An educational needs assessment of children with juvenile rheumatoid arthritis

Development of a Rheumatoid Arthritis Education Program using the PRECEDE_PROCEED Model

BACKGROUND

In order to help rheumatoid arthritis (RA) patients in carrying out and at-taining relevant self-care behaviors and adaptation to the physical limitations of this dis-ease and, conse-quently, promoting their level of health status, an education program based on the PRECEDE component of the PRECEDE-PROCEED model targeting patients with RA was developed. This paper describes the planning of a RA Patient Education Program (RAPEP) designed to promote their quality of life.

METHODS

The development of the program began with a comprehensive review of the li-terature. This included a review of the signs and symptoms of RA, accompanying func-tional disabilities, previous educational programs and the effect of the disease on the pa-tient's quality of life. Be-sides, in order to help inform RAPEP program development, and organize the survey according to the factors identified in the PRECEDE model a cross-sectional survey was applied on a non-prob-ability sample of 181 outpatients in Yazd, center of Iran.

RESULTS

The quality of life (QOL) problem identified was the considerable low role func-tioning, health perception and physical functioning due to chronic pain. One of the most significant modi-fiable behavioral factors impacting pain and functional limitations was self-care behaviors in RA patients. Higher level of knowledge, attitude, self-efficacy, enabling factors and social support is associated with better self-care behavior.

CONCLUSIONS

The PRECEDE component of the PRECEDE-PROCEED model provided a com-prehensive conceptual framework for the development of RAPEP aiming at RA pa-tients in Yazd. Further research to evaluate this educational program is suggested.

Models and theories in studies on educating and counseling children about physical health: a systematic review

The aim of this review is to gain a comprehensive view on the theories and models referred to in studies on educating and counseling children about physical health. A computer search was conducted using PubMed Medline, and Silverplatter Webspirs Psycinfo. Original studies, reviews, and theoretical papers published between 1992-2003 were included. The review presents the results of the 35 studies in which the majority of the subjects were between 0 and 12 years of age. A classification system is proposed that helped grouping the models, and the interrelationship between this classification and the characteristics of the reviewed studies is explored. The classification could function as an introductory guide and help to select appropriate theories and models when defining future research agenda's. The results of this review may attribute to the refinement of the theoretical underpinning of child education and counseling in physical health.

Bridging the "med-ed gap" for students with special health care needs: a model school liaison program

A successful school experience is critical to the development of all children, particularly in the areas of academic achievement, regular school attendance, and social competency. Vulnerabilities in achieving each of these three goals have been documented among students with special health care needs (SSHCN), and ascribed to the influence of their health-related disabilities. Despite recognition of these vulnerabilities, barriers still exist to successful integration of SSHCN into educational settings. A key barrier to successful integration involves poor linkages between the health and education systems. This article describes a model linkage system--the School Liaison Program at Texas Children's Hospital, developed as a U.S. Dept. of Health and Human Services Maternal and Child Health Bureau Special Project of Regional and National Significance. The program provides educational liaison services between the largest pediatric hospital in the United States and school districts in the fourth largest city. A description of the linkage system emphasizes interdisciplinary staffing by both special educators and health providers. The model for educational liaison service delivery presented includes the elements of eligibility, assessment of the educational implications of illness, plan development and referral, involvement in educational placement, and monitoring. Resources for integrating SSHCN into educational settings are suggested.