Measuring educational needs among patients with rheumatoid arthritis using the Dutch version of the Educational Needs Assessment Tool (DENAT)

Clin Rheumatol. 2009 Sep;28(9):1073-7. doi: 10.1007/s10067-009-1190-3. Epub 2009 May 16.


The Educational Needs Assessment Tool (ENAT) was developed in the United Kingdom (UK) to systematically assess the educational needs of patients with arthritis. The aim of the present study was to describe the educational needs of Dutch patients with rheumatoid arthritis (RA) by using the Dutch version of the ENAT (DENAT). The original UK version of the ENAT, comprising 39 items grouped into seven domains, was translated into Dutch according to international guidelines for cross-cultural translation and adaptation. The DENAT was then sent to a random sample of 319 RA patients registered at the outpatient clinic of a university hospital. For each domain (score range 1-5, equalling low-high educational needs), a median score with the inter-quartile range was computed. The Kruskal-Wallis test was used to determine possible associations between educational needs and age, disease duration, gender and educational background. The response rate was 165 out of 319 (52%). The median educational needs scores were 2.5 for "managing pain", 3.0 for "movement", 2.0 for "feelings", 4.0 for "arthritis process", 4.0 for "treatments from health professionals", 3.5 for "self-help measures" and 2.5 for "support systems". Lower age and longer [corrected] disease duration were associated with more educational needs in the domain "support systems". In addition, younger patients had more educational needs regarding managing pain and feelings than older patients. There were no associations between gender or educational background and educational needs. The DENAT has demonstrated its ability to identify individual educational needs of Dutch patients with RA. The lower age and shorter disease duration were associated with more educational needs. The practical applicability of the DENAT needs further research.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological
  • Aged
  • Arthritis, Rheumatoid / psychology*
  • Arthritis, Rheumatoid / therapy*
  • Cross-Sectional Studies
  • Female
  • Health Education
  • Humans
  • Male
  • Middle Aged
  • Needs Assessment / statistics & numerical data*
  • Netherlands
  • Pain / psychology
  • Pain Management
  • Patient Education as Topic / statistics & numerical data*
  • Self Care*
  • Social Support
  • Surveys and Questionnaires