ADAPTATION OF THE EDUCATIONAL NEEDS ASSESSMENT TOOL FOR USE IN 4 EUROPEAN COUNTRIES

Background: The ENAT has been developed to quickly assess the educational and information needs of patients with RA. It comprises 7 domains; managing pain, movement, feelings, arthritis process, treatments, self help and support from others. It takes patients just a few minutes to complete. Scoring is by 1–5 Likert type scales ranging from `not at all important' to `extremely important'. The tool has been shown to be reliable (test/retest r=0.823: p<0.01) and Rasch analysis of the English version has demonstrated it is robust, unidimensional and free from Differential Item Functioning.Method: In this study the ENAT will be translated into Dutch, Finnish, Spanish and Swedish, and then further validation will be undertaken by subjecting the 4 adapted questionnaires to Rasch analysis. The method used to translate the ENAT is well established (Beaton et al 2000). It comprises five stages in each target language:I. Initial translation, Forward translation is undertaken by two independent bilingual translators whose mother tongue is the target language. Each produces a written report of their translation including comments to highlight challenging phrases or uncertainties along with the rationale for final choices.2. Synthesis of these translations. A third person serves as a mediator in discussions of translation differences, and produces written documentation of the process.3. Back-translation. An independent assessor translates the newly translated ENAT back into English. This is a process of validity checking that ensures that the translated version accurately reflects the item content of the original version.4. Expert Committee. The Expert Committee includes a methodologist, a health professional, all the translators and a translation recorder. Their role is to consolidate all the versions of the ENAT and agree the final version for field testing.5. Testing the adapted version. This comprises 30 RA patients completing the ENAT and being interviewed to assess their understanding of the questions.Rasch analysis. Once the translated version is completed, this adapted ENAT is sent by post to be completed by 125 RA patients. These questionnaires will be forwarded to Leeds, where Rasch analysis will be undertaken.Results: This 3 year EULAR funded study began in January 2005 and will complete in December 2007. The only problems encountered in translation to date has been confusion regarding the demographic page, which seeks to explore the patients educational level. This data is not part of the actual ENAT, but the data it provides is necessary for Rasch analysis. The Finnish ENAT has completed stages 1 to 5 and is in the process of Rasch analysis, and these results will be discussed. The Spanish and Swedish questionnaires are being collected for Rash analysis, and the Dutch ENAT is at stage 5. All questionnaires for Rasch analysis will be completed by the end of June 2007, as per protocol.Conclusions: No conclusions can be drawn at this stage of the study.References: Beaton DE, Bombardier C, Guillemin F, Ferraz MB (2000). Guidelines for the process of cross cultural adaptation of self-report measures. Spine,24:3186-3191.Citation: Ann Rheum Dis, volume 66, supplement II, year 2007, page 27Session: EULAR AHP Research Grants 2003–2006