159. Clinical Use of the Educational Needs Assessment Tool: A Qualitative Study Among Patients with Rheumatoid Arthritis and Clinical Nurse Specialists

Abstract

Background: The Educational Needs Assessment Tool (ENAT) was developed to determine the education needs of patients with RAand to address a gap in patient education provision. This self-completed questionnaire allows RA patients to identify and prioritize their educational needs so that the health professional is able to provide education based on the patient's immediate priorities. The ENAT has been validated and translated into 9 European languages, however its usability in clinical practice had not been studied. The aims of this study were (i) to evaluate the usability of the ENAT in clinical practice, from both a practitioner and patient perspective, and (ii) to establish whether patients perceive that they are getting an equally good or equally inadequate educational service for their needs. Methods: This was a qualitative study conducted alongside a multicentre RCT where patients were randomized into either ENATfocused education (EG) or usual care (CG). Both groups were seen by a Clinical Nurse Specialist (CNS) and followed up for 6 months. Patients were recruited into the qualitative study from both EG and CG using a sampling frame based on RA disease state and gender. Data were collected by interviews with patients and CNS. Analysis followed the Framework approach. Results: The sample comprised 16 patients (8 of which had moderatehigh disease state and 8 were female) and 4 CNSs withmean experience (range) of 13.25 (4-25) years. Patients found the ENAT to be a straightforward, comprehensive and easy to use tool. For the majority of the respondents completing the ENAT, the process helped them to focus on what they needed to know from the CNS and for some of the respondents it made them think of additional questions to ask and topics to think about. Both the respondents and the CNSs thought that the ENAT would be useful as a template for newly diagnosed patients and particularly for new nurses. Both the EG and CG perceived that they were getting a good and adequate education provision from their CNS. All respondents felt supported and reassured by their CNS and the importance of continuity of care was expressed by the majority of the respondents, having built good relationships with their respective CNS. Many felt that this relationship was paramount in helping them to understand and process the education and information received, enabling them to manage their RA at home more effectively. Conclusion: This study provides useful insights into the ability of the ENAT tool to assess the educational needs of patients with RA in routine clinical practice. The ENAT would be a useful tool as a structured guide for nurses to use when assessing individual patient education needs.