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Ali SS, Wincup C. #RheumTwitter - the Rise of Social Media in Rheumatology: Research, Collaboration, Education, and Engagement. RHEUMATOLOGY AND IMMUNOLOGY RESEARCH 2022; 3:163-168. [PMID: 36879837 PMCID: PMC9984932 DOI: 10.2478/rir-2022-0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 10/30/2022] [Indexed: 06/18/2023]
Abstract
Social media broadly refers to an internet-based platform that allows for the online publication of content that is shared across a virtual community or network. Over recent years, there has been growing utilization of social media in the medical community. The field of rheumatology is no different. Social media allows for the sharing of information among rheumatologists, which can be useful in online education, disseminating research findings, forming new networks of collaborators, and discussing the latest advances in the field. However, there are several challenges facing clinicians using social media. As such, regulatory bodies have produced advisory codes of conduct to ensure better awareness concerning the appropriate use of social media among clinicians. In addition, clinicians (even those who do not use social media) need to be mindful of the fact that many patients will use these online platforms to find information, and with this comes the risk of false information. In this review, we highlight the benefits and challenges facing rheumatologists in relation to the world of social media.
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Affiliation(s)
- Sasha Saadia Ali
- King’s College Hospital NHS Trust, Denmark Hill, London, SE5 9RS, United Kingdom
| | - Chris Wincup
- King’s College Hospital NHS Trust, Denmark Hill, London, SE5 9RS, United Kingdom
- Department of Rheumatology, University College London, London, United Kingdom
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2
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Hammer NM, Flurey CA, Jensen KV, Andersen L, Esbensen B. Preferences for Self‐Management and Support Services in Patients With Inflammatory Joint Disease: A Danish Nationwide Cross‐Sectional Study. Arthritis Care Res (Hoboken) 2021; 73:1479-1489. [DOI: 10.1002/acr.24344] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 05/22/2020] [Indexed: 01/15/2023]
Affiliation(s)
- Nanna Maria Hammer
- Copenhagen Center for Arthritis Research and Rigshospitalet Glostrup Denmark
| | | | - Kim Vilbæk Jensen
- Copenhagen Center for Arthritis Research and Rigshospitalet Glostrup Denmark
| | - Lena Andersen
- Copenhagen Center for Arthritis Research and Rigshospitalet Glostrup Denmark
| | - Bente Appel Esbensen
- Copenhagen Center for Arthritis Research and Rigshospitalet, Glostrup, and University of Copenhagen Copenhagen Denmark
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Favero M, Ometto F, Salaffi F, Belluzzi E, Ortolan A, Lorenzin M, Felicetti M, Punzi L, Ndosi M, Ramonda R. Validation of the Italian Version of the Educational Needs Assessment Tool in Rheumatoid Arthritis Patients and Factors Associated with Educational Needs. J Pers Med 2020; 10:jpm10040150. [PMID: 33019610 PMCID: PMC7712017 DOI: 10.3390/jpm10040150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 09/16/2020] [Accepted: 09/23/2020] [Indexed: 12/12/2022] Open
Abstract
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.
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Affiliation(s)
- Marta Favero
- Rheumatology Unit, Department of Medicine (DIMED), University of Padova, 35128 Padova, Italy; (M.F.); (F.O.); (E.B.); (A.O.); (M.L.); (M.F.)
| | - Francesca Ometto
- Rheumatology Unit, Department of Medicine (DIMED), University of Padova, 35128 Padova, Italy; (M.F.); (F.O.); (E.B.); (A.O.); (M.L.); (M.F.)
| | - Fausto Salaffi
- Rheumatological Clinic, Ospedale Carlo Urbani, Università Politecnica delle Marche, 60035 Jesi, Italy;
| | - Elisa Belluzzi
- Rheumatology Unit, Department of Medicine (DIMED), University of Padova, 35128 Padova, Italy; (M.F.); (F.O.); (E.B.); (A.O.); (M.L.); (M.F.)
| | - Augusta Ortolan
- Rheumatology Unit, Department of Medicine (DIMED), University of Padova, 35128 Padova, Italy; (M.F.); (F.O.); (E.B.); (A.O.); (M.L.); (M.F.)
| | - Mariagrazia Lorenzin
- Rheumatology Unit, Department of Medicine (DIMED), University of Padova, 35128 Padova, Italy; (M.F.); (F.O.); (E.B.); (A.O.); (M.L.); (M.F.)
| | - Mara Felicetti
- Rheumatology Unit, Department of Medicine (DIMED), University of Padova, 35128 Padova, Italy; (M.F.); (F.O.); (E.B.); (A.O.); (M.L.); (M.F.)
| | - Leonardo Punzi
- Centre for Gout and Metabolic Bone and Joint Diseases, Rheumatology, SS Giovanni and Paolo Hospital, 30122 Venice, Italy;
| | - Mwidimi Ndosi
- Department of Nursing and Midwifery, University of the West of England, Bristol BS16 1DD, UK;
- Academic Rheumatology Unit, University Hospitals Bristol, Bristol BS2 8HW, UK
| | - Roberta Ramonda
- Rheumatology Unit, Department of Medicine (DIMED), University of Padova, 35128 Padova, Italy; (M.F.); (F.O.); (E.B.); (A.O.); (M.L.); (M.F.)
- Correspondence: ; Tel.: +39-049-821-2199
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Pérez S, Santa Cruz M, Sosa J, Kohan P, Medina M, Klajn D, Papasidero S, Caracciolo J, Pendón G, Giordano F, Pereira D, Alvarez D, Astudillo V, Kerzberg E, Perez Dávila A, Bohr A, Melo F, Lloves N, Mamani M, Hartvig C, Sanchez G, Sacnum M, Chichotky Y, Velazco Zamora J, Benegas M, Rosa J, García M, Raiti L, Cruzat V, Quintana R, Pons-Estel B, Kirmayr K, D'Orazio A, Retamozo C, Romano O, Perez Alamino R, Correa M, Citera G, Rillo O, Zalazar M, Costi A, García M, Gomez G, Maldonado Ficco H. Evaluation of the Educational Needs in Argentine Patients with Rheumatoid Arthritis Using the SpENAT Questionnaire. ACTA ACUST UNITED AC 2018; 16:386-390. [PMID: 30385296 DOI: 10.1016/j.reuma.2018.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 09/10/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND The SpENAT, a Spanish version of the Educational Needs Assessment Tool, is a self-completed questionnaire that assesses educational needs (ENs) with the purpose of providing tailored and patient-centered information. It consists of 39 questions grouped into the 7 following domains: Pain management, Movement, Feelings, Arthritic process, Treatments, Self-help measures and Support system. OBJECTIVES The objective of the study was to describe the ENs of rheumatoid arthritis (RA) patients using the SpENAT and to determine the main sources of information consulted by these patients. MATERIAL AND METHODS Multicenter, observational, cross-sectional study. We included consecutive patients≥18 years with diagnosis of RA (ACR 87/ACR-EULAR 2010). Sociodemographic data, disease characteristics and clinimetric properties were recorded. All patients completed the SpENAT and were asked about the sources employed to obtain information about their disease. STATISTICAL ANALYSIS Population characteristics were described. ENs were determined as percentages of the highest possible score for each domain. Needs for each domain according to sex, years of education, disease duration, use of biologicals and functional capacity were analyzed by means of ANOVA, and bivariate comparisons were made with Student's t-test and the Bonferroni correction. Correlation between domains was determined with the Spearman correlation coefficient. We compared patients' age by source of information with Student's t-test. RESULTS We included 496 patients from 20 centers across the country. More ENs were observed in the domains of Movement, Feelings and the Arthritic process. Patients with higher educational level (>7 years) reported more ENs in the Arthritic process and Self-help measure domains. A higher functional impairment (HAQ-A≥0.87) was associated with more ENs in every domain. Patients with high activity showed more ENs than those in remission in the domains of Pain management, Movement, Feelings, Treatments and Support system, as well as those with low activity in Self-help measures and Support system domains. All SpENAT domains showed positive correlations among each other (P<.0001), the most important being Pain management/Movement and Treatments/Arthritic process (r≥0.7). The source of information most frequently consulted was the rheumatologist (93.95%); those who made use of Internet were on average younger (P=.0004). CONCLUSION RA patients were very interested about knowing more about their disease. High functional impairment was associated with more ENs. Patients with high disease activity had higher EN levels in almost every domain. The rheumatologist was the main source of information for the patient with RA.
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Affiliation(s)
- Silvana Pérez
- Hospital General de Agudos Dr. E. Tornú, Ciudad Autónoma de Buenos Aires, Argentina.
| | - María Santa Cruz
- Hospital General de Agudos Dr. E. Tornú, Ciudad Autónoma de Buenos Aires, Argentina
| | - Julia Sosa
- Hospital General de Agudos Dr. E. Tornú, Ciudad Autónoma de Buenos Aires, Argentina
| | - Paula Kohan
- Hospital General de Agudos Dr. E. Tornú, Ciudad Autónoma de Buenos Aires, Argentina
| | - María Medina
- Hospital General de Agudos Dr. E. Tornú, Ciudad Autónoma de Buenos Aires, Argentina
| | - Diana Klajn
- Hospital General de Agudos Dr. E. Tornú, Ciudad Autónoma de Buenos Aires, Argentina
| | - Silvia Papasidero
- Hospital General de Agudos Dr. E. Tornú, Ciudad Autónoma de Buenos Aires, Argentina
| | - José Caracciolo
- Hospital General de Agudos Dr. E. Tornú, Ciudad Autónoma de Buenos Aires, Argentina
| | - Gisela Pendón
- Hospital Ricardo Gutiérrez, La Plata, Buenos Aires, Argentina
| | | | - Dora Pereira
- Hospital Ricardo Gutiérrez, La Plata, Buenos Aires, Argentina
| | - Damaris Alvarez
- Hospital Ramos Mejía, Ciudad Autónoma de Buenos Aires, Argentina
| | | | - Eduardo Kerzberg
- Hospital Ramos Mejía, Ciudad Autónoma de Buenos Aires, Argentina
| | - Adriana Perez Dávila
- Hospital de Rehabilitación Manuel Rocca, Ciudad Autónoma de Buenos Aires, Argentina
| | - Analía Bohr
- Hospital de Rehabilitación Manuel Rocca, Ciudad Autónoma de Buenos Aires, Argentina
| | - Fernando Melo
- Hospital Bernardino Rivadavia, Ciudad Autónoma de Buenos Aires, Argentina
| | - Nicolás Lloves
- Hospital Bernardino Rivadavia, Ciudad Autónoma de Buenos Aires, Argentina
| | - Marta Mamani
- Hospital Bernardino Rivadavia, Ciudad Autónoma de Buenos Aires, Argentina
| | - Claudia Hartvig
- Hospital Provincial de Rosario, Rosario, Santa Fe, Argentina
| | | | - Mónica Sacnum
- Hospital Provincial de Rosario, Rosario, Santa Fe, Argentina
| | | | | | - Mariana Benegas
- Sanatorio de la Providencia, Ciudad Autónoma de Buenos Aires, Argentina
| | - Javier Rosa
- Hospital Italiano, Ciudad Autónoma de Buenos Aires, Argentina
| | - María García
- Hospital Italiano, Ciudad Autónoma de Buenos Aires, Argentina
| | - Laura Raiti
- Clínica Bessone, San Miguel, Buenos Aires, Argentina
| | - Vanesa Cruzat
- Clínica Bessone, San Miguel, Buenos Aires, Argentina
| | | | | | - Karin Kirmayr
- Sanatorio San Carlos, Bariloche, Río Negro, Argentina
| | - Andrea D'Orazio
- Hospital Interzonal General De Agudos Dr. José Penna, Bahía Blanca, Buenos Aires, Argentina
| | - Cinthya Retamozo
- Centro de Estudios sobre Derecho y Religión, San Ramón de la Nueva Orán, Salta, Argentina
| | - Olga Romano
- Hospital de Clínicas Pte. Dr. Nicolás Avellaneda, San Miguel de Tucumán, Tucumán, Argentina
| | - Rodolfo Perez Alamino
- Hospital de Clínicas Pte. Dr. Nicolás Avellaneda, San Miguel de Tucumán, Tucumán, Argentina
| | - María Correa
- Instituto de Rehabilitación Psicofísica, Ciudad Autónoma de Buenos Aires, Argentina
| | - Gustavo Citera
- Instituto de Rehabilitación Psicofísica, Ciudad Autónoma de Buenos Aires, Argentina
| | - Oscar Rillo
- Hospital Pirovano, Ciudad Autónoma de Buenos Aires, Argentina
| | - María Zalazar
- Hospital Pirovano, Ciudad Autónoma de Buenos Aires, Argentina
| | - Ana Costi
- Hospital San Martín, La Plata, Buenos Aires, Argentina
| | | | - Graciela Gomez
- Instituto Lanari, Ciudad Autónoma de Buenos Aires, Argentina
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McBain H, Shipley M, Newman S. Clinician and Patient Views About Self‐Management Support in Arthritis: A Cross‐Sectional
UK
Survey. Arthritis Care Res (Hoboken) 2018; 70:1607-1613. [DOI: 10.1002/acr.23540] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 02/06/2018] [Indexed: 01/15/2023]
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Connelly K, Segan J, Lu A, Saini M, Cicuttini FM, Chou L, Briggs AM, Sullivan K, Seneviwickrama M, Wluka AE. Patients' perceived health information needs in inflammatory arthritis: A systematic review. Semin Arthritis Rheum 2018; 48:900-910. [PMID: 30185378 DOI: 10.1016/j.semarthrit.2018.07.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 04/21/2018] [Accepted: 07/26/2018] [Indexed: 01/01/2023]
Abstract
OBJECTIVES To identify the breadth of the literature regarding patients' perceived health information needs related to inflammatory arthritis care. METHODS A systematic scoping review of MEDLINE, EMBASE, CINAHL and PsycINFO was performed to identify relevant articles (1990 -2016) examining patients' perceived needs relating to health information in inflammatory arthritis. Data and themes were identified and categorised and risk of bias assessed. RESULTS Twenty nine studies (11 quantitative, 14 qualitative and 4 mixed methods) from 4121 identified articles were relevant for inclusion. Most focussed on rheumatoid arthritis. Key findings included: (1) Reasons for seeking health information often focussed on gaining ownership over their condition and facilitating self-management. (2) Demographic differences in information needs were inconsistent, but women and younger patients generally reported more needs. (3) Desired information content was broad, and included targeted and practical information covering disease treatment and psychosocial wellbeing. (4) Preferred information delivery method was consultation with a Rheumatologist; however group sessions had advantages for psychosocial issues while written information provided useful supplementation. (5) Barriers to meeting health information needs were around timely access. CONCLUSIONS Patients with inflammatory arthritis have high information needs, desiring practical and individualised information. When developing strategies to meet patients' information needs, aligning patient expectations with delivery methods that are accessible, cost-effective and flexible may help to optimize patient outcomes.
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Affiliation(s)
- Kathryn Connelly
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - Julian Segan
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - Alicia Lu
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - Meher Saini
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - Flavia M Cicuttini
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - Louisa Chou
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - Andrew M Briggs
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia; MOVE: Muscle, Bone & Joint Health, Victoria, Australia
| | - Kaye Sullivan
- Monash University Library, Monash University, Melbourne, Victoria, Australia
| | - Maheeka Seneviwickrama
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - Anita E Wluka
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia.
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7
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Forbes R, Mandrusiak A, Smith M, Russell T. A comparison of patient education practices and perceptions of novice and experienced physiotherapists in Australian physiotherapy settings. Musculoskelet Sci Pract 2017; 28:46-53. [PMID: 28171778 DOI: 10.1016/j.msksp.2017.01.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 12/13/2016] [Accepted: 01/16/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND Patient education is an integral component of physiotherapy practice. Little is known about the differences in reported use and perception of patient education between experienced and novice physiotherapists. Understanding these differences has important implications for training approaches and physiotherapy practice. OBJECTIVES To compare how experienced and novice physiotherapists report frequency of patient education practices and their perceptions of the importance of these practices. DESIGN AND METHODS A web-based purpose-designed survey was developed, piloted and administered to practicing physiotherapists through direct email. Of 305 complete responses, two subgroups were explored for comparative analysis: 'novice' (≤5years' experience, n = 52); and 'experienced' (≥11 years' experience, n = 204). RESULTS The experienced group rated 14 of 15 educational items higher than the novice group in relation to frequency of use and perceived importance. Experienced physiotherapists reported a significantly higher frequency of using one-to-one discussion, personalised handouts and explicitly seeking patient understanding (p < 0.05). Novice physiotherapists perceived more barriers to patient education, particularly those related to characteristics of the patient (p < 0.05). CONCLUSION Experienced physiotherapists report higher use of self-management education and education content that is patient-centred. Experienced therapists report a higher frequency of seeking explicit patient understanding to evaluate their teaching than novice physiotherapists and perceive fewer patient-related barriers to their practice. These findings are important when considering teaching and learning of patient education skills. Students or novice physiotherapists may benefit from strategies to facilitate patient-centred education, self-management education, evaluation approaches and strategies to manage barriers.
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Affiliation(s)
- Roma Forbes
- School of Health and Rehabilitation Sciences, The University of Queensland, Australia.
| | - Allison Mandrusiak
- School of Health and Rehabilitation Sciences, The University of Queensland, Australia
| | - Michelle Smith
- School of Health and Rehabilitation Sciences, The University of Queensland, Australia
| | - Trevor Russell
- School of Health and Rehabilitation Sciences, The University of Queensland, Australia
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8
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Karimi S, Safiri S, Bayat M, Mottaghi P, Shokri A, Moosazadeh M, Fattahi H. Assessment of the Quality of Delivered Care for Iranian patients with Rheumatoid Arthritis by Using Comprehensive Quality Measurement Model in Health Care (CQMH). J Caring Sci 2015; 4:287-96. [PMID: 26744728 PMCID: PMC4699501 DOI: 10.15171/jcs.2015.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 05/17/2015] [Indexed: 01/18/2023] Open
Abstract
Introduction: Quality of care has become increasingly critical in the evaluation of healthcare
and healthcare services. The aim of this study was to assess quality of delivered care
among patients with rheumatoid arthritis using a model of Comprehensive Quality
Measurement in Health Care (CQMH). Methods: This cross-sectional study was conducted on 172 patients with rheumatoid
arthritis (RA) who were received care from private clinics of Isfahan University of
medical sciences in 2013. CQMH questionnaires were used for assessing the quality of care.
Data were analyzed using SPSS for Windows. Results: The mean scores of Quality Index, Service Quality (SQ), Technical Quality (TQ),
and Costumer Quality (CQ) were 72.70, 79.09, 68.54 and 70.25 out of 100, respectively. For
CQ only 19.8% of participations staying the course of action even under stress and
financial constraints, there is a significant gap between what RA care they received with
what was recommended in the guideline for TQ. Scores of service quality was low in
majority of aspects especially in "availability of support group" section. Conclusion: Study shows paradoxical findings and expresses that quality scores of service
delivery for patients with arthritis rheumatoid from patient's perspective is relatively
low. Therefore, for fixing this paradoxical problem, improving the participation of
patients and their family and empowering them for self-management and decision should be
regarded by health systems.
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Affiliation(s)
- Saeed Karimi
- Department of Health Services Management, Health Management & Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saeid Safiri
- Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Mahboubeh Bayat
- Health Services Management of Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Payman Mottaghi
- Department of Rheumatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azad Shokri
- Department of Health Services Management, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmood Moosazadeh
- Department of Epidemiology, Health Sciences Research Center, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hamed Fattahi
- Deputy of Development and Resource Management, Ministry of Health and Medical Education, Tehran, Iran
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Hardware B, Johnson D, Hale C, Ndosi M, Adebajo A. Patients and nursing staff views of using the education needs assessment tool in rheumatology clinics: a qualitative study. J Clin Nurs 2014; 24:1048-58. [DOI: 10.1111/jocn.12733] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Bernadette Hardware
- Research & Development Department; Barnsley Hospital NHS Foundation Trust; Barnsley UK
| | - Dawn Johnson
- Research & Development Department; Barnsley Hospital NHS Foundation Trust; Barnsley UK
| | - Claire Hale
- School of Healthcare; University of Leeds; Leeds UK
| | - Mwidimi Ndosi
- School of Healthcare; University of Leeds; Leeds UK
- Academic and Clinical Unit for Musculoskeletal Nursing; Leeds Institute of Rheumatic and Musculoskeletal Medicine; University of Leeds; Leeds UK
| | - Adewale Adebajo
- Department of Rheumatology; Barnsley Hospital NHS Foundation Trust; Barnsley UK
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10
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Developing the Polish Educational Needs Assessment Tool (Pol-ENAT) in rheumatoid arthritis and systemic sclerosis: a cross-cultural validation study using Rasch analysis. Qual Life Res 2014; 24:721-33. [PMID: 25231203 PMCID: PMC4349946 DOI: 10.1007/s11136-014-0805-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2014] [Indexed: 11/04/2022]
Abstract
Objectives To 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. Methods The 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. Results An 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, X2(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. Conclusion Using 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 material The online version of this article (doi:10.1007/s11136-014-0805-6) contains supplementary material, which is available to authorized users.
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11
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Dures E, Hewlett S, Ambler N, Jenkins R, Clarke J, Gooberman-Hill R. Rheumatology clinicians' experiences of brief training and implementation of skills to support patient self-management. BMC Musculoskelet Disord 2014; 15:108. [PMID: 24678645 PMCID: PMC3978089 DOI: 10.1186/1471-2474-15-108] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Accepted: 03/13/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Self-management of arthritis requires informed, activated patients to manage its physical and psychosocial consequences. Patient activation and self-management can be enhanced through the use of cognitive-behavioural approaches, which have a strong evidence base and provide insight into the variation in outcome of patients with ostensibly the same degree of disease activity. However, training for rheumatology health professionals in theory and skills underpinning the facilitation of self-management is not widely available. To develop such training, this study explored rheumatology clinicians' experiences of a variety of brief skills training courses to understand which aspects were helpful or unhelpful, and to identify the barriers and facilitators of applying the skills in clinical practice. METHODS 16 clinicians who had previously attended communication and self-management skills training participated in semi-structured interviews: 3 physicians, 3 physiotherapists, 4 nurses, 6 occupational therapists. Transcripts were analysed (ED) using a hybrid inductive and deductive thematic approach, with a subset independently analysed (SH, RG-H, RJ). RESULTS 3 overarching themes captured views about training undertaken and subsequent use of approaches to facilitate self-management. In 'putting theory into practice', clinicians felt that generic training was not as relevant as rheumatology-specific training. They wanted a balance between theory and skills practice, and identified the importance of access to ongoing support. In 'challenging professional identity', models of care and working cultures influenced learning and implementation. Training often challenged a tendency to problem-solve on behalf of patients and broadened clinicians' remit from a primary focus on physical symptoms to the mind and body interaction. In 'enhanced practice', clinicians viewed consultations as enhanced after training. Focus had shifted from clinicians' agendas to those of patients, and clinicians reported eliciting patients' priorities and the use of theoretically-driven strategies such as goal-setting. CONCLUSIONS To varying extents, clinicians were able to learn and implement new approaches to support patient self-management after brief training. They believed that cognitive behavioural and communication skills to facilitate self-management enhanced their practice. To optimise self-management support in routine care brief, skills-based, rheumatology-specific training needs to be developed, alongside ongoing clinical supervision. Further research should examine patients' perspectives of care based on these approaches.
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Affiliation(s)
- Emma Dures
- University of the West of England, Bristol, UK.
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Abstract
A revolution is underway in the fields of education and health practice. Social media are now considered by the new generations of students, doctors and patients as a useful tool for learning and for doctor-doctor, doctor-patient and patient-patient communications. However, should we be excited by this revolution or afraid of it? Advantages and challenges of such new tools for medicine in general and rheumatology in particular are discussed in this Perspectives.
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Tingey P, Khanafer M, Singh K, Thompson A, Le Riche N, Barra L, Haig S, Rohekar G, Rohekar S, Nielson W, Pope JE. Social persuasion in rheumatology: a randomized trial of testimonials on television in the rheumatology clinic waiting room to increase attendance for multidisciplinary education. Rheumatol Int 2014; 34:903-7. [PMID: 24509936 DOI: 10.1007/s00296-014-2961-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Accepted: 01/31/2014] [Indexed: 11/26/2022]
Abstract
Multidisciplinary self-management programs are important in inflammatory arthritis as adjunctive treatment. Patients often have excuses as to why they do not attend these programs. The purpose of this study was to determine whether an intervention of televised testimonials from rheumatologists and allied health professionals increases attendance at a multidisciplinary education day for rheumatology patients seen in a large university hospital clinic. This was an RCT of intervention: playing televised interviews in the waiting room where rheumatology patients were seen versus no TV. There was a total of 6 months (3 months with and 3 without the televised interview playing). All eligible patients who attended the rheumatology outpatient clinic were then tracked to determine whether they attended a subsequent education day over the next 10 months. The sample size was calculated to have a 15% increase in attendance at the education days. There was a 20% increase in attendees at the multidisciplinary education days for patients who saw the televised testimonials. Sixty-three patients who viewed the testimonials (2.17% of 2,908) attended the education day compared to 39 who did not receive the intervention (1.80% of 2,168); however, the increase was not statistically significant (p = 0.36). Attendance of eligible patients increased using televised testimonials; however, the increase was not significant as the rates of attendance were still very low in both groups. Many eligible patients did not attend the program. Other interventions are necessary to encourage attendance in a multidisciplinary program.
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Affiliation(s)
- Paul Tingey
- St. Joseph's Health Care, 268 Grosvenor St., London, ON, N6A 4V2, Canada
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Drăgoi RG, Ndosi M, Sadlonova M, Hill J, Duer M, Graninger W, Smolen J, Stamm TA. Patient education, disease activity and physical function: can we be more targeted? A cross sectional study among people with rheumatoid arthritis, psoriatic arthritis and hand osteoarthritis. Arthritis Res Ther 2013; 15:R156. [PMID: 24286444 PMCID: PMC3978882 DOI: 10.1186/ar4339] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 09/27/2013] [Indexed: 11/10/2022] Open
Abstract
Introduction In order to target educational needs of patients more effectively, an Austrian-German educational needs assessment tool (OENAT) was developed, the educational needs of patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and hand osteoarthritis (HOA) were described and the relationships between educational needs, gender, disease activity and function were explored. Methods The English ENAT was adapted into Austrian-German using Beaton's cross-cultural adaptation process. Internal construct validity was assessed by Rasch analysis. Educational needs across diagnostic groups and subgroups of patients were summarized descriptively and their relationship with disease activity and physical functioning explored. Results The sample comprised 130 RA, 125 PsA and 48 HOA patients. Their mean ages ± SD were 56 ± 14, 51 ± 11 and 64 ± 7 years for RA, PsA and HOA; disease duration was 11 ± 9, 11 ± 11 and 14 ± 9 years, respectively. More than 70% in each patient group expressed interest in receiving education about their disease. The educational needs differed significantly between women and men in all 3 groups. In RA and PsA, female patients expressed significantly higher educational needs than men in 'movements’ and 'feelings’ domains (p=0.04 and p=0.03 for RA and p<0.01 and p=0.01 for PsA). Female patients in the HOA group had significantly higher scores on all domains except for the 'movements’. Older patients with PsA scored significantly higher than their younger counterparts in the 'pain’ domain (p=0.05). RA patients with disease duration >5 years), expressed higher educational needs in 'movements’ (p<0.01). Educational background had effects in the PsA group only, patients with basic education had greater scores than those with higher education on 'movements’ and 'arthritis process’ (p=0.01). In the RA group, DAS28 correlated significantly with 'movements’ (r=0.24, p=0.01), 'feelings’ (r=0.22, p=0.02), and 'treatments’ (r=0.22, p=0.03). In the PsA group, all OENAT domains correlated with disease activity (DAPSA and CDAI). Conclusions This study showed that educational needs vary with personal characteristics. Patient education may be more targeted and effective, if gender, age, educational background and disease duration are taken into account. Correlations with disease activity and function suggest that the OENAT could enable identification of 'intervention points’, which can be ideal opportunities for effective patient education.
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Deng W, Hu J. The effects of a pilot intervention for community-dwelling adults with rheumatoid arthritis in wuhan, china. Front Public Health 2013; 1:43. [PMID: 24350212 PMCID: PMC3860135 DOI: 10.3389/fpubh.2013.00043] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 09/24/2013] [Indexed: 11/21/2022] Open
Abstract
This study examined the effects of a pilot educational intervention program on knowledge, perceived self-efficacy, and health-related quality of life (HRQoL) of community-dwelling adults with rheumatoid arthritis (RA). A convenience sample of 16 participants with RA completed the program in Wuhan, China. Data were collected in face-to-face interviews using questionnaires at baseline, post-test, and 1 month follow-up. Knowledge scores were significantly increased over time. Significant differences were found in pain self-efficacy, symptoms self-efficacy, bodily pain, social functioning, and role emotional functions. Community health providers should provide educational programs to improve HRQoL for adults with RA.
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Affiliation(s)
- Wenfang Deng
- Hope School of Nursing, Wuhan University , Wuhan , China
| | - Jie Hu
- School of Nursing, The University of North Carolina at Greensboro , Greensboro, NC , USA
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Poulsen E, Hartvigsen J, Christensen HW, Roos EM, Vach W, Overgaard S. Patient education with or without manual therapy compared to a control group in patients with osteoarthritis of the hip. A proof-of-principle three-arm parallel group randomized clinical trial. Osteoarthritis Cartilage 2013; 21:1494-503. [PMID: 23792189 DOI: 10.1016/j.joca.2013.06.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2012] [Revised: 05/03/2013] [Accepted: 06/05/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the effectiveness of a patient education (PE) program with or without the added effect of manual therapy (MT) compared to a minimal control intervention (MCI). METHODS In a single-center university hospital setting, a total of 118 patients with clinical and radiographic unilateral hip osteoarthritis (OA) from primary care were randomized into one of three groups: PE, PE plus MT or MCI. The PE was taught by a physiotherapist involving five sessions. The MT was delivered by a chiropractor involving 12 sessions and the MCI included a home stretching program. Primary outcome was self-reported pain severity on an 11-box numeric rating scale (NRS) immediately following a 6-week intervention period. Patients were followed for 1 year. RESULTS Primary analysis included 111 patients (94%). In the combined group (PE + MT), a clinically relevant reduction in pain severity compared to the MCI of 1.90 points (95% confidence interval (CI) 0.9-2.9) was achieved. Effect size (Cohen's d) for the PE + MT minus the MCI was 0.92 (95% CI 0.41-1.42). Number needed to treat for PE + MT was 3 (95% CI 2-7). No difference was found between the PE and MCI groups, with mean difference 0.0 (95% CI -1.0 to 1.0). At 12 months, not including patients receiving hip surgery the statistically significant difference favoring PE + MT was maintained. CONCLUSIONS For primary care patients with OA of the hip, a combined intervention of MT and PE was more effective than a MCI. PE alone was not superior to the MCI. TRIAL REGISTRATION clinicaltrials.govNCT01039337.
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Affiliation(s)
- E Poulsen
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark.
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Uhlig T. Tai Chi and yoga as complementary therapies in rheumatologic conditions. Best Pract Res Clin Rheumatol 2013; 26:387-98. [PMID: 22867933 DOI: 10.1016/j.berh.2012.05.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2012] [Accepted: 05/24/2012] [Indexed: 02/06/2023]
Abstract
Tai Chi and yoga are complementary therapies which have, during the last few decades, emerged as popular treatments for rheumatologic and musculoskeletal diseases. This review covers the evidence of Tai Chi and yoga in the management of rheumatologic diseases, especially osteoarthritis of the knee, hip and hand, and rheumatoid arthritis. There is evidence that Tai Chi and yoga are safe, and some evidence that they have benefit, leading to reduction of pain and improvement of physical function and quality of life in patients. Recommendations for Tai Chi in knee osteoarthritis have recently been issued by the American College of Rheumatology. To allow broader recommendations for the use of Tai Chi and yoga in rheumatic diseases, there is a need to collect more evidence researched with larger randomised controlled trials.
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Affiliation(s)
- Till Uhlig
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
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Graham AS, Hammond A, Williams AE. Foot health education for people with rheumatoid arthritis: the practitioner's perspective. J Foot Ankle Res 2012; 5:2. [PMID: 22233879 PMCID: PMC3275442 DOI: 10.1186/1757-1146-5-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Accepted: 01/10/2012] [Indexed: 12/02/2022] Open
Abstract
Background Patient education is considered to be a key role for podiatrists in the management of patients with rheumatoid arthritis (RA). Patient education has undoubtedly led to improved clinical outcomes, however no attempts have been made to optimise its content or delivery to maximise benefits within the context of the foot affected by rheumatoid arthritis. The aim of this study was to identify the nature and content of podiatrists' foot health education for people with RA. Any potential barriers to its provision were also explored. Methods A focus group was conducted. The audio dialogue was recorded digitally, transcribed verbatim and analysed using a structured, thematic approach. The full transcription was verified by the focus group as an accurate account of what was said. The thematic analysis framework was verified by members of the research team to ensure validity of the data. Results Twelve members (all female) of the north west Podiatry Clinical Effectiveness Group for Rheumatology participated. Six overarching themes emerged: (i) the essence of patient education; (ii) the content; (iii) patient-centred approach to content and timing; (iv) barriers to provision; (v) the therapeutic relationship; and (vi) tools of the trade. Conclusion The study identified aspects of patient education that this group of podiatrists consider most important in relation to its: content, timing, delivery and barriers to its provision. General disease and foot health information in relation to RA together with a potential prognosis for foot health, the role of the podiatrist in management of foot health, and appropriate self-management strategies were considered to be key aspects of content, delivered according to the needs of the individual. Barriers to foot health education provision, including financial constraints and difficulties in establishing effective therapeutic relationships, were viewed as factors that strongly influenced foot health education provision. These data will contribute to the development of a patient-centred, negotiated approach to the provision of foot health education for people with RA.
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Affiliation(s)
- Andrea S Graham
- Centre for Health, Sport and Rehabilitation Research, University of Salford, Frederick Road, Salford, UK.
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Graham A, Hammond A, Williams A. Therapeutic foot health education for patients with rheumatoid arthritis: a narrative review. Musculoskeletal Care 2011; 9:141-151. [PMID: 21634000 DOI: 10.1002/msc.205] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
PURPOSE Foot health interventions such as foot orthoses for people with rheumatoid arthritis (RA) reduce pain, improve function and improve overall quality of life. Additionally, patient education (PE) is considered essential in achieving good outcomes with interventions such as foot orthoses, footwear and self-care. The aim of this literature review was to identify evidence in relation to the content, use and delivery of PE in the management of RA foot problems. METHODS An electronic search of the following databases was performed: PubMed, CINAHL, AMED, Medline and the Cochrane Library, between March 2000 and March 2010. In order to be included, studies had to be published in English, involve adults (>18 years) with RA, and assist in answering the research question. No publications regarding PE for the management of foot health-related problems in RA were found. However, other key terms emerged that embraced PE for people with RA and informed a further search. Thirty-two papers met the inclusion criteria and were reviewed with regard to the subject area, content of the paper, methodological issues and their key findings. RESULTS The present review provides evidence for the effectiveness of PE for people with RA delivered via a staged approach, with the content and timing of education provision being driven by the needs of the patient. CONCLUSIONS The effect of PE delivered from a podiatric context needs to be explored, and the nature and requirements of PE for individuals with RA-related foot problems from a patient and practitioner perspective requires investigation. Alternative and innovative ways of providing PE and, potentially, self-management need to be investigated and defined.
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Affiliation(s)
- As Graham
- Directorate of Prosthetics, Orthotics and Podiatry, University of Salford, Salford, UK.
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Cross-cultural validation of the Educational Needs Assessment Tool in RA in 7 European countries. BMC Musculoskelet Disord 2011; 12:110. [PMID: 21609481 PMCID: PMC3126763 DOI: 10.1186/1471-2474-12-110] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2010] [Accepted: 05/24/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Educational Needs Assessment Tool (the ENAT) is a 39-item patient questionnaire originally developed in the UK to assess educational needs of patients with rheumatoid arthritis (RA). The objective of this study was to assess the cross-cultural validity of the ENAT in 7 European countries. METHODS The ENAT was translated into Dutch, Finnish, Norwegian, Portuguese, Spanish and Swedish versions by using Beaton's cross-cultural adaptation process, and was completed by a convenience sample of patients with RA in each country. The generated country-specific data were assessed for construct validity and were then pooled and assessed for cross-cultural invariance using Rasch analysis. RESULTS Individual country-specific analysis showed adequate fit to the Rasch model after adjustment for local dependency within domains. When data from the different countries were pooled, the 39 items deviated significantly from Rasch model's expectations (X(2)=977.055, DF=351, p=0.000, PSI=0.976). Again, most items within domains were found to be locally dependent, significantly affecting the fit. Consequently each domain was treated as a unit (i.e. testlet) and the ENAT was re-analysed as a seven-testlet scale resulting into a good fit to the Rasch model (X(2)=71.909; DF=63; p=0.207, PSI=0.951). A test of strict unidimensionality confirmed that all domains contributed to measuring a single construct. Cross-cultural non-invariance was discounted by splitting domains for DIF maintaining an excellent fit to the Rasch model. This allowed calibration of the ENAT into an interval scale. CONCLUSION The ENAT is a simple tool, which is a valid measure of educational needs of people with RA. Adjustment for cross-cultural non-invariance is available if data from the 7 European countries are to be pooled or compared.
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Gagliardi AR, Légaré F, Brouwers MC, Webster F, Wiljer D, Badley E, Straus S. Protocol: developing a conceptual framework of patient mediated knowledge translation, systematic review using a realist approach. Implement Sci 2011; 6:25. [PMID: 21426573 PMCID: PMC3076239 DOI: 10.1186/1748-5908-6-25] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2011] [Accepted: 03/22/2011] [Indexed: 11/10/2022] Open
Abstract
Background Patient involvement in healthcare represents the means by which to achieve a healthcare system that is responsive to patient needs and values. Characterization and evaluation of strategies for involving patients in their healthcare may benefit from a knowledge translation (KT) approach. The purpose of this knowledge synthesis is to develop a conceptual framework for patient-mediated KT interventions. Methods A preliminary conceptual framework for patient-mediated KT interventions was compiled to describe intended purpose, recipients, delivery context, intervention, and outcomes. A realist review will be conducted in consultation with stakeholders from the arthritis and cancer fields to explore how these interventions work, for whom, and in what contexts. To identify patient-mediated KT interventions in these fields, we will search MEDLINE, the Cochrane Library, and EMBASE from 1995 to 2010; scan references of all eligible studies; and examine five years of tables of contents for journals likely to publish quantitative or qualitative studies that focus on developing, implementing, or evaluating patient-mediated KT interventions. Screening and data collection will be performed independently by two individuals. Conclusions The conceptual framework of patient-mediated KT options and outcomes could be used by healthcare providers, managers, educationalists, patient advocates, and policy makers to guide program planning, service delivery, and quality improvement and by us and other researchers to evaluate existing interventions or develop new interventions. By raising awareness of options for involving patients in improving their own care, outcomes based on using a KT approach may lead to greater patient-centred care delivery and improved healthcare outcomes.
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Affiliation(s)
- Anna R Gagliardi
- Departments of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
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Ilioudi S, Lazakidou A, Tsironi M. Information and communication technologies for better patient self-management and self-efficacy. ACTA ACUST UNITED AC 2011; 5:327-39. [PMID: 21041173 DOI: 10.1504/ijeh.2010.036205] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Achieving benefits from the introduction of ICTs as part of processes aimed at building sustainable self-efficacy and self-management is very difficult, not least because of a desire to avoid simply replacing patient dependency on health professionals with dependency on technology. Chronic illnesses require ongoing attention that differs from traditional, encounter-based care for acute illnesses. Patients with chronic illnesses such as asthma, cardiovascular disease, depression, diabetes, heart failure and migraine headaches play a central role in managing the broad array of factors that contribute to their health. Individuals with diabetes, for example, provide close to 95% of their own care. Self-efficacy is enhanced when patients succeed in solving patient-identified problems. Patients with chronic conditions make day-to-day decisions about - self-manage - their illnesses. The paper highlights that in deploying ICTs, it is important to ensure that solutions implemented are based on a detailed understanding of users, their needs and complex interactions with health professionals, the health system and their wider environment.
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Affiliation(s)
- Stamatia Ilioudi
- Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Sparti General Hospital Building Complex, GR-23100, Sparti, Greece.
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Zangi HA, Garratt A, Hagen KB, Stanton AL, Mowinckel P, Finset A. Emotion regulation in patients with rheumatic diseases: validity and responsiveness of the Emotional Approach Coping Scale (EAC). BMC Musculoskelet Disord 2009; 10:107. [PMID: 19728869 PMCID: PMC2749806 DOI: 10.1186/1471-2474-10-107] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2009] [Accepted: 09/03/2009] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Chronic rheumatic diseases are painful conditions which are not entirely controllable and can place high emotional demands on individuals. Increasing evidence has shown that emotion regulation in terms of actively processing and expressing disease-related emotions are likely to promote positive adjustment in patients with chronic diseases. The Emotional Approach Coping Scale (EAC) measures active attempts to acknowledge, understand, and express emotions. Although tested in other clinical samples, the EAC has not been validated for patients with rheumatic diseases. This study evaluated the data quality, internal consistency reliability, validity and responsiveness of the Norwegian version of the EAC for this group of patients. METHODS 220 patients with different rheumatic diseases were included in a cross-sectional study in which data quality and internal consistency were assessed. Construct validity was assessed through comparisons with the Brief Approach/Avoidance Coping Questionnaire (BACQ) and the General Health Questionnaire (GHQ-20). Responsiveness was tested in a longitudinal pretest-posttest study of two different coping interventions, the Vitality Training Program (VTP) and a Self-Management Program (SMP). RESULTS The EAC had low levels of missing data. Results from principal component analysis supported two subscales, Emotional Expression and Emotional Processing, which had high Cronbach's alphas of 0.90 and 0.92, respectively. The EAC had correlations with approach-oriented items in the BACQ in the range 0.17-0.50. The EAC Expression scale had a significant negative correlation with the GHQ-20 of -0.13. As hypothesized, participation in the VTP significantly improved EAC scores, indicating responsiveness to change. CONCLUSION The EAC is an acceptable and valid instrument for measuring emotional processing and expression in patients with rheumatic diseases. The EAC scales were responsive to change in an intervention designed to promote emotion regulation. The instrument has not yet been tested for test-retest reliability, which is recommended in future studies.
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Affiliation(s)
- Heidi A Zangi
- National Resource Center for Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Pb, 23 Vinderen, Oslo, Norway.
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Zangi HA, Finset A, Steen E, Mowinkel P, Hagen KB. The effects of a vitality training programme on psychological distress in patients with inflammatory rheumatic diseases and fibromyalgia: a 1-year follow-up. Scand J Rheumatol 2009; 38:231-2. [PMID: 19165650 DOI: 10.1080/03009740802474680] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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