Background/Purpose:   Systemic sclerosis is a chronic autoimmune connective tissue disorder that results in skin thickening, vascular insufficiency, and fibrosis of internal organs, such as the heart, lungs, kidneys, gastrointestinal tract, and joints and muscles. People have difficulty participating in daily tasks due to pain, finger ulcers, Raynaud’s phenomenon, and internal organ involvement, particularly decreased pulmonary function. Most of the research on scleroderma has focused on performance of basic daily living and work tasks. Little is known about participation in household, leisure, and community activities. The Valued Life Activities Scale (VLA) measures difficulty in self-care, household, leisure and community activities (1). The VLA has been used to track changes over time in persons with different rheumatic diseases and thus, maybe useful for people with scleroderma. However, the 33 items may be too long for clinical use. Purpose: To examine the internal consistency and validity of the 14 item Short-VLA Scale in persons with systemic sclerosis.

Methods:   The sample was a convenience sample of 83 people with systemic sclerosis recruited from the Scleroderma Foundation website and annual conference. Participants completed the VLA, a questionnaire with 33 items under three domains: obligatory, committed, and discretionary. Obligatory activities include self-care, committed activities include household tasks, and discretionary activities include leisure and community activities. For each item, participants rated difficulty with performance from 0 (no difficulty) to 3 (unable to do). A Short-VLA score is calculated as the mean from 14 of the items as described by Katz et al.(2). Participants also completed a demographics questionnaire, questions regarding the presence and severity of disease symptoms, the Health Assessment Questionnaire (HAQ), and Center for Epidemiologic Studies Depression Scale (CES-D) and the Adelaide Activities Profile (AAP), a measure of frequency of participation in household and community tasks.

Results:   The majority of the participants were Caucasian (94%), female (90%), and married; 98% had Raynaud’s phenomenon, 93% reported gastrointestinal problems and 50% reported lung involvement. Our participants had a mean age of 53 years and mean disease duration of 9 years. About half of the participants had limited SSc and half had diffuse SSc. The mean score on the S-VLA was 1.10 indicating mild difficulty. Internal consistency of the S-VLA was excellent (Cronbach’s alpha=0.92). The correlation between the S-VLA and the original long form VLA was excellent (r=0.96). A moderate correlation was also found between the S-VLA and the HAQ (r=0.73) and AAP (r = 0.56), however the correlation with the CES-D was only fair (r=0.35).

Conclusion:   The S-VLA was found to be a reliable and valid measure in persons with SSc. In addition, the S-VLA may be useful to monitor participation in household, leisure, and community activities as decreasing participation in these types of activities has been correlated with depression and decreased quality of life (1).

1. Katz PP et al. Ann Rheum Dis 2006; 65; 763-9.
2. Katz PP et al. Arthritis Care Res 2011; 63; 1664-71.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/use-of-the-short-valued-life-activities-scale-in-people-with-systemic-sclerosis/