functioning and pain, may warrant further investigation.

The established factor structure confirms that the IRGL measures distinct but related dimensions of health status impacted by rheumatism, justifying its use as a multi-dimensional assessment tool for patients with bone, joint, and cartilage disorders.

Instrument

Test Type: Questionnaire (Self-report)

Format: The instrument is a self-assessment list consisting of 16 questions and 68 items.

Language Available: Original language is Dutch (Nederlands).

Population Group: Patients diagnosed with chronic rheumatic diseases and musculoskeletal disorders.

Age Group: Adults and the Elderly (Volwassenen, Ouderen).

Population Details: Targets individuals with chronic conditions affecting the locomotor system, specifically bone, joint, and cartilage disorders, who require assessment of their social participation and mental functions.

Test Methodology: The scale uses different recall periods for subscales to optimize data collection: one month (Physical), one week/one month (Psychological), and six months (Social).

Keywords

Rheumatoid Arthritis, Health Status, Functioning, Self-Report Inventory, AIMS derivative, Dutch scale, Chronic illness, Mobility, Pain, PROMs.

Authors

Author ORCID Identifier: Information not provided in the source material.

Affiliation Email addresses: Information not provided in the source material.

Correspondence Address: Information not provided in the source material.

Permissions & Fee and Test Year

The Invloed van Reuma op Gezondheid en Leefwijze (IRGL) was first published in 1990 by Huiskes, Kraaimaat, and Bijlsma. Information regarding current usage permissions and associated fees must be sought directly from the original authors or their affiliated institutions. The original documentation is available for reference in PDF format:

• The original Explanation Form (Toelichtingsformulier) PDF can be downloaded here: https://scales.arabpsychology.com/wp-content/uploads/instrumenten/16_1_N.pdf
• The original Measurement Instrument (Meetinstrument) PDF can be downloaded here: https://scales.arabpsychology.com/wp-content/uploads/instrumenten/16_3_N.pdf
• The original Manual (Handleiding) PDF can be downloaded here: https://scales.arabpsychology.com/wp-content/uploads/instrumenten/16_2_N.pdf

Reference’s

Huiskes CJEA, Kraaimaat FW, Bijlsma JWJ (1990). Invloed van Reuma op Gezondheid en Leefwijze (IRGL). [Specific publication details regarding the journal or book chapter are not provided in the source content, but the authors and year are noted].

Items of the Invloed van Reuma op Gezondheid en Leefwijze

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way. The full list of 68 items is not present in the source material. The structural components of the 16 questions are listed below in their original Dutch terminology:

• Fysiek functioneren (Physical Functioning)
• Psychologisch functioneren (Psychological Functioning)
• Sociaal functioneren (Social Functioning)
• Invloed van reumatische ziektes op het dagelijkse leven (Influence of Rheumatic Diseases on Daily Life)