The educational needs of patients with undifferentiated spondyloarthritis: Validation of the ENAT questionnaire and needs assessment

Bremander, Ann; Haglund, Emma; Bergman, Stefan; Ndosi, M.

Abstract

Copyright © 2018 John Wiley & Sons, Ltd. Objectives: The aim of the present study was to validate the Swedish version of the educational needs assessment tool (SwENAT) in undifferentiated spondyloarthritis (USpA) and use it to study the educational needs of patients with USpA. Methods: This was a cross-sectional study, recruiting a random sample of patients with USpA from a hospital register in Sweden. Educational needs data were collected, together with disease activity and function indices (Bath Ankylosing Spondylitis Disease Activity Index [BASDAI] and Bath Ankylosing Spondylitis Functional Index [BASFI]). Rasch analysis was utilized to evaluate the construct validity, internal consistency and unidimensionality of the SwENAT before studying differences in educational needs between patient subgroups (gender, age and disease severity). Results: Complete responses were obtained from 77 patients (48 women), with a mean age (standard deviation [SD]) of 50 (12) years, a disease duration of 16 (11) years, a BASDAI score of 4.9 (1.9) and a BASFI score of 3.1 (2.3). The SwENAT satisfied the requirements of the Rasch model (χ 2 = 11.488; p = 0.119), including strict unidimensionality. Overall, the mean (SD) SwENAT score was 86 (32). Women reported higher needs than men in the domains of pain (mean [SD] 13.1 [6.8] versus 10.1 [6.0]; p = 0.05); movement (mean [SD] 13.0 [5.5] versus 9.9 [5.7]; p = 0.02) and self-help (mean [SD] 17.0 [5.8] versus 14.1 [5.0]; p = 0.03). Higher disease activity (BASDAI >4) was associated with higher educational needs (mean [SD] 92.6 [31.9] versus 73.7 [29.4]; p = 0.02). Conclusions: These data suggest that the SwENAT is valid in USpA. Women and patients with higher disease activity are more likely to have high levels of educational needs, so special attention and strategies to target patient education are warranted.

• Journal Article Type: Article
• Acceptance Date: Dec 11, 2017
• Online Publication Date: Feb 7, 2018
• Publication Date: Jun 1, 2018
• Deposit Date: Dec 12, 2017
• Publicly Available Date: Feb 7, 2019
• Journal: Musculoskeletal Care
• Print ISSN: 1478-2189
• Electronic ISSN: 1557-0681
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 16
• Issue: 2
• Pages: 313-317
• DOI: https://doi.org/10.1002/msc.1231
• Keywords: patient education, needs assessment, undifferentiated spondyloarthritis, tool validation, cross-sectional study
• Public URL: https://uwe-repository.worktribe.com/output/856073
• Publisher URL: https://doi.org/10.1002/msc.1231
• Additional Information: Additional Information : This is the peer reviewed version of the following article: Bremander, A., Haglund, E., Bergman, S. and Ndosi, M. (2018) The educational needs of patients with undifferentiated spondyloarthritis: Validation of the ENAT questionnaire and needs assessment. Musculoskeletal Care. ISSN 1557-0681, which has been published in final form at https://doi.org/10.1002/msc.1231. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
• Contract Date: Dec 12, 2017