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A Cochrane review of interventions to improve outcomes in patients with multimorbidity in primary care suggested that interventions focusing on functional difficulties experienced by patients with multimorbidity may improve outcomes [ 19].
In general, patient oriented interventions not linked to healthcare delivery seemed less effective, although the exception was a professional led patient oriented intervention focused on functional difficulties, which was associated with significant improvements including a reduction in mortality in the intervention group.
The PHQ-9 is a 10-item self-report depression scale which scores each of the nine Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria for a diagnosis of major depression episode plus an extra item on functional difficulties as a result of the depressive symptoms.
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Recent evidence indicates that a spouse's perception and understanding of a service member's combat exposure and reasons for functional difficulties have a significant bearing on marital satisfaction (Renshaw et al. 2008).
Scores from each activity are summed to give an overall indication of functional difficulty, where 0 indicates maximal difficulty and 80 indicates no difficulty.
For example, the highest item response category on the functional difficulty scale of the OA-FUNCTION-CAT was slightly over 80, whereas the WOMAC was limited to a little over 70 as its highest item response category expected score.
Flexion contracture may have a great impact on daily living due to the functional difficulties, e.g. difficulty in washing the face or putting on gloves [ 2].
[ 1, 2] Functional difficulties reported on the specific activities subscale of the PRWE presented very severe difficulty at baseline.
The results indicated that it is difficult to improve outcomes in this population but that interventions focusing on particular risk factors in comorbid conditions or functional difficulties in multimorbidity may be more effective.
To investigate concurrent validity of the Functional Difficulties Questionnaire (FDQ-9) using balance tasks on the SMARTwobbleboard.
Observations of each LTID groups were combined to indicate co-existence of chronic conditions, functional difficulties and learning difficulties.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com