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Translations of instruments for measuring quality of life developed in certain, mostly more developed, parts of the world usually do not cover regionally specific aspects of health-related quality of life, even after transcultural validation. The aim of this study was to develop and validate a reliable questionnaire in Serbian, Croatian, Bosnian, and Montenegrin languages suitable for measuring health-related quality of life in adults.The study was of a cross-sectional type, assessing the reliability and validity of a newly developed questionnaire for measuring health-related quality of life (HRQoL) in adults residing in western Balkan states (WB-HRQoL). It was conducted on a sample of 489 adults from Serbia, Croatia, BosniaHerzegovina, and Montenegro, with a mean age of 52.2±14.4 years and a male/female ratio of 195/294 (39.9%/60.1%).The definitive version of the WB-HRQoL scale with 19 items showed very good reliability, with Cronbach's alpha 0.905. The scale was temporally stable, and satisfactory results were obtained for divergent and convergent validity tests. Exploratory factorial analysis brought to the surface four domains of health-related quality of life, namely the physical, psychical, social, and environmental.The WB-HRQoL scale is a reliable and valid generic instrument for measuring HRQoL that takes into account the cultural specifics of the western Balkan region.Prenos instrumentov za merjenje kakovosti življenja, razvitih v nekaterih, večinoma razvitejših delih sveta, zahteva transkulturno validacijo. Kljub temu tovrstni instrumenti običajno ne zajemajo regionalno specifičnih vidikov kakovosti življenja, povezanih z zdravjem. Namen študije je bil razviti in potrditi zanesljiv vprašalnik v srbskem, hrvaškem, bosansko-hrvaško-srbskem in črnogorskem jeziku, primeren za merjenje kakovosti življenja, povezanega z zdravjem odraslih.V presečni študiji smo ocenili zanesljivost in veljavnost novo razvitega vprašalnika za merjenje kakovosti življenja, povezanega z zdravjem (HRQoL) pri odraslih, ki prebivajo v državah zahodnega Balkana (WB-HRQoL). V študijo smo vključili 489 odraslih iz Srbije, Hrvaške, Bosne in Hercegovine ter Črne gore s povprečno starostjo 52,2 ± 14,4 let in razmerjem med moškimi in ženskami 195 : 294 (39,9 : 60,1 %).Dokončna različica lestvice WB-HRQoL z 19 elementi je pokazala zelo dobro zanesljivost (koeficient Cronbach alfa 0,905). Lestvica je bila stabilna, tako za divergentne kot konvergentne teste veljavnosti smo pridobili zadovoljive rezultate. Raziskovalna faktorska analiza je pokazala štiri področja zdravstvene kakovosti, povezane z zdravjem: fizično, psihično, socialno in okoljsko.Lestvica WB-HRQoL je zanesljiv in veljaven generični instrument za merjenje HRQoL, ki upošteva kulturne posebnosti regije zahodnega Balkana.

Pridobljena možganska okvara je vodilen vzrok smrti in invalidnosti, ki lahko popolnoma spremeni posameznikovo življenje in vpliva na njegovo kakovost. Namen magistrskega dela je bil ugotoviti, ali se različni vidiki z zdravjem povezane kakovosti življenja po pridobljeni možganski okvari povezujejo z nekaterimi demografskimi spremenljivkami, socialno oporo, zadovoljstvom z življenjem in samooceno. V raziskavi je sodelovalo 40 posameznikov s pridobljeno možgansko okvaro. Udeleženci so bili izven procesa rehabilitacije, od poškodbe je minilo vsaj eno leto. Izpolnili so naslednje vprašalnike: Kratka oblika vprašalnika o zdravju s 36 postavkami, Lestvica zadovoljstva z življenjem in Vprašalnik socialne opore. Rezultati so pokazali, da moški poročajo o več težavah, povezanih z z zdravjem povezano kakovostjo življenja kot ženske. Do razlik prihaja tudi med skupinami, razdeljenimi glede na zakonski stan, ne pa tudi med skupinami, razdeljenimi glede na najvišjo doseženo stopnjo izobrazbe. Starost, starost ob poškodbi in čas od poškodbe se statistično pomembno ne povezujejo z z zdravjem povezano kakovostjo življenja. Zadovoljstvo z življenjem se povezuje s splošnim zdravjem, duševnim zdravjem in vitalnostjo. Količina socialne opore se statistično pomembno ne povezuje z z zdravjem povezano kakovostjo življenja. Zadovoljstvo z oporo pa se povezuje s socialnim funkcioniranjem. Ugotovitve dajejo vpogled v dejavnike, ki se povezujejo z z zdravjem povezano kakovostjo življenja po pridobljeni možganski okvari, prav tako lahko predstavljajo izhodišče za ukrepe, ki so usmerjeni k izboljšanju posameznikove z zdravjem povezane kakovosti življenja po pridobljeni možganski okvari. Acquired brain injury is a leading cause of death and disability and can completely change a person's life and affect their quality of life. The purpose of my master's thesis was to determine whether various aspects of health-related quality of life, after acquired brain injury are associated with certain demographic variables, social support, life satisfaction and self-appraisal. 40 participants with acquired brain injury were included in the research. The participants were out of the rehabilitation process and were at least one year post-injury. They completed the following questionnaires: The Medical Outcome Study Short Form, Satisfaction With Life Scale and Social Support Questionnaire 6. The results showed that men report more health-related problems related to quality of life than women. There is also a difference between groups divided according to marital status, but not between groups divided according to the highest level of education. Age, age at injury and time since injury are not statistically significantly associated with health-related quality of life. Life satisfaction is associated with general health, mental health and vitality. While the amount of social support is not statistically significantly associated with health-related quality of life, results show that satisfaction with support is associated with social functioning. The findings provide insight into the factors associated with health-related quality of life after acquired brain injury, and can also represent a starting point for improvements, aimed at improving individuals' health-related quality of life after acquired brain injury.

Due to the availability of the EQ-5D-5L instrument official translation into Slovenian its use is widespread in Slovenia. However, the health profiles obtained in many studies cannot be ascribed their appropriate values as the EQ-5D-5L value set does not yet exist in Slovenia. Our aim was to estimate an interim EQ-5D-5L value set for Slovenia using the crosswalk methodology developed by the EuroQol Group on the basis of the EQ-5D-3L Slovenian TTO value set. Our secondary aim was to compare the interim values obtained with the EQ-5D-3L Slovenian values.To obtain a Slovenian interim EQ-5D-5L value set, we applied the crosswalk methodology developed by the EuroQol Group to the Slovenian EQ-5D-3L TTO value set. We examined the differences between values by comparing the mean 3L and 5L value scores and the distribution of values across all respondents.By definition, 3-level and 5-level versions have the same range (from 1 to -0.495) and a health state coded 22222 in the 3-level version corresponds to 33333 in the 5-level version. While the addition of a "slight" severity level (22222) in the 5-level version has a low informational value, the addition of a "severe" health state (44444) covers larger range of the scale. The 5-level version results in fewer health states being valued below 0 and above 0.8.The EQ-5D-5L value set, based on the crosswalk methodology, should be used until a value set for the EQ-5D-5L is derived from preferences elicited directly from a representative sample of the Slovenian general population.Uporaba instrumenta EQ-5D-5L je v Sloveniji že zelo razširjena zaradi razpoložljivosti uradnega prevoda instrumenta v slovenski jezik. Žal zdravstvenim profilom raziskovane populacije, pridobljenim v številnih raziskavah, ni mogoče pripisati njihovih vrednosti, saj v Sloveniji še nimamo izračunanih vrednosti EQ-5D-5L zdravstvenih stanj. Naš cilj je bil oceniti vrednosti zdravstvenih stanj EQ-5D-5L za Slovenijo z metodo mapiranja, ki jo je razvila skupina EuroQol. Za osnovo smo uporabili slovenske vrednosti zdravstvenih stanj EQ-5D-3L. Naš sekundarni cilj je bil primerjati pridobljene 5L vrednosti s slovenskimi vrednostmi EQ-5D-3L.Za pridobitev slovenskega nabora vrednosti EQ-5D-5L smo uporabili metodologijo mapiranja, ki jo je razvila skupina EuroQol, preračunali pa smo jo iz vrednosti EQ-5D-3L TTO. Razlike med vrednostmi smo preučili s primerjavo povprečnih vrednosti 3L in 5L in porazdelitvijo vrednosti med vsemi anketiranci.Po definiciji imata seta vrednosti za 3 in 5 ravni (EQ-5D-3L in EQ-5D-5L) enak razpon vrednosti (od 1 do −0,495), zdravstveno stanje 22222 v 3-stopenjski različici pa ustreza stanju 33333 v 5-stopenjski različici. Medtem ko ima dodatek “manjše” stopnje težavnosti oz. kodiranega stanja 22222 v 5-stopenjski različici majhno informacijsko vrednost, je dodana vrednost “hude” stopnje težavnosti oz. zdravstvenega stanja kodiranega kot 44444 večja in zajema večji obseg lestvice. 5-stopenjski set vrednosti rezultira v manj zdravstvenih stanjih, ki so ocenjene pod 0 in nad 0,8.Nabor vrednosti EQ-5D-5L, ki je pridobljen z mapiranjem, lahko raziskovalci v Sloveniji uporabljajo vse dokler ne bodo na razpolago vrednosti stanja EQ-5D-5L, pridobljene neposredno iz preferenc reprezentativnega vzorca slovenske splošne populacije do zdravstvenih stanj.

Uvod: Posledice nevroloških motenj se odražajo v spremenjeni gibalni, senzorični, kognitivni in vedenjski funkciji posameznikov, kar vodi v njihovo dolgoročno zmanjšano zmožnost, omejitve dejavnosti in sodelovanja. Hipoterapija in terapevtsko jahanje ustvarjata možnost učinkovitega komplementarnega pristopa k zdravljenju nevroloških okvar pri otrocih in odraslih. Izgradnja odnosa s konjem spodbuja zaupanje, spretnosti v medosebnih odnosih in reševanju težav. Jahač tako pridobiva nove izkušnje in postaja samostojnejši, kar vodi v njegovo boljšo samopodobo in posledično tudi kakovost življenja. Namen: Namen diplomskega dela je bil na podlagi pregleda strokovne in znanstvene literature ugotoviti, kakšen je vpliv hipoterapije in terapevtskega jahanja na kakovost življenja oseb z različnimi nevrološkimi boleznimi in okvarami. Metode dela: Literatura je bila iskana v podatkovni bazi PubMed. Pri iskanju smo uporabili napredno iskanje s sledečimi iskalnimi nizi: hippotherapy OR therapeutic riding OR equine-assisted therapy AND quality of life hippotherapy AND quality of life hippotherapy AND stroke hippotherapy AND multiple sclerosis hippotherapy AND cerebral palsy hippotherapy AND spinal cord injury hippotherapy AND ADHD. Rezultati: Na podlagi vključitvenih in izključitvenih dejavnikov je bilo v pregled literature vključenih 8 raziskav, objavljenih med letoma 2007 in 2019. Nevrološka stanja pacientov so bila možganska kap, multipla skleroza, cerebralna paraliza, poškodba hrbtenjače in ADHD. Program terapije s pomočjo konja je trajal od najmanj 4 tedne do največ 16-20 tednov. V šestih raziskavah so potrdili ugoden vpliv hipoterapije ali terapevtskega jahanja na različne vidike z zdravjem povezane kakovosti življenja, medtem ko v dveh primerih do splošnih pozitivnih zaključkov niso prišli. V dveh raziskavah so opazovali tudi dolgoročne učinke hipoterapije, v eni so jih ovrgli, v drugi pa potrdili, vendar v slednji rezultatov niso statistično ovrednotili. Razprava in zaključek: Ugotovimo lahko, da so v večini raziskav poročali o statistično pomembnih učinkih hipoterapije ali terapevtskega jahanja na kakovost življenja preiskovancev v primerjavi z ostalimi intervencijami. Kljub temu so bila odstopanja med raziskavami prevelika, da bi lahko zaključili o splošni učinkovitosti hipoterapije kot komplementarne metode zdravljenja pri različnih nevroloških motnjah. Raziskave z enotnejšim vzorcem, programom intervencije in načinom ocenjevanja bi podale zanesljivejše zaključke o vplivu konja, kot posrednika med terapijo, na kakovost življenja jahača. Introduction: The consequences of neurological disorders are reflected in the altered motor, sensory, cognitive and behavioural function of individuals. This leads to their long-term reduced ability, limitations of activity and participation. Hippotherapy and therapeutic riding create an effective complementary approach to treating neurological impairment in children and adults. Building a relationship with a horse promotes confidence, interpersonal skills and problem-solving abilities. The rider thus gains new experience and becomes more independent, which leads to a better self-image and, consequently, a better quality of life. Purpose: The purpose of the thesis was to determine the impact of hippotherapy and therapeutic riding on the quality of life of persons with various neurological diseases and impairments, based on a review of scientific writings. Methods: The scientific literature was sought in the PubMed database. We used advanced search with the following search strings: hippotherapy OR therapeutic riding OR equine-assisted therapy AND quality of life hippotherapy AND quality of life hippotherapy AND stroke hippotherapy AND multiple sclerosis hippotherapy AND cerebral palsy hippotherapy AND spinal cord injury hippotherapy AND ADHD. Results: Based on the inclusion and exclusion criteria, 8 studies published between 2007 and 2019 were included in the literature review. Neurological disorders of patients were stroke, multiple sclerosis, cerebral palsy, spinal cord injury and ADHD. The horse therapy program lasted from a minimum of 4 weeks to a maximum of 16-20 weeks. The beneficial impact of hippotherapy or therapeutic riding on various aspects of a health-related quality of life was confirmed in six studies, while in two cases no overall positive conclusions were determined. In two studies the long-term effects of hippotherapy have been observed. In one they were not confirmed, in the other confirmed, but in the latter the results were not statistically evaluated. Discussion and conclusion: It can be concluded that most studies have reported statistically significant effects of hippotherapy or therapeutic riding on the quality of life of subjects compared to other interventions. Nevertheless, there have been too many differences between the studies to conclude on the overall efficacy of hippotherapy as a complementary treatment method in a variety of neurological disorders. Research with a more uniform sample, intervention program, and evaluation method would give more reliable conclusions about the impact of a horse as a mediator during therapy on rider's quality of life.

Aims To clinically validate the new four-dimensional oral health model (4DOHM) by analyzing the level of correlation between oral health-related quality of life (OHRQoL) according to the 4DOHM and health-related quality of life (HRQoL), by analyzing the level of correlation between the Psychosocial Impact dimension of the 4DOHM and depression and anxiety, and by analyzing international dentists’ assessments of how their patients’ problems fit the 4DOHM. Methods We analyzed Oral Health Impact Profile, Patient-Reported Outcomes Measurement Information System Global Health, Depression, and Anxiety questionnaires of adult dental patients attending HealthPartners clinics in Minnesota, USA. We performed structural equation modeling confirmatory factor analysis and path analysis, and an international survey among dentists from all World Health Organization regions. Results Data came from 2,076 dental patients with the mean age 54.7±16.2 years (40.3% females). Correlation coefficients between OHRQoL and HRQoL, OHRQoL and Physical Health, OHRQoL and Mental Health, Psychosocial Impact and depression, and Psychosocial Impact and anxiety, were 0.56, 0.55, 0.51, 0.53, and 0.56, respectively, and they were all “large,” according to Cohen. In total, 1,580 (53.4%) of dentists (54% females) with the mean age of 38.6±10.5 years, from 32 countries, participated in the survey and reported that 94.2% of patients' problems could be categorized into the four dimensions. Conclusions The OHRQoL, according to the 4DOHM, is highly correlated to the HRQoL, and the Psychosocial Impact dimension of 4DOHM is highly correlated to depression and anxiety. Dentists categorized almost all their dental patients’ oral health problems according to the 4DOHM. The 4DOHM is clinically valid. Namen Klinična validacija novega štiridimenzionalnega modela oralnega zdravja (4DMOZ), pri čemer smo: 1. analizirali stopnje povezanosti med »z oralnim zdravjem povezano kakovostjo življenja« (angl. oral health-related quality of life, OHRQoL), opredeljeno po 4DMOZ, in »z zdravjem povezano kakovostjo življenja« (angl. health-related quality of life, HRQoL) 2. analizirali stopnje povezanosti med psihosocialno dimenzijo 4DMOZ in depresijo oz. anksioznostjo in 3. analizirali ocene zobozdravnikov o tem, kako so težave njihovih pacientov uvrščene v 4DMOZ. Metode Analizirali smo vprašalnike Oral Health Impact Profile, Patient-Reported Outcome Measurement Information System’s Adult Global Health, Depression in Anxiety odraslih zobozdravstvenih pacientov klinike HealthPartners v Minnesoti v ZDA. Izvedli smo konfirmatorno faktorsko analizo in analizo poti. Izvedli smo mednarodno anketiranje zobozdravnikov iz vseh regij, ki jih je določila Svetovna zdravstvena organizacija. Rezultati Analizirali smo podatke 2076 zobozdravstvenih pacientov s povprečno starostjo 54,7±16,2 leta (40,3 % žensk). Korelacijski koeficienti so bili: med OHRQoL in HRQoL 0,56 med OHRQoL in telesnim zdravjem 0,55 med OHRQoL in duševnim zdravjem 0,51 med psihosocialno dimenzijo in depresijo 0,53 ter med psihosocialno dimenzijo in anksioznostjo 0,56. Vse korelacije so bile po Cohenu »visoke«. Spletno anketo je izpolnilo 1580 (53,4 %) zobozdravnikov iz 32 držav (54 % žensk) s povprečno starostjo 38,6±10,5 leta. V 4DMOZ so zobozdravniki uvrstili 94,2 % ustno-obraznih težav svojih pacientov. Zaključek Konstrukt OHRQoL, opredeljen po 4DMOZ, je zelo povezan s konstruktom HRQoL. Psihosocialna dimenzija 4DMOZ je zelo povezana z depresijo oz. anksioznostjo. Zobozdravniki so uvrstili skoraj vse težave svojih pacientov v 4DMOZ. Novi 4DMOZ je klinično veljaven.

Health-related quality of life (HRQoL) is measuring a patient's experience of his health status and represents an outcome of medical interventions. Existing data proves that a healthy lifestyle is positively associated with HRQoL in all age groups. Patients with a high risk for cardiovascular disease typically led an unhealthy lifestyle combined with risk diseases. We aimed to analyse these characteristics and their reflection in HRQoL.A cross-sectional study in 36 family practices, stratified by location and size. Each practice invited 30 high-risk patients from the register. Data were obtained from medical records and patient questionnaire. The EQ-5D questionnaire and the VAS scale were used for measuring the patient's HRQoL as an independent variable.871 patients (80.6% response rate) were included in the analysis. 60.0% had 3-4 uncontrolled risk factors for CVD. The average VAS scale was 63.2 (SD 19.4). The correlation of EQ-5D was found in the number of visits in the practice (r=-0.31, p0.001), the socioeconomic status (r=-0.25, p=0.001), age (r=-0.27, p=0.001) and healthy diet (r=0.20, p=0.006). In a multivariate model, only physical activity among lifestyle characteristics was an independent predictor of HRQoL (p=0.001, t=3.3), along with the frequency of visits (p0.001, t=-5.3) and age (p=0.025, t=-2.2).This study has been performed on a specific group of patients, not being "really sick", but having less optimal lifestyle in many cases. Encouragement to improve or keep healthy lifestyle, especially physical activity, is important, not only to lower the risk for CVD, but also to improve HRQoL.Z zdravjem povezana kakovost življenja (HRQoL) meri bolnikovo lastno izkušnjo njegovega zdravstvenega stanja in je eden od izidov zdravstvenih intervencij. Številne raziskave potrjujejo, da je zdrav življenjski slog v vseh starostnih skupinah povezan z boljšo kakovostjo življenja. Značilno je, da imajo bolniki z visoko ogroženostjo za nastanek bolezni srca in ožilja nezdrav življenjski slog, ob prisotnih sočasnih tako imenovanih boleznih tveganja, kot je npr. arterijska hipertenzija. V predstavljeni raziskavi so analizirane značilnosti življenjskega sloga, z namenom ugotoviti, ali se te odražajo v bolnikovi kakovosti življenja.Presečna raziskava je bila izvedena v 36 ambulantah družinske medicine, stratificiranih glede na lokacijo (mesto, podeželje) in velikost (do dva oz. več polno zaposlenih zdravnikov na lokaciji). Vsaka ambulanta je k sodelovanju povabila 30 bolnikov iz registra visoko ogroženih za nastanek bolezni srca in ožilja (BSO) po Framinghamski tabeli ogroženosti. Ustrezni podatki so bili pridobljeni iz zdravstvenih kartotek in s pomočjo vprašalnikov za bolnike. Z zdravjem povezana kakovost življenja je bila merjena s petdimenzionalnim EQ-5D vprašalnikom in z VAS lestvico kakovosti življenja, ki sta predstavljala neodvisni spremenljivki.V analizo je bilo vključenih 871 bolnikov (80,6 % vseh vabljenih). Od teh je 60,0 % imelo 3–4 prisotne dejavnike tveganja za nastanek BSO. Povprečna vrednost VAS lestvice je bila 63,2 (SE 0,72). Ugotovljena je bila korelacija med EQ-5D in pogostostjo obiskov bolnika v enem letu v ambulanti (r=-0,31, p0,001), socialnoekonomskim statusom bolnika (r=-0,25, p=0,001), starostjo bolnika (r=-0,27, p=0,001) in zdravim nacinom prehranjevanja (r=0,20, p=0,006). Med vsemi spremenljivkami so bili v multivariatnem modelu neodvisni napovedni dejavniki HRQoL telesna aktivnost (p=0,001, t=3,3), pogostost obiskov bolnika v ambulanti (p0,001, t=-5,3) in starost bolnika (p=0,025, t=-2,2).Raziskava o kakovosti življenja je bila opravljena v specifični skupini oseb z visokim tveganjem za nastanek BSO, ki niso »pravi« bolniki, pogosto pa imajo neustrezen življenjski slog. Spodbujanje k zdravemu življenjskemu slogu, posebej k telesni aktivnosti, je pomembno ne le za zniževanje tveganja za nastanek BSO, ampak tudi za izboljšanje z zdravjem povezane kakovosti življenja.

V magistrskem delu smo opredelili problematiko življenja obolelih za multiplo sklerozo s poudarkom na opredelitvi kakovosti življenja. Predstavili in opisali smo instrumente ocenjevanja kakovosti življenja ter njihovo uporabnost. Namen je bil raziskati, kakšna je kakovost življenja obolelih za multiplo sklerozo v Sloveniji ter ugotoviti morebitne razlike glede na demografske in klinične značilnosti. Raziskovalna metodologija. Uporabljena je bila kvantitativna metodologija. Podatke smo zbrali s pomočjo prirejenega specifičnega instrumenta FILMS. V raziskavo je bilo vključenih 25 obolelih za multiplo sklerozo, ki so opravljali rehabilitacijo v enem od slovenskih zdravilišč. Rezultate smo obdelali s pomočjo računalniških programov Microsoft Office Word 2010, Microsoft Office Excel 2010 ter IBM SPSS Statistics 19. Rezultati raziskave. Skupno dosežena povprečna vrednost pri FILMS lestvici je znašala 70,32, kar govori o slabši kakovosti življenja. Rezultati so pokazali, da bolečina in utrujenost pomembno ovirata obolele v vsakdanjem življenju, nezadovoljni pa so tudi s telesnim delovanjem. S statističnimi testi smo potrdili, da starost, trajanje in oblika multiple skleroze pomembno vplivajo na kakovost življenja. Sklep. Ocena kakovosti življenja nam pove, kako multipla skleroza vpliva na življenje obolelega, pomaga pa nam tudi pri načrtovanju in vrednotenju zdravstvene oskrbe. V praksi te instrumente zaradi njihovih pomanjkljivosti le redko uporabljamo. S preizkušanjem in razvojem preprostih instrumentov ter predvidenih intervencij bi se njihova uporabnost povečala. In this Master’s degree, we have defined the problems of life of people living with multiple sclerosis with emphasis on defining the quality of life. We presented and described the quality of life assessment instruments and their applicability. The purpuse was to explore the quality of life of people living with multiple sclerosis in Slovenia and to identify eventual differences regarding demographic and clinical characteristics. Research methodology. We applied the quantitative methodology. The data was collected using a modified specific FILMS instrument. The study included 25 people living with multiple sclerosis who were going through rehabilitation at one of ours health resort. The results were processed using computer programs Microsoft Office Word 2010, Microsoft Office Excel 2010, and IBM SPSS Statistics 19. Results. The total average value obtained in the FILMS scale was 70.32, which implies a lower quality of life. The results have shown that pain and fatigue significantly hinder the affected in their daily lives, and they are discontented with their body functions as well. With statistical tests, we have confirmed that age, duration and the type of multiple sclerosis have a significant impact on the quality of life. Conclusion. The quality of life assessment tells us in which way multiple sclerosis affects the life of a patient, but helps us to plan and evaluate health care as well. These instruments are rarely used in practice due to their deficiencies. By testing and development of simple instruments and anticipated interventions, their applicability would be increased.