Rheumatology International

, Volume 38, Issue 8, pp 1557–1564 | Cite as

A new biopsychosocial and clinical questionnaire to assess juvenile idiopathic arthritis: JAB-Q

  • Edibe Unal
  • Ezgi Deniz Batu
  • Hafize Emine Sonmez
  • Zehra Serap Arici
  • Gamze Arin
  • Nur Banu Karaca
  • Erdal Sag
  • Selcan Demir
  • Duygu Aydin Hakli
  • Aykut Ozcadirci
  • Fatma Birgul Oflaz
  • Reha Alpar
  • Yelda Bilginer
  • Seza OzenEmail author
Validation Studies



To create a new multidimensional questionnaire for the assessment of juvenile idiopathic arthritis (JIA) patients in standard clinical practice and study the validity and reliability of this questionnaire.


The Juvenile Arthritis Biopsychosocial and Clinical Questionnaire (JAB-Q) was created using the Delphi technique and consensus conference following an initial literature search. The questionnaire has three parts including a clinician form, child form and parent form. This is a patient/parent-centered outcome tool, which helps us to evaluate the biopsychosocial aspects of the patient, including disease activity, posture, functional and psychosocial status, fatigue, and performance in school. From January 2015 to January 2018, 6–18 years old children with JIA were enrolled in the study. The previously validated questionnaires were also applied to each participant to validate the JAB-Q: Juvenile Idiopathic Disease Arthritis Score (JADAS) and Childhood Health Assessment Questionnaire (CHAQ), and the Family Impact Questionnaire (FIS). The same questionnaire was re-administered after one week to assess the test–retest reliability in randomly selected 50 children and their parents.


A group of experts were invited to the Delphi survey. After the Delphi tours, the final form of the questionnaire containing three parts as clinician form, child form and parent form was created. This tool was applied to 310 JIA patients and their parents. The children and parents easily handled the JAB-Q and filled the forms in around 10–15 min. The validity of the clinician, child and parents’ forms were assessed by the JADAS, CHAQ, and FIS, respectively. The validity of these three scales were determined as moderate. In addition, the test–retest reliability of the clinician, child and parents’ forms were considerably high.


JAB-Q is a valid and reliable multidimensional biopsychosocial outcome tool that can be used routinely in clinical practice of pediatric rheumatology. The main advantage of this tool is incorporation of patients’ and parents’ perspectives separately while providing a practical and standard setting for the clinician’s evaluation. However, further validation of this tool in an independent cohort is needed to improve its applicability.


Juvenile idiopathic arthritis Outcome Biopsychosocial 



We thank to all clinicians and physiotherapists, especially to Pınar Kisacik, PT-PhD, for their help during Delphi surveys and data collection.

Author contributions

All authors contributed to the study concept, design, acquisition, and interpretation of data. EDB, HES, ZSA, GA, NBK, ES, SD, AO, and FBO drafted the manuscript. Literature review was conducted by NBK, GA, and AO. EU, YB, and SO revised the manuscript critically. DAH and RA performed the statistical analysis. All authors have read and approved the final form of the manuscript for publication.


No financial support was received in the preparation of this article.

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

Ethical approval

The study was approved by the ethics committee of Hacettepe University (March 18 2015; GO 15/231-11). Written informed consent was obtained from all participants (both children and their parents).

Supplementary material

296_2018_4075_MOESM1_ESM.docx (163 kb)
Supplementary material 1 (DOCX 163 KB)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Edibe Unal
    • 1
  • Ezgi Deniz Batu
    • 2
  • Hafize Emine Sonmez
    • 2
  • Zehra Serap Arici
    • 3
  • Gamze Arin
    • 1
  • Nur Banu Karaca
    • 1
  • Erdal Sag
    • 2
  • Selcan Demir
    • 2
  • Duygu Aydin Hakli
    • 4
  • Aykut Ozcadirci
    • 1
  • Fatma Birgul Oflaz
    • 1
  • Reha Alpar
    • 4
  • Yelda Bilginer
    • 2
  • Seza Ozen
    • 2
    • 5
    Email author
  1. 1.Department of Physical Therapy and RehabilitationHacettepe University Faculty of Health SciencesAnkaraTurkey
  2. 2.Department of Pediatric RheumatologyHacettepe University Faculty of MedicineAnkaraTurkey
  3. 3.Department of Pediatric RheumatologyŞanlıurfa Training and Research HospitalŞanlıurfaTurkey
  4. 4.Department of BiostatisticsHacettepe University Faculty of MedicineAnkaraTurkey
  5. 5.Department of Pediatrics, Division of RheumatologyHacettepe University Faculty of MedicineAnkaraTurkey

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