Developing the Polish Educational Needs Assessment Tool (Pol-ENAT) in rheumatoid arthritis and systemic sclerosis: a cross-cultural validation study using Rasch analysis

Matylda Sierakowska,Mwidimi Ndosi,Stanisław Sierakowski,Justyna Sierakowska,Mike Horton

doi:10.1007/s11136-014-0805-6

Abstract

ObjectivesTo undertake cross-cultural adaptation and validation of the educational needs assessment tool (ENAT) for use with people with rheumatoid arthritis (RA) and systemic sclerosis (SSc) in Poland.MethodsThe study involved two main phases: (1) cross-cultural adaptation of the ENAT from English into Polish and (2) Cross-cultural validation of Polish Educational Needs Assessment Tool (Pol-ENAT). The first phase followed an established process of cross-cultural adaptation of self-report measures. The second phase involved completion of the Pol-ENAT by patients and subjecting the data to Rasch analysis to assess the construct validity, unidimensionality, internal consistency and cross-cultural invariance.ResultsAn adequate conceptual equivalence was achieved following the adaptation process. The dataset for validation comprised a total of 278 patients, 237 (85.3 %) of which were female. In each disease group (145, RA and 133, SSc), the 7 domains of the Pol-ENAT were found to fit the Rasch model, X 2(df) = 16.953(14), p = 0.259 and 8.132(14), p = 0.882 for RA and SSc, respectively. Internal consistency of the Pol-ENAT was high (patient separation index = 0.85 and 0.89 for SSc and RA, respectively), and unidimensionality was confirmed. Cross-cultural differential item functioning (DIF) was detected in some subscales, and DIF-adjusted conversion tables were calibrated to enable cross-cultural comparison of data between Poland and the UK.ConclusionUsing a standard process in cross-cultural adaptation, conceptual equivalence was achieved between the original (UK) ENAT and the adapted Pol-ENAT. Fit to the Rasch model, confirmed that the construct validity, unidimensionality and internal consistency of the ENAT have been preserved.Electronic supplementary materialThe online version of this article (doi:10.1007/s11136-014-0805-6) contains supplementary material, which is available to authorized users.

Highlights

Rheumatoid arthritis (RA) is a systemic inflammatory disease characterized by the presence of a destructive polyarthritis with a predisposition for affecting the peripheral joints [1]
Using a standard process in cross-cultural adaptation, conceptual equivalence was achieved between the original (UK) educational needs assessment tool (ENAT) and the adapted Pol-ENAT
Our research has provided a valid tool with which clinicians in Poland can assess the educational needs of patients with rheumatoid arthritis (RA) and systemic sclerosis (SSc)

Summary

Introduction

Rheumatoid arthritis (RA) is a systemic inflammatory disease characterized by the presence of a destructive polyarthritis with a predisposition for affecting the peripheral joints [1]. Qual Life Res (2015) 24:721–733 vessel vasculopathy, autoantibody production and excessive collagen deposition in the skin and internal organs [2] Both RA and SSc are chronic disabling diseases, which have a negative impact on individuals’ physical, social and psychological functioning [3,4,5]. Patients’ expectations determine whether patient education is likely to lead to behavioural change [13]; it is extremely important for health professionals to assess patient’s educational needs and priorities before providing education. This assessment will help tailor education to meet patient’s priorities and promote shared decisionmaking

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Conclusion