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Nowell WB, Gavigan K, Garza K, O'Beirne R, Safford M, George M, Ogdie A, Walsh JA, Danila MI, Venkatachalam S, Stradford L, Rivera E, Curtis JR. Which Educational Topics and Smartphone App Functions Are Prioritized by US Patients With Rheumatic and Musculoskeletal Diseases? A Mixed-Methods Study. J Rheumatol 2024; 51:904-912. [PMID: 38749562 DOI: 10.3899/jrheum.2023-1021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2024] [Indexed: 06/17/2024]
Abstract
OBJECTIVE We sought to identify (1) what types of information US adults with rheumatic and musculoskeletal diseases (RMD) perceive as most important to know about their disease, and (2) what functions they would use in an RMD-specific smartphone app. METHODS Nominal groups with patients with RMD were conducted using online tools to generate a list of needed educational topics. Based on nominal group results, a survey with final educational items was administered online, along with questions about desired functions of a smartphone app for RMD and wearable use, to patients within a large community rheumatology practice-based research network and the PatientSpot registry. Chi-square tests and multivariate regression models were used to determine differences in priorities between groups of respondents with rheumatic inflammatory conditions (RICs) and osteoarthritis (OA), and possible associations. RESULTS At least 80% of respondents considered finding a rheumatologist, understanding tests and medications, and quickly recognizing and communicating symptoms to doctors as extremely important educational topics. The highest-ranked topic for both RIC and OA groups was "knowing when the medication is not working." The app functions that most respondents considered useful were viewing laboratory results, recording symptoms to share with their rheumatology provider, and recording symptoms (eg, pain, fatigue) or disease flares for health tracking over time. Approximately one-third of respondents owned and regularly used a wearable activity tracker. CONCLUSION People with RMD prioritized information about laboratory test results, medications, and disease and symptom monitoring, which can be used to create educational and digital tools that support patients during their disease journey.
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Affiliation(s)
- William B Nowell
- W.B. Nowell, MSW, PhD, K. Gavigan, MPH, S. Venkatachalam, MPH, PhD, L. Stradford, MPH, E. Rivera, MS, Global Healthy Living Foundation, Upper Nyack, New York
| | - Kelly Gavigan
- W.B. Nowell, MSW, PhD, K. Gavigan, MPH, S. Venkatachalam, MPH, PhD, L. Stradford, MPH, E. Rivera, MS, Global Healthy Living Foundation, Upper Nyack, New York;
| | - Kimberly Garza
- K. Garza, PharmD, MBA, PhD, Auburn University, Harrison College of Pharmacy, Auburn, Alabama
| | - Ronan O'Beirne
- R. O'Beirne, EdD, Division of Continuing Medical Education, University of Alabama at Birmingham, Birmingham, Alabama
| | - Monika Safford
- M. Safford, MD, Division of General Internal Medicine, Weill Cornell Medicine, New York, New York
| | - Michael George
- M. George, MD, MSCE, A. Ogdie, MD, MSCE, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Alexis Ogdie
- M. George, MD, MSCE, A. Ogdie, MD, MSCE, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jessica A Walsh
- J.A. Walsh, MD, University of Utah, and George E. Wahlen Veterans Affairs Medical Center, Rheumatology, Salt Lake City, Utah
| | - Maria I Danila
- M.I. Danila, MD, MSc, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, and Geriatric Research Education and Clinical Center, Birmingham VA Medical Center, Birmingham, Alabama
| | - Shilpa Venkatachalam
- W.B. Nowell, MSW, PhD, K. Gavigan, MPH, S. Venkatachalam, MPH, PhD, L. Stradford, MPH, E. Rivera, MS, Global Healthy Living Foundation, Upper Nyack, New York
| | - Laura Stradford
- W.B. Nowell, MSW, PhD, K. Gavigan, MPH, S. Venkatachalam, MPH, PhD, L. Stradford, MPH, E. Rivera, MS, Global Healthy Living Foundation, Upper Nyack, New York
| | - Esteban Rivera
- W.B. Nowell, MSW, PhD, K. Gavigan, MPH, S. Venkatachalam, MPH, PhD, L. Stradford, MPH, E. Rivera, MS, Global Healthy Living Foundation, Upper Nyack, New York
| | - Jeffrey R Curtis
- J.R. Curtis, MD, MS, MPH, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama, USA
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van der Kraan YM, Paap D, Lennips N, Veenstra ECA, Wink FR, Kieskamp SC, Spoorenberg A. Patients' Needs Concerning Patient Education in Axial Spondyloarthritis: A Qualitative Study. Rheumatol Ther 2023; 10:1349-1368. [PMID: 37523038 PMCID: PMC10469151 DOI: 10.1007/s40744-023-00585-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 07/12/2023] [Indexed: 08/01/2023] Open
Abstract
INTRODUCTION Within the EULAR recommendations, patient education (PE) is stated as the basis of the management of axial spondyloarthritis (axSpA). However, educational needs are scarcely qualitatively studied in axSpA. Therefore, we aimed to explore experiences and needs of PE in patients with axSpA. METHODS A phenomenological approach was used, with semi-structured in-depth interviews with patients with axSpA including broad variation in characteristics. Thematic analysis was applied. To enhance credibility, data saturation, research triangulation, peer debriefing, member checking, theoretical notes, and bracketing were performed. RESULTS Three interrelated themes regarding PE were identified from 20 interviews: illness perception, content, and 'availability'. Illness perception affects how patients experience and process PE, which consequently influences coping strategies. Prognosis, treatment, and coaching to self-management were identified as the most important content of PE. Regarding 'availability', face-to-face PE is preferred for exploring needs, supplemented by self-education, which can be freely applied. Additionally, sufficient time and a comprehensible amount of information were important and participants emphasized the need for axSpA-tailored information for relatives and friends. Participants reported a trusting patient-healthcare provider (HCP) relationship, and multidisciplinary and interdisciplinary attunement between HCPs as prerequisites for effective PE. CONCLUSIONS This first qualitative study exploring patients' experiences and needs of PE in axSpA revealed that prognosis, treatment, and coaching to self-management are important regarding content, and the combination of face-to-face contact and self-education the preferred modalities. It seems essential that patients' illness perceptions are taken into account for effective PE. These results add relevant insights for future PE guidelines in axSpA.
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Affiliation(s)
- Yvonne M van der Kraan
- Department of Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, PO Box 30 001, 9700 RB, Groningen, The Netherlands.
| | - Davy Paap
- Department of Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, PO Box 30 001, 9700 RB, Groningen, The Netherlands
- Department of Physiotherapy, School of Health, Saxion University of Applied Sciences, 7513 AB, Enschede, The Netherlands
| | - Niels Lennips
- Department of Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, PO Box 30 001, 9700 RB, Groningen, The Netherlands
| | - Else C A Veenstra
- Department of Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, PO Box 30 001, 9700 RB, Groningen, The Netherlands
| | - Freke R Wink
- Department of Rheumatology, Medical Center Leeuwarden, 8934 AD, Leeuwarden, The Netherlands
| | - Stan C Kieskamp
- Department of Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, PO Box 30 001, 9700 RB, Groningen, The Netherlands
| | - Anneke Spoorenberg
- Department of Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, PO Box 30 001, 9700 RB, Groningen, The Netherlands
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Damgaard AJ, Primdahl J, Esbensen BA, Latocha KM, Bremander A. Self-management support needs of patients with inflammatory arthritis and the content of self-management interventions: a scoping review. Semin Arthritis Rheum 2023; 60:152203. [PMID: 37068398 DOI: 10.1016/j.semarthrit.2023.152203] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/29/2023] [Accepted: 04/03/2023] [Indexed: 04/09/2023]
Abstract
BACKGROUND Self-management skills can empower a person to manage the physical, psychological, and social impact of a health condition. However, the components of self-management interventions differ widely between studies and interventions. By performing a scoping review, we aimed to describe patients' self-management needs and how health professionals (HPs) can provide effective self-management support to patients with inflammatory arthritis (IA). OBJECTIVES 1) to identify the evidence for self-management support needs of patients with IA, and 2) to identify the content (theory/theoretical approach, mode of delivery, duration and frequency) of self-management interventions that target patients with IA. METHODS In May 2021, we performed a systematic literature search (from 2000 onward) in five databases (CINAHL (Ebsco), Cochrane Library, Embase (Ovid), Medline (Ovid) and PsycINFO (Ovid)) regarding self-management in patients with IA. RESULTS Out of 11,748 records identified, we included 31 articles describing patients' support needs and 33 articles describing the content of self-management interventions. Patients' support needs were sorted into six topics: 1) disease impact and the pharmacological treatment, 2) care continuity and relations with HPs, 3) the importance of non-pharmacological treatment, 4) the need for support from family and friends, 5) support needs related to work issues, and 6) contextual preferences for self-management support. The theory/theoretical approach, mode of delivery, duration and frequency varied widely and were often unclearly or insufficiently described. In addition, the self-management concept was scarcely - or not - defined in the included articles. The identified topics for support needs were compared with the described content in the included articles. Only a few self-management interventions focused on patients' need for support in relation to work, and to family and friends. CONCLUSION HPs provided self-management support to patients with IA in various ways, but there were gaps between the patients' support needs and the identified interventions. In developing self-management interventions, the self-management concept needs to be defined and a clear theory is required to support the development of the intervention. Future studies should seek to investigate various modes of delivery, frequency and duration, to develop effective interventions that meet patients' support needs.
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Beauvais C, Pereira B, Pham T, Sordet C, Claudepierre P, Fayet F, Wendling D, Costantino F, Carton L, Grange L, Soubrier M, Legoupil N, Perdriger A, Tavares I, Dernis E, Gossec L, Rodère M. Development and Validation of a Self-Administered Questionnaire Measuring Essential Knowledge in Patients With Axial Spondyloarthritis. J Rheumatol Suppl 2023; 50:56-65. [PMID: 35840152 DOI: 10.3899/jrheum.211314] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2022] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To develop and validate a patient knowledge questionnaire regarding axial spondyloarthritis (axSpA). METHODS Knowledge considered essential for patients with axSpA was identified through Delphi rounds among rheumatologists, healthcare professionals (HCPs), and patients, then reformulated to develop the knowledge questionnaire. Cross-sectional validation was performed in 14 rheumatology departments to assess internal validity (Kuder-Richardson coefficient), external validity, acceptability, reproducibility (Lin concordance correlation coefficient), and sensitivity to change (knowledge score before vs after patient education sessions and effect size). RESULTS The Spondyloarthritis Knowledge Questionnaire (SPAKE) is a self-administered 42-item questionnaire with a 32-item short form, both scored 0 to 100, assessing knowledge of disease, comorbidities, pharmacological treatments, nonpharmacological treatments, self-care, and adaptive skills. In the validation study (130 patients; 67 [51.5%] male, mean age 43.5 [SD 12.9] yrs), the mean (SD) score of the long-form questionnaire was 71.6 (15.4), with higher scores (better knowledge) in nonpharmacological treatments and adaptive skills and lower scores in cardiovascular comorbidity and pharmacological treatments. Acceptability was good, with no missing data; the internal validity coefficient was 0.85. Reproducibility was good (0.81, 95% CI 0.72-0.89). SPAKE showed good sensitivity to change; scores were 69.2 (15.3) then 82.7 (14.0) after patient education sessions (Hedges effect size = 0.92, 95% CI 0.52-1.31). CONCLUSION SPAKE is a knowledge questionnaire for patients with axSpA, developed with the involvement of HCPs and patients and reflecting current recommendations for the management of axSpA. SPAKE will be useful in assessing knowledge acquisition and self-management strategies in routine care and research.
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Affiliation(s)
- Catherine Beauvais
- C. Beauvais, MD, Service de Rhumatologie Centre Hospitalier Universitaire Saint Antoine, Sorbonne Université, AP-HP, Paris;
| | - Bruno Pereira
- B. Pereira, PhD, Département de Biostatistique Centre Hospitalier Universitaire Gabriel-Montpied, Clermont-Ferrand
| | - Thao Pham
- T. Pham, MD, PhD, Service de Rhumatologie, Centre Hospitalier Universitaire Sainte Marguerite, Université Aix Marseille, Marseille
| | - Christelle Sordet
- C. Sordet, MD, PhD, Service de Rhumatologie, Hôpitaux Universitaires Strasbourg, Strasbourg
| | - Pascal Claudepierre
- P. Claudepierre, MD, PhD, Service de Rhumatologie, Centre Hospitalier Universitaire Henri Mondor, AP-HP, Université Créteil, Paris
| | - Françoise Fayet
- F. Fayet, BSc, M. Soubrier, MD, PhD, M. Rodère, BSc, Service de Rhumatologie, Centre Hospitalier Universitaire Gabriel-Montpied, Clermont-Ferrand
| | - Daniel Wendling
- D. Wendling, MD, PhD, Service de Rhumatologie, Centre Hospitalier Régional Universitaire de Besançon, and EA 4266 EPILAB, Université Bourgogne Franche-Comté, Besançon
| | - Félicie Costantino
- F. Costantino, MD, PhD, Service de Rhumatologie, Hôpital Universitaire Ambroise Paré, AP-HP, Université Paris Saclay, Boulogne-Billancourt
| | - Laurence Carton
- L. Carton, Association AFLAR (Association Française de Lutte Anti-Rhumatismale), Paris
| | - Laurent Grange
- L. Grange, MD, PhD, Service de Rhumatologie, Centre Hospitalier Universitaire Grenoble Alpes, Echirolles
| | - Martin Soubrier
- F. Fayet, BSc, M. Soubrier, MD, PhD, M. Rodère, BSc, Service de Rhumatologie, Centre Hospitalier Universitaire Gabriel-Montpied, Clermont-Ferrand
| | - Nathalie Legoupil
- N. Legoupil, MD, Service de Rhumatologie, Centre Hospitalier Universitaire Cochin, AP-HP, Paris
| | - Aleth Perdriger
- A. Perdriger, MD, PhD, Service de Rhumatologie, Centre Hospitalier Universitaire, Rennes
| | - Isabel Tavares
- I. Tavares, Service de Rééducation, Hôpital Universitaire Montpellier, Montpellier
| | - Emmanuelle Dernis
- E. Dernis, MD, MSc, Service de Rhumatologie, Hôpital Le Mans, Le Mans
| | - Laure Gossec
- L. Gossec, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, and Service de Rhumatologie, Centre Hospitalier Universitaire Pitié Salpétrière, Sorbonne Université AP-HP, Paris France
| | - Malory Rodère
- F. Fayet, BSc, M. Soubrier, MD, PhD, M. Rodère, BSc, Service de Rhumatologie, Centre Hospitalier Universitaire Gabriel-Montpied, Clermont-Ferrand
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Martínez-Gonzáles PL, Chico Capote A, Estévez Del Toro M, Hidalgo Costa T. Educational needs in patients with knee osteoarthritis using the SpENAT questionnaire. REUMATOLOGIA CLINICA 2022; 18:603-607. [PMID: 35484071 DOI: 10.1016/j.reumae.2021.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 09/02/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Knee osteoarthritis (KOA) is a major public health issue because it causes pain and functional limitation in patients. Engagement with self-management may, however, minimize the impact of KOA on the health of patients suffering this illness. To be fully engaged with self-management activities, knowledge about KOA is a prerequisite. There is data on people's understanding of KOA and their needs for information about KOA. The Educational Needs Assessment Tool-Spanish version (SpENAT) is a self-reported questionnaire that assesses educational needs (Ned) in order to provide information adapted and focused on patients with knee KOA. It comprises 39 questions grouped into seven domains: Pain, Movement, Feelings, Osteoarthritis, Medical treatment, Non-medical treatment, Help. OBJECTIVES To estimate the Ned in patients with knee KOA using the SpENAT. MATERIAL AND METHOD An observational, descriptive, and cross-sectional study was carried out in 215 patients with a diagnosis of knee KOA according to the criteria of the American College of Rheumatology who attended the service's protocolized consultation of knee conditions of rheumatology at the "Hermanos Ameijeiras" Surgical Clinical Hospital during the study period between January 2017 and August 2020. Demographic data, educational level and characteristics of the disease were recorded. All patients completed the SpENAT and were questioned about the sources they turn to obtain information on their disease. RESULTS Women over 50 years of age and overweight with a diagnosis of OA predominated. Major Ned were observed in the domains of movement, help, pain, feeling, KOA. Patients over 50 years of age, female, normal weight, and active workers showed greater interest in the movement domain. The most used source of information was the rheumatologist (91.60%). CONCLUSION The Ned in patients with knee KOA are high, and are higher in the domains of movement, pain, help and feeling. The rheumatologist is the main source of information for patients with KOA, it seems wise to design a targeted strategy to educate people about KOA to provide, support and prepare them for self-management.
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Affiliation(s)
| | - Araceli Chico Capote
- Servicio de Reumatología, Hospital Docente Clínico-Quirúrgico Hermanos Ameijeiras, La Habana, Cuba
| | - Miguel Estévez Del Toro
- Servicio de Reumatología, Hospital Docente Clínico-Quirúrgico Hermanos Ameijeiras, La Habana, Cuba
| | - Tania Hidalgo Costa
- Servicio de Bioestadística, Hospital Docente Clínico-Quirúrgico Hermanos Ameijeiras, La Habana, Cuba
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Song Y, Reifsnider E, Chen Y, Wang Y, Chen H. The Impact of a Theory-Based mHealth Intervention on Disease Knowledge, Self-efficacy, and Exercise Adherence Among Ankylosing Spondylitis Patients: Randomized Controlled Trial. J Med Internet Res 2022; 24:e38501. [PMID: 36264605 DOI: 10.2196/38501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/14/2022] [Accepted: 09/26/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patient education is recommended as an integral part of disease management in ankylosing spondylitis (AS), a chronic rheumatic disease that predominantly affects young males and requires long-term disease management. Convenient and cost-effective approaches to deliver patient education are required to these patients. OBJECTIVE This study aimed to examine the effects of a theory-based educational intervention delivered through a social networking app, WeChat, on disease knowledge, self-efficacy, exercise adherence, and health outcomes in Chinese AS patients. METHODS This study was a single-blind randomized controlled trial conducted in a tertiary hospital in Chengdu, China. Eligible participants were randomly allocated to the intervention or control group. Participants in the control group received standard care. The intervention group received the health belief model (HBM)-based educational intervention, consisting of 4 individual educational sessions and educational information sharing through WeChat, the predominant social networking app in China. The primary outcomes were disease knowledge, self-efficacy, and exercise adherence. The secondary outcomes were disease activity and physical function. Data were collected at baseline and at the end of the intervention (12th week). Chi-square test, t test, Mann-Whitney U tests were used to examine the effects of educational intervention. RESULTS This study included 118 patients with AS. The majority of participants were male (93/118, 78.8%). Around half of them were married (56/118, 47.5%), never smoked (70/118, 59.3%), and had college educational level or above (62/118, 52.5%). At posttest, participants in the intervention group had higher disease knowledge (all P<.001) and self-efficacy (P<.001), and a larger proportion of participants in the intervention group adhered to regular exercise routines than those in the control group (P=.003). The within-group analyses for the intervention group showed increases in all scores of disease knowledge (all P<.001) and self-efficacy score (P<.001), but only correct answer score (P=.04) and general knowledge score (P=.002) of disease knowledge in the control group improved. The within-group analysis for the control group found a decline of physical function (P=.002) but no significant change in disease activity (P>.05). The within-group analysis for the intervention group showed no significant change in disease activity or physical function (P>.05). At posttest, no statistically significant difference was found on disease activity or physical function between the intervention and control groups (P>.05). CONCLUSIONS The HBM-based educational intervention through WeChat can effectively improve patient disease knowledge, self-efficacy, and exercise adherence. WeChat is feasible and effective to deliver patient education for patients with chronic diseases such as AS. This mHealth intervention can be integrated into routine rheumatology care. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR-IPR-16009293; https://tinyurl.com/swxt8xk7.
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Affiliation(s)
- Yuqing Song
- West China School of Nursing, West China Hospital, Sichuan University, Chengdu, China
| | - Elizabeth Reifsnider
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States
| | - Yanling Chen
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Ying Wang
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Hong Chen
- West China School of Nursing, West China Hospital, Sichuan University, Chengdu, China
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Brolin S, Welin E, Lövström B, Bruchfeld A, Gunnarsson I, Pettersson S. Exploring the educational needs of patients with systemic vasculitis using the educational needs assessment tool. Rheumatol Adv Pract 2022; 6:rkac062. [PMID: 35993015 PMCID: PMC9382267 DOI: 10.1093/rap/rkac062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 07/15/2022] [Indexed: 11/14/2022] Open
Abstract
Abstract
Objectives
Knowledge 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).
Methods
This 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.
Results
One 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).
Conclusion
This 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.
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Affiliation(s)
- Sara Brolin
- Department of Rheumatology, Karolinska University Hospital
- Department of Medicine Solna, Karolinska Institutet, Stockholm
| | | | - Björn Lövström
- Department of Rheumatology, Karolinska University Hospital
- Department of Medicine Solna, Karolinska Institutet, Stockholm
| | - Annette Bruchfeld
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping
- Department of Renal Medicine, Karolinska University Hospital
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Iva Gunnarsson
- Department of Rheumatology, Karolinska University Hospital
- Department of Medicine Solna, Karolinska Institutet, Stockholm
| | - Susanne Pettersson
- Correspondence to: Susanne Pettersson, Department of Medicine, Solna, Rheumatology Unit, Karolinska Instiutet, 171 77 Stockholm, Sweden. E-mail:
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Song Y, Chen H. Evaluating Chinese Mobile Health Apps for Ankylosing Spondylitis Management: Systematic App Search. JMIR Mhealth Uhealth 2021; 9:e27234. [PMID: 34259644 PMCID: PMC8319772 DOI: 10.2196/27234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 04/01/2021] [Accepted: 05/27/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Patients with ankylosing spondylitis (AS), a chronic systematic inflammatory disease, require long-term treatment and management. Mobile health (mHealth) apps can deliver health services through mobile devices, facilitate long-term disease management, support patient-health care provider communication, and enable patients to engage in disease management. There are some apps targeted at patients with AS, but the feature and quality of these apps have not been systematically examined. OBJECTIVE The aim of this study was to identify existing, publicly available Chinese mHealth apps for AS management and to evaluate their features and quality. METHODS We systematically searched potential apps for AS management on the Apple and Huawei App Stores, using 4 search terms: ankylosing spondylitis, spondyloarthritis, rheumatic disease, and arthritis. Apps were included if they were in the Chinese language, targeted at patients with AS, could be downloaded and run on Android and/or iOS operating systems, and incorporated elements of disease management and/or patient education. We excluded apps that were not for patient use, not relevant to AS, or had not been updated since 2018. Apps that met the inclusion criteria were downloaded for final analysis. We formulated a list of app quality measures from and consistent with international guidelines for mHealth apps and AS management to evaluate the features and quality of the included app. The user version of the Mobile App Rating Scale (uMARS) was also used to rate the apps' quality. RESULTS Of the 354 apps screened, 5 met the inclusion criteria and were included in our analysis. All apps were free, and most apps (4/5, 80%) had a privacy policy. Of the 5 apps, 1 (20%) involved medical professionals in the development process, 2 (40%) were developed by companies, and 2 (40%) were developed by medical institutions. All apps provided educational information about AS. Around half of the apps had functions like a basic information record (ie, users can input gender, age, disease history, etc) (n=3, 60%), patient-health care provider (and patient-patient) communication (n=2, 40%), symptom tracking (n=2, 40%), and information sharing (n=3, 60%). Only 1 (20%) app provided comprehensive functions that adhered to international guidelines for AS management and mHealth apps. The overall uMARS scores ranged from 2.7 to 4.2; only 1 app, with an overall uMARS score of 4.2, was considered as a high-quality app. CONCLUSIONS Most apps lacked comprehensive functions for AS management. One high-quality app provided comprehensive functions to help patients manage their conditions. This study assessed and summarized the features and quality of the apps but did not evaluate their efficacy. Future studies should evaluate the feasibility and efficacy of these apps. International guidelines and regulations for the design, development, validation, and implementation of mHealth apps are needed in the future. Meanwhile, health care providers, patients with AS, and app developers should collaborate to develop high-quality, evidence-based apps that take into account patients' needs and health care professionals' perspectives.
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Affiliation(s)
- Yuqing Song
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu, China
| | - Hong Chen
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu, China
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Grønning K, Lim S, Bratås O. A longitudinal study of educational needs among patients with inflammatory arthritis. Musculoskeletal Care 2021; 20:151-157. [PMID: 34091994 DOI: 10.1002/msc.1575] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 05/25/2021] [Accepted: 05/27/2021] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Patient education is important in the follow-up and disease management for patients with chronic inflammatory arthritis. Patients' needs for education and information varies, and it is important that the education is tailored to the individual patient. Hence, the aim of this study is to investigate whether patients' educational needs change over time, and which demographic, disease-related or self-management characteristics that are associated with patients' educational needs. METHODS The Mann-Whitney U-test was used to study patients' longitudinal educational needs and whether their needs change over time, while multivariable linear regression analyses were used to investigate associations between patients' educational needs and demographic variables, disease-related and self-management characteristics. RESULTS There were no changes in patients' educational needs in the domains of managing pain, movement, feelings, arthritis process and treatment from health professionals during the study period of seven years. A small decrease in educational needs in the domains self-help measures (p-value 0.047) and support from others (p-value 0.010) was detected. The regression analyses showed that higher educational needs were associated with being female, lower educational level, shorter disease duration, and a lower level of patient activation. CONCLUSIONS Patients with chronic inflammatory arthritis have continual needs for patient education throughout their disease trajectory. Nurses and health care professionals must therefore ask their patients what kind of education they need at every follow-up throughout the disease course.
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Affiliation(s)
- Kjersti Grønning
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Rheumatology, The University Hospital, St.Olavs Hospital, Trondheim, Norway
| | - Siriwan Lim
- Yong Loo Lin School of Medicine, Clinical Research Centre, Alice Lee Centre for Nursing Studies, Singapore
| | - Ola Bratås
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Martin A, Chopra R, Nicassio PM. Nonpharmacologic Pain Management in Inflammatory Arthritis. Rheum Dis Clin North Am 2021; 47:277-295. [PMID: 33781495 DOI: 10.1016/j.rdc.2020.12.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
This article provides an overview of nonpharmacologic options for the treatment of pain in patients with inflammatory arthritis, such as peripheral spondyloarthritis, psoriatic arthritis, ankylosing spondylitis, and rheumatoid arthritis. The experience of pain in chronic disease is a complex process influenced by multiple domains of health. The discussion focuses on the establishment of a framework for pain control that engages with factors that influence the experience of pain and explores the evidence base that supports specific modalities of nonpharmacologic pain control, such as mindfulness, cognitive behavioral therapy, exercise, massage, splinting, and heat therapy. Rheumatoid and spondyloarthritides are considered separately.
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Affiliation(s)
- Alexander Martin
- Division of Rheumatology, UMass Medical School, 119 Belmont Street, Worcester, MA 01605, USA
| | - Ratnesh Chopra
- Division of Rheumatology, UMass Medical School, 119 Belmont Street, Worcester, MA 01605, USA.
| | - Perry M Nicassio
- Department of Psychiatry, UCLA, 760 Westwood Plaza, C9-402, Los Angeles, CA 90095, USA
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11
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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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Hirsch JK, Toussaint L, Offenbächer M, Kohls N, Hanshans C, Vallejo M, Rivera J, Sirois F, Untner J, Hölzl B, Gaisberger M, Ndosi M. Educational needs of patients with rheumatic and musculoskeletal diseases attending a large health facility in Austria. Musculoskeletal Care 2020; 18:391-396. [PMID: 32314524 DOI: 10.1002/msc.1474] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 04/04/2020] [Accepted: 04/05/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Patient education is an important part of the management of rheumatic and musculoskeletal diseases. Given that patients with diverse diseases do not have the same needs, it is crucial to assess the educational requirements of targeted groups to provide tailored educational interventions. The aim of our study was to assess educational needs of a large cohort of patients with different rheumatic and musculoskeletal diseases attending a health facility in Austria. METHODS We assessed educational needs, via an online survey of patients with fibromyalgia (FMS), rheumatoid arthritis (RA), and ankylosing spondylitis (AS) recruited from an Austrian health-care facility, using the Austrian version of the Educational Needs Assessment Tool (OENAT). RESULTS For our sample of 603 patients, AS (62%), RA (15%), and FMS (24%), there were no educational need differences for the domains of movements, disease process, and self-help measures. Patients with FMS had less need for pain management education and greater need for education about feelings, than other disease groups. Patients with RA had a greater need for education related to treatments than other groups, and patients with AS had a greater need for treatment education than patients with FMS. Patients with AS reported greater need for support system education than other patient groups. CONCLUSION Educational needs vary by disease groups, suggesting that health-care professionals should assess disease-specific needs for education to provide optimal assistance in disease management for patients.
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Affiliation(s)
- Jameson K Hirsch
- Department of Psychology, East Tennessee State University, Johnson City, Tennessee, USA
| | - Loren Toussaint
- Department of Psychology, Luther College, Decorah, Iowa, USA
| | | | - Niko Kohls
- Department of Integrative Health Promotion, University of Applied Science, Coburg, Germany
| | - Christian Hanshans
- Department of Applied Sciences and Mechatronics, University of Applied Science, Munich, Germany
| | - Miguel Vallejo
- Department of Psychology, National Distance Education University, Madrid, Spain
| | - Javier Rivera
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Fuschia Sirois
- Department of Psychology, University of Sheffield, Sheffield, UK
| | | | | | - Martin Gaisberger
- Institute of Physiology and Pathophysiology, Paracelsus Medical University, Salzburg, Austria
| | - Mwidimi Ndosi
- Department of Nursing and Midwifery, University of the West of England, Bristol, UK
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de Thurah A, Bremander A, Primdahl J. High-quality RMD rehabilitation and telehealth: Evidence and clinical practice. Best Pract Res Clin Rheumatol 2020; 34:101513. [PMID: 32307230 DOI: 10.1016/j.berh.2020.101513] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Within rheumatology, telehealth is essential to modern rehabilitation due to the demographic development with more and more elderly people. At present, telehealth solutions are used as part of the rehabilitation process in assessment, interventions and evaluation. Telehealth interventions are as effective as conventional follow-ups or self-management assessments, but the evidence on the effect is still sparse. Telehealth interventions seem to support a physically active lifestyle in the short term. In general, telehealth solutions are well received by patients, but the development must be based on user involvement, behaviour theory and the World Health Organisation principles of creating health literate organisations in order to ensure usability, effectiveness and further implementation.
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Affiliation(s)
- Annette de Thurah
- Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
| | - Ann Bremander
- Danish Hospital for Rheumatic Diseases, University Hospital of Southern Jutland, Sønderborg, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark; Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Rheumatology, Lund, Sweden.
| | - Jette Primdahl
- Danish Hospital for Rheumatic Diseases, University Hospital of Southern Jutland, Sønderborg, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark; Hospital of Southern Jutland, University Hospital of Southern Denmark, Aabenraa, Denmark.
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Bremander A, Haglund E, Bergman S, Ndosi M. The educational needs of patients with undifferentiated spondyloarthritis: Validation of the ENAT questionnaire and needs assessment. Musculoskeletal Care 2018; 16:313-317. [PMID: 29417718 DOI: 10.1002/msc.1231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 12/10/2017] [Accepted: 12/11/2017] [Indexed: 12/20/2022]
Abstract
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 (χ2 = 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.
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Affiliation(s)
- A Bremander
- Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden.,School of Business, Engineering and Science, Rydberg Laboratory of Applied Science, Halmstad University, Halmstad, Sweden.,Spenshult Research and Development Center, Halmstad, Sweden
| | - E Haglund
- School of Business, Engineering and Science, Rydberg Laboratory of Applied Science, Halmstad University, Halmstad, Sweden.,Spenshult Research and Development Center, Halmstad, Sweden
| | - S Bergman
- Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden.,Spenshult Research and Development Center, Halmstad, Sweden.,Primary Health Care Unit, Department of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - M Ndosi
- Department of Nursing and Midwifery, University of the West of England, Bristol, UK
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