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AB1193 Developing the korean educational needs assessment tool (KOREAN-ENAT) in rheumatoid arthritis: a cross-cultural validation using rasch analysis
  1. Y-K Sung1,
  2. D Kim1,
  3. SJ Cha1,
  4. D Yoo1,
  5. S-H Kim2,
  6. M Ndosi3,
  7. S-K Cho1
  1. 1Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul
  2. 2Department of Measurement and Evaluation of Physical Education, Chungbuk National University, Cheongju, Korea, Republic Of
  3. 3Centre for Health and Clinical Research, University of the West of England, Bristol, United Kingdom


Background The Educational Needs Assessment Tool (ENAT) is a 39-item patient-completed questionnaire designed to help patients identify and prioritize their educational needs. It was originally developed in the UK and validated in 7 rheumatic diseases including rheumatoid arthritis (RA).1

Objectives This study aimed to undertake cross-cultural adaptation and validation of the ENAT in RA for use in Korea.

Methods The study involved two main phases: (1) Cross-cultural adaptation of the ENAT from English into Korean and (2) validation of the Korean-ENAT. The first phase followed an established process of cross-cultural adaptation of self-report measures.2 For the second phase, patients with RA completed the Korean-ENAT at the outpatient clinic of a university hospital and Rasch measurement computer program, WINSTEPS, was used to analyze the data. Fit to the model was determined by the observed data Infit and Outfit statistics (≥0.50 and ≤1.50); where a value of 1.00 suggests a perfect fit to the model expectations. The unidimensionality of the scale was determined by item (and person) separation index ≥2.00 and reliability ≥0.80.

Results An adequate conceptual equivalence was achieved following the adaptation process. A total of 123 patients completed the Korean-ENAT. Their mean ± SD age was 46.7±12.3, disease duration 53.7±71.2 months and the majority (81.3%) were female. Thirty-five of the 39 items displayed good fit to the model. The 4 items deviating from the model had Infit and Outfit >1.50. The item separation index (5.26) and item reliability index (0.97) provided evidence for good reliability of items. All the 7 domains of the Korean-ENAT were found to fit the Rasch model. The internal consistency of the Korean-ENAT was high and unidimensionality was confirmed (Person separation index =3.41 reliability index =0.92; item separation index =16.82 and reliability index =1.00).

Table 1.

Fit statistics for the Korean ENAT subscales

Conclusions Using a standard process in cross-cultural adaptation, the ENAT was adapted into Korean and Rasch analysis confirmed that the construct validity, reliability, and unidimensionality of the Korean-ENAT. The Korean-ENAT provides valid and reliable estimates of educational needs of people with RA in Korea.


  1. Ndosi M, et al. Validation of the educational needs assessment tool as a generic instrument for rheumatic diseases in seven European countries. Ann Rheum Dis 2014; 73: 2122–9.

  2. Beaton DE, et al. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine 2000; 25: 3186–91.


Disclosure of Interest None declared

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