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Title: The development and validation of a condition-specific, patient-reported outcome measure for peripheral nerve disorders of the hand : the impact of hand nerve disorders (I-HaND©) scale
Author: Ashwood, Mark
ISNI:       0000 0004 6351 1932
Awarding Body: University of East Anglia
Current Institution: University of East Anglia
Date of Award: 2017
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Nerve disorders of the hand result in impairments as well as activity limitations and participation restrictions. There are currently no patient-reported outcome measures (PROMs), that evaluate this impact specifically in people with a range of nerve conditions. To address this need, the Impact of Hand Nerve Disorders (I-HaND©) Scale was developed. A multi-centre, three-phase study using mixed methods was undertaken to develop and validate the I-HaND. Face-to-face interviews with 14 patients and subsequent pilot-testing with 61 patients resulted in the development of the content of a new 32-item PROM. A final longitudinal, repeated-measures validation study with 82 patients assessed the psychometric properties of the I-HaND. Patients found the I-HaND to be relevant and highly acceptable. A single-factor structure was confirmed through Principal Components Analysis. A very high internal consistency (Cronbach’s alpha = 0.98) and good criterion-related validity with the Quick DASH (Pearson’s r = 0.87) were demonstrated. Test-retest reliability was assessed from repeated administration over a 2-week interval. The test-retest reliability was excellent (Intraclass Correlation Coefficients = 0.97; 95% CI = 0.94 to 0.98). Responsiveness was assessed over a 12-week interval and calculated as Cohen’s Effect Size (ES) and the Standardised Response Mean (SRM). The I-HaND was able to detect change in a group of patients where change was expected (ES = 0.51; SRM = 0.60) and was marginally more responsive relative to the Quick DASH (ES = 0.42; SRM = 0.56). The I-HaND is the first condition-specific PROM validated for people with a range of hand nerve disorders. The study also provides new insights into the impact of hand nerve disorders on patients. Subject to further research into its psychometric properties, the I-HaND has the potential to be used alongside other outcome measures for hand nerve disorders and to become part of a core outcome set for use in future clinical trials.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available