From the Guidelines
To use the Sheehan Disability Scale in telemedicine, send the scale to patients electronically before the appointment or share your screen during the session, as this approach has been shown to be effective in remote clinical services, such as diagnosis and monitoring 1. The Sheehan Disability Scale (SDS) is a brief 3-item self-report tool that assesses functional impairment in work/school, social life, and family life/home responsibilities on a 0-10 scale.
- Ask patients to rate how their symptoms have disrupted each area from 0 (not at all) to 10 (extremely),
- then discuss their responses during the video visit. You can document their scores in their electronic health record and track changes over time. The scale takes only 1-2 minutes to complete and provides valuable insight into how mental health symptoms affect daily functioning. For optimal results,
- explain the purpose of the scale to patients,
- ensure they understand the rating system,
- and use their responses to guide treatment planning and measure progress. The SDS is particularly useful for conditions like depression, anxiety, and PTSD, helping both you and the patient visualize functional improvement alongside symptom reduction, as supported by the adaptation of clinical practice guidelines for telemedicine 1. Telemedicine has been emerging as a valuable tool for remote clinical services, enabling better access to medical specialty services, and its use has been recommended for the management of various conditions, including hypertension 1 and cognitive impairments 1. The use of telemedicine for the administration of the SDS can be facilitated through various technologies, including video conferencing, email, and messaging, as discussed in the context of telehealth and smart working 1. Overall, the use of the SDS in telemedicine can be a valuable tool for assessing functional impairment and guiding treatment planning, and its implementation can be supported by the adaptation of clinical practice guidelines and the use of various technologies.
From the Research
Using the Sheehan Disability Scale in Telemedicine
- The Sheehan Disability Scale (SDS) is a patient-rated, discretized analog measure of functional disability in work, social, and family life 2.
- It can be valuable in assessing impairment and thus in correctly diagnosing major depressive disorder, and can be used to assess the relationship between functioning and discontinuation of antidepressant medication 3.
- The SDS has been found to be a reliable, valid, and useful clinical tool for measuring disability in primary care patients 4.
Telemedicine-enabled Assessment of Disability
- Remote assessment of neurological disability using telemedicine can improve access to clinical care and efficiency of clinical research 5.
- A telemedicine-based disability examination has been developed and validated, showing high correlation with in-person evaluations 5.
- The use of telemedicine-enabled assessments can facilitate the use of the SDS in remote settings, allowing for more convenient and accessible assessments of disability.
Implementation in Telemedicine
- The SDS can be administered via telemedicine platforms, allowing patients to complete the scale remotely and clinicians to assess disability and monitor treatment effects 3, 5.
- The scale's simplicity and brevity make it well-suited for use in telemedicine settings, where patients may have limited time or attention span.
- Clinicians can use the SDS to identify patients who require more intensive interventions or support, and to monitor changes in disability over time 2, 4.