| Objective1.To test the reliability and validity of the Chinese version of Arthritis Eduational Needs Assessment Tool after being translated,back-translated and cultual adapted in patients with rheumatoid arthritis.2.To describe the educational needs of patients with rheumatoid arthritis in China and explore the related influencing factors.Methods1.English version of Arthritis Educational Needs Assessment Tool were chinesized according to Beaton’s Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures strictly.230 patients with rheumatoid arthritis from the department of rheumatology clinic in General Hospital Affiliated to Tianjin Medical University from April 2016 to October 2016 were selected as the research object by using convenience sampling method.The reliability and validity of Chinese version of Arthritis Educational Needs Assessment Tool was tested by the following methods: Items analysis was used to assess the degree of discrimination;Content validity indexes were used to evaluate the content validity of each item and the whole scale;exploratory factor analysis was used to analyze the construct validity;Cronbach’s alpha was calculated to evaluate the internal consistency reliability;the correlation coefficient was calculated to evaluate the test-retest reliability.2.By using convenience sampling method,220 patients with rheumatoid arthritis from the department of rheumatology clinic in General Hospital Affiliated to Tianjin Medical University from July 2016 to October 2016 were selected as the research object.Patients were surveyed by the general information questionnaire,Chinese version of Arthritis Educational Needs Assessment Tool(C-AENAT),the Visual Analogue Scale(VAS),Arthritis Self-efficacy Scale-8 item version(ASES-8),Perceived Social Support Scale(PSSS)and Medical Coping Model Questionnaire(MCMQ).The single factor analysis was conducted by independent sample t test,ANOVA,Mann-Whitney U test and Spearman/Pearson correlation analysis.The multiple linear stepwise regression was used to explore the influencing factors of patients’ educational needs.Results1.The Chinese version of Arthritis Educational Needs Assessment Tool consists39 items.In the test of validity and reliability of the scale,225 of 230 patients returned effective questionaires,then the effective recovery rate was 97.8%.Items analysis showed that each item can identify the high group and low group.The item content validity index ranged 0.8~1.0,Universal agreement of scale-level content validity index was 0.949,and the average scale-level content validity index was0.979,then each item was preserved.Exploratory factor analysis showed that KMO value was 0.845 and Bartlett test value was 6900.566(P < 0.001)indicating the data were suitable for factor analysis.By using principal component analysis and maximum variance orthogonal rotation method,a total of 8 common factors were extracted according to the standard of the gravel map and the characteristic value of more than 1.The cumulative variance contribution rate was 70.54%.8 common factors were positively correlated with the total score of the scale(r = 0.302~0.784,P < 0.001).The factor load of each item ranged from 0.440 to 0.922.The reliability test showed that the Cronbach’s alpha coefficient of the scale was 0.918 and the Cronbach’s alpha coefficient of each dimension was 0.631~0.944.30 patients were retested after two weeks.The test-retest reliability of the scale was 0.974 and the test-retest reliability of each dimension ranged 0.902~0.971.2.In the survey of the influencing factor of educational needs in patients with rheumatoid arthritis,a total of 220 questionnaires were released and 212 valid questionnaires were recycled.The effective recovery rate was 96.4%.Patients had a medium level of educational needs and the average score of Chinese version of Arthritis Educational Needs Assessment Tool was(78.46±18.52).Each dimension sorted from high to low according to the standardized scores were: Self-help measures(66.67%),Disease treatment(58.33%),Support system(50%),Movement(43.75%),Disease process(42.86%),Feelings(37.50%),Managing pain(35%)and Adjuvant therapy(25%).Univariate analysis showed that the influencing factors of educational needs in patients with rheumatoid arthritis were as follows: source of patients(department or clinic,t=3.249,P=0.001),per capita income(F=3.898,P=0.010),whether smoking or not(t=3.106,P=0.002),disease duration(less than 4years or above 4 years,t=3.849,P<0.001),whether taking NSAIDs(t=2.827,P=0.005),TJC(r=0.249,P<0.001),STC(r=0.174,P=0.013),CRP(r=0.245,P=0.049),DAS28(r=0.298,P=0.017),ASES-8(r=0.390,P<0.001)and the medical copingmodel of confronce(r=0.162,P=0.018).The multivariate analysis showed that the per capita monthly income,ASES-8,DAS28 and the medical coping model of confronce entered the regression equation and the standard partial regression coefficient were-0.500,0.451,0.373 and 0.343 respectively,all P value < 0.05.These five virables explained 52.6% of the total variance of patients’ educational needs.ConclusionThe Chinese version of Arthritis Educational Needs Assessment Tool consists 8dimensions and 39 items.It has good validity and reliability and can be used for the evaluation of the educational needs of patients with rheumatoid arthritis.The level of educational needs in Chinese patients with rheumatoid arthritis is at medium and needs to be improved.Patients’ educational needs are mainly affected by the per capita monthly income,self-efficacy,the disease activity and positive attitude to face disease.In clinical nursing work,we should pay great attention to patients with lower per capita income,higher self-efficacy,higher disease activity and those who actively facing the disease.To assess their educational needs accurately and then take corresponding health intervention measures to meet their needs and so as to improve patient’s ability of disease recognition and self-management. |
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