Objectives To validate the educational needs assessment tool (The ENAT) as a generic tool with which to assess the educational needs of patients with rheumatic diseases in European Countries.
Methods The study followed a quantitative cross-sectional design. Participants comprised a convenience sample of patients from 7 European countries with each of the following diagnostic group: ankylosing spondylitis (AS), psoriatic arthritis (PsA), systemic sclerosis (SSc), systemic lupus erythematosus (SLE), osteoarthritis (OA) and fibromyalgia syndrome (FMS). Rasch analysis was used to assess the construct validity of the adapted ENATs and cross-cultural invariance.
Results The sample comprised 3015 patients with mean (SD) age 52.6 (13.1), disease duration 13.7 (10.7) years, 1996 (66.2%) of which were female. Patient characteristics (stratified by diagnostic group) were comparable across countries except the educational background, which was variable.
Initially, the data from each country and diagnostic group was fitted to the Rasch model separately, and then the pooled data from each diagnostic group. On each occasion the data were required to satisfy Rasch model expectations, after correction for local dependency by creating clusters of items known as teslets. The OA group was an exception as it only did so in country-specific datasets, not within the pooled data. There was no significant differential item functioning (DIF) by age, gender, disease duration or educational background, indicating that the ENAT works in the same way across different patient groups. Uniform cross-cultural DIF was present and this was accounted for by ‘splitting’ the testlets that were affected. Subsequently, DIF-adjusted conversion tables were calibrated, to enable parametric analyses fully adjusted for cross-cultural bias when comparison of multinational data is required.
Conclusions The ENAT is a cross-culturally valid and a reliable tool, providing accurate estimation of educational needs of people with rheumatic diseases. Further research is required for its cross-cultural use in OA.
Disclosure of Interest None Declared
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