Educational Needs Assessment Tool Research Articles

Exploring the educational needs of patients with systemic vasculitis using the educational needs assessment tool.

ObjectivesKnowledge and health literacy enable patients to monitor symptoms and disease impact. Educational needs have previously been explored in rheumatology, but scarcely for patients with ANCA-associated vasculitis (AAV). The aim of the study was to assess the educational needs among patients with AAV using the educational needs assessment tool (ENAT).MethodsThis was a cross-sectional observational study including adults with AAV. Educational needs were captured by ENAT. Total ENAT (0–117 points, with higher numbers indicating higher educational need) and the seven domains (managing pain, movement, feelings, disease process, treatment, self-management and support systems) were explored regarding sex, age, education, diagnosis, disease duration and disease activity. To compare domains, a percentage response (0–100%) was calculated.ResultsOne hundred and seventy-eight individuals (50% men; 34% with disease duration ≤2 years) were included. The total ENAT mean was 66.5 (s.d. 26.6; 57%), with domains as follows: disease process, 78%; self-management, 69%; treatments, 64%; feelings, 56%; managing pain, 48%; support systems, 47%; and movement, 41%. Higher educational needs were found among women in the domains movement, feelings and disease process and in total ENAT (all P < 0.04) compared with men. Higher educational needs were also seen in patients with disease duration ≤2 years regarding disease process, self-management and support systems and in total ENAT compared with patients with longer disease duration (all P < 0.03).ConclusionThis study revealed great educational needs among AAV patients. Some groups expressed higher needs (women and those with shorter disease duration). Increased education for patients with AAV might lead to improved self-care and treatment adherence.

Developing the Korean Educational Needs Assessment Tool (Korean ENAT) in rheumatoid arthritis: cross-cultural validation using Rasch analysis.

Background/AimsThis study was performed to undertake cross-cultural adaptation and validation of the Educational Needs Assessment Tool (ENAT) in rheumatoid arthritis (RA) for use in Korea.MethodsThe study involved two main phases: cross-cultural adaptation of the ENAT from English into Korean, and validation of the Korean ENAT. The first phase followed the established process of cross-cultural adaptation of self-report measures, and in the second phase, the Korean ENAT data were analyzed using the Rasch measurement model. Fit to the model was determined using the observed data infit and outfit statistics. Additional tests of validity included unidimensionality and internal consistency.ResultsAdequate conceptual equivalence was achieved following the adaptation process. A total of 123 patients completed the Korean ENAT. The mean age was 46.7 ± 12.3 years and the majority of patients (81.3%) were female. Thirty-five of the 39 items gave good fit to the model. The four items deviating from the model had infit and outfit > 1.50. The item separation index (5.26) and item reliability index (0.97) provided evidence for good reliability of items. All seven domains of the Korean ENAT fit the Rasch model. The internal consistency of the Korean ENAT was high, and unidimensionality was confirmed (person separation index, 3.41; reliability index, 0.92; item separation index, 16.82; reliability index, 1.00).ConclusionsUsing the standard procedure for cross-cultural adaptation, the ENAT has been adapted into Korean, and Rasch analysis has confirmed the construct validity, reliability, and unidimensionality of the Korean ENAT.

Validation of the Italian Version of the Educational Needs Assessment Tool in Rheumatoid Arthritis Patients and Factors Associated with Educational Needs.

The educational needs assessment tool (ENAT) is a seven-domain questionnaire assessing the educational needs (EN) of patients with rheumatoid arthritis (RA). The aim of this study was to validate the Italian version of the ENAT and to identify factors associated with EN in people with RA. The original English ENAT version was translated into Italian according to Beaton’s method and subjected to Rasch analysis for validity testing. Socio-demographic and clinical variables were tested for associations with the ENAT domain scores using a multivariable linear regression model. The ENAT translated well into Italian and retained its construct validity. Some adjustments were needed when pooling the Italian and English datasets. The overall score of the ENAT had a high median: 82.8 (interquartile range (IQR): 57.5 to 100) i.e., 72.4% of the maximum score. The highest score was observed in the domain “Arthritis process” and the lowest was in “Support systems”. Only gender was independently associated with EN (females having higher EN than males). The Italian ENAT is feasible for the use in the clinical setting and may help the health care practitioners to tailor educational interventions for RA patients. The characteristics of the patients, particularly female gender, may be associated with higher EN.

P100 Factors associated with educational needs in patients with inflammatory arthritis

Abstract Background With an overarching aim to inform person-centred patient-education, this study had two objectives: (i) to identify factors that may be associated with educational needs in patients with inflammatory arthritis (IA) (ii) to assess whether educational needs and priorities differ between subtypes of inflammatory arthritis i.e. rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS). Methods Secondary analysis of cross-sectional survey data originally used to validate the Educational Needs Assessment Tool (ENAT) was conducted. The outcome variable was educational needs, summarised as ENAT domain scores. The explanatory variables were: Age, gender, IA subtype, school leaving age and disease duration. ENAT scores were Rasch-transformed prior to analysis. Univariable analyses were conducted to explore differences between groups and multivariable analyses (multiple regression) to determine factors associated with educational needs. All explanatory factors were entered into a preliminary multivariable model. Factors that achieved statistical significance at the 10% level were entered into the final multivariable model. Those that achieved a statistical significance at the 5% level were associated with educational needs. To determine educational priorities, percentage contribution of each domain score to the total score was calculated and compared between factors with one-way analysis of variance. Results The evaluable population comprised 388 patients, 125 with RA, 133 with AS and 130 with PsA. Their mean (SD) age was 48 (13.95) years and male/female ratio 177/210. Those with early arthritis (disease duration &amp;lt;2 years) were 36 (9.2%), RA = 15, AS = 3 and PsA=18, and 116 (29.7%) left school before the age of 16. Table 1 presents the final multi-variable models. The proportion of variance explained by the model varied across ENAT domains, the highest being movement (25%). Female gender was found to be an independent predictor of educational needs across all ENAT domains. Significant differences in educational priorities were observed between disease groups in all domains except disease process and support. Conclusion Female gender is independently associated with educational needs across all three sub-types of IA. Results of this secondary analysis are inconclusive due to limitations in the available data. Further research should include factors such as disease severity, treatments, disability and self-efficacy. Disclosures A.R. Johnston Other; Work conducted as part of Nurse and Allied Health Professional Internship Programme funded by versus Arthritis (Grant number 20867). M. Ndosi None.

Cross-cultural validation of the educational needs assessment tool into Chinese for use in severe knee osteoarthritis.

BackgroundPatient education is an integral part of the management of osteoarthritis. The educational needs assessment tool (ENAT) was developed in the UK to help direct needs-based patient education in rheumatic diseases.AimThe aim of the study was to adapt and validate the ENAT into Chinese, for use in severe knee osteoarthritis (KOA).MethodsThis cross-cultural validation study took two phases: 1) adaptation of the ENAT into Chinese (CENAT) and 2) validation of the CENAT. The Construct validity was determined using factor analysis and criterion-related validity by comparing data from CENAT with data from different self-efficacy scales: patient–physician interactions scale (PEPPI-10), self-efficacy for rehabilitation outcome scale (SER), and the self-efficacy for exercise scale (SEE).ResultsThe sample comprised 196 patients, with mean age 63.6±8.7 years, disease duration was11.5 years, and 57.1% were female. The CENAT was found to have high internal consistency. The CENAT had weak correlations with the Chinese versions of PEPPI r=0.40, SER r=0.40, and SEE r=0.39. There were no correlations with age r=−0.03 or disease duration r=−0.11.ConclusionThe ENAT translated well into Chinese and has evidence of validity in KOA. Future studies will further inform its usefulness in clinics, community, and online settings.

Educational needs in patients with spondyloarthritis in Sweden \u2013 a mixed-methods study

BackgroundThere is a demand for a flexible and individually tailored patient education to meet patients’ specific needs and priorities, but this area has seldom been studied in patients with spondyloarthritis (SpA), a family of inflammatory rheumatic diseases. The aim of the present study was to identify needs and priorities in patient education in patients with SpA. A second aim was to investigate patients’ experiences and preferences of receiving patient education.MethodsData collection included a questionnaire survey with the Educational Needs Assessment Tool (ENAT) and interviews, using a mixed-methods design. Patients were identified through a specialist clinic register. Descriptive data are presented as mean with standard deviation, or frequencies. Chi-square test and independent-samples t-test were used for group comparisons. A manifest qualitative conventional content analysis was conducted to explore patients’ experiences and needs in patient education, based on two focus groups (n = 6) and five individual interviews.ResultsAlmost half (43%) of the 183 SpA patients had educational needs, particularly regarding aspects of self-help, feelings, and the disease process. More educational needs were reported by women and in patients with higher disease activity, while duration of disease did not affect the needs. The qualitative analysis highlighted the importance of obtaining a guiding, reliable, and easily available patient education for management of SpA. Individual contacts with healthcare professionals were of importance, but newer media were also requested.ConclusionThere are considerable educational needs in patients with SpA, and education concerning self-help, feelings, and the diseases process were raised as important issues. Healthcare professionals need to consider the importance of presenting varied formats of education based on the experiences and preferences of patients with SpA.

Effects of needs-based patient education on self-efficacy and health outcomes in people with rheumatoid arthritis: a multicentre, single blind, randomised controlled trial

ObjectivesThe Educational Needs Assessment Tool (ENAT) is a self-completed questionnaire, which allows patients with arthritis to prioritise their educational needs. The aim of this study was to evaluate the effects...

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

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.

Measuring educational needs among patients with systemic lupus erythematosus (SLE) using the Dutch version of the Educational Needs Assessment Tool (D-ENAT).

The Educational Needs Assessment Tool (ENAT) was developed in the United Kingdom (UK) to systematically assess the educational needs of patients with rheumatic diseases. The aim of the present study was to describe the educational needs of Dutch patients with systemic lupus erythematosus (SLE) by means of a Dutch version of the ENAT (D-ENAT). The D-ENAT was sent to a random sample of 244 SLE patients registered at the outpatient clinic of a university hospital. D-ENAT consists of 39 items in seven domains. The D-ENAT domain scores range from 0-16 to 0-28 (higher scoring equals higher educational needs) depending of the number of items in the domain. A total D-ENAT score (0-156) is calculated by summing all 39 items. In addition, age, disease duration, gender, educational level, present information need (yes/no) and the extent of information need (1-4: nothing-everything) were recorded. Univariate regression analysis was used to examine the D-ENAT's potential determinants. The response rate was 122 out of 244 (50%). The mean (% of maximum score) educational needs scores were 56% for 'D-ENAT total score', 62% for 'Self-help measures', 60% for 'Disease process', 58% for 'Feelings', 56% for 'Treatments', 50% for 'Movement', 49% for 'Support systems' and 46% for 'Managing pain'. Being female was significantly associated with higher scoring on the D-ENAT total score (β 23.0; 95% CI 5.9, 40.3). SLE patients demonstrated substantial educational needs, especially in the domains: 'Self-help measures', 'Disease process' and 'Feelings'. The validity and practical applicability of the D-ENAT to make an inventory of SLE patients' educational needs requires further investigation.

OP0207-HPR Gender Differences in Educational Needs to Manage the Disease in Individuals with Spondyloarthritis

BackgroundPatient education is a recommended part of the management of rheumatic diseases but knowledge is scarce concerning what educational needs that are most important from the patient's point of view.ObjectivesThe...

Validation of the educational needs assessment tool as a generic instrument for rheumatic diseases in seven European countries

ObjectivesTo validate the educational needs assessment tool (ENAT) as a generic tool for assessing the educational needs of patients with rheumatic diseases in European Countries.MethodsA convenience sample of patients from...

THU0595 Adaptation and Validation of the Education Needs Assessment Tool into Polish: A Cross Sectional, Tool Validation Study

BackgroundThe Educational Needs Assessment Tool (ENAT) is a self-completed questionnaire developed in the UK to measure educational needs of patients with rheumatic diseases.ObjectivesThe aim of this study was to adapt...

THU0559 Patient Education, Disease Activity and Physical Function. Can we be more Targeting? A Cross Sectional Study among People with RA, PsA and Hand OA

BackgroundTargeted education is likely to enable people with arthritis manage their disease and maintain quality of life. Educational needs assessment tool (ENAT) was developed to help practitioners assess relevant and...

A study evaluating the effect of Educational Needs Assessment Tool (ENAT) focused patient education, on health outcomes in patients with Rheumatoid Arthritis: Protocol of an ongoing study

Aims and objectives: To evaluate the effectiveness of a patient education tool (the ENAT) on self efficacy, patient knowledge, health outcomes and its usability in practice. Background: The effectiveness and value of patient education in rheumatoid arthritis have been questioned. The ENAT was developed to help the nurses to provide more focused, individualized and relevant education. The psychometric properties of the ENAT have been assessed. Design: This study is a single blind randomized controlled trial using both quantitative and qualitative methodology. The primary outcome is patient self efficacy. Secondary outcomes are physical function, psychological status, pain levels, social interaction and patient knowledge of disease. Methods: 130 RA patients will be randomized into an experimental (EG) or control group (CG). The EG patients will complete the ENAT prior to seeing a Clinical Nurse Specialist (CNS) at weeks 0, 16 and 32. The CNS will use the ENAT as a template to meet patients perceived educational needs in addition to the usual care. The CG will receive their usual care from the CNS without the aid of the ENAT. To determine the ENAT’s usability, semi-structured quailtative interviews will take place with the practitioners and a sample of patients once they have completed the quantitative arm of the study. Results: The study commenced in April 2011 and the results are expected to be available after April 2013. Conclusions: It is hypothesized that nurses’ use of the ENAT will lead to increased patient self efficacy, and improved patient knowledge and health outcomes among the patients who used it. Furthermore, it is hypothesized that the ENAT will be easy for staff and patients to use. Relevance to clinical practice: The ENAT was developed to assess the perceived educational needs of patients with rheumatoid arthritis and thus help the nurses to provide more focused, individualised and relevant education.

Measuring educational needs among patients with rheumatoid arthritis using the Dutch version of the Educational Needs Assessment Tool (DENAT)

The Educational Needs Assessment Tool (ENAT) was developed in the United Kingdom (UK) to systematically assess the educational needs of patients with arthritis. The aim of the present study was to describe the educational needs of Dutch patients with rheumatoid arthritis (RA) by using the Dutch version of the ENAT (DENAT). The original UK version of the ENAT, comprising 39 items grouped into seven domains, was translated into Dutch according to international guidelines for cross-cultural translation and adaptation. The DENAT was then sent to a random sample of 319 RA patients registered at the outpatient clinic of a university hospital. For each domain (score range 1–5, equalling low–high educational needs), a median score with the inter-quartile range was computed. The Kruskal–Wallis test was used to determine possible associations between educational needs and age, disease duration, gender and educational background. The response rate was 165 out of 319 (52%). The median educational needs scores were 2.5 for “managing pain”, 3.0 for “movement”, 2.0 for “feelings”, 4.0 for “arthritis process”, 4.0 for “treatments from health professionals”, 3.5 for “self-help measures” and 2.5 for “support systems”. Lower age and shorter disease duration were associated with more educational needs in the domain “support systems”. In addition, younger patients had more educational needs regarding managing pain and feelings than older patients. There were no associations between gender or educational background and educational needs. The DENAT has demonstrated its ability to identify individual educational needs of Dutch patients with RA. The lower age and shorter disease duration were associated with more educational needs. The practical applicability of the DENAT needs further research.