The needs of patients with arthritis: the patient's perspective.
OBJECTIVE
To identify concerns and learning interests of patients with arthritis.


METHODS
A questionnaire was developed, pilot tested, and then used to evaluate 197 patients with arthritis, including osteoarthritis (OA) (n = 41), rheumatoid arthritis (RA) (n = 57), back disease (n = 55), systemic lupus erythematosus (n = 27), and systemic sclerosis (SSc) (n = 17). Twenty concerns and 12 learning interests were rated. Questionnaires were also administered to assess physical disability (Health Assessment Questionnaire), psychological disability (Arthritis Impact Measurement Scales 2), and pain (visual analog scale). Participants addressed accessibility of health services, satisfaction with their physician, psychosocial needs, use of self-help groups, and behavioral strategies used to assist coping. Patients with RA, OA, and back disease, at both a community and a hospital center, were tested to assess whether concerns and learning interests differed based on site of treatment. Analytic methods included analysis of variance, factor analysis, and multiple linear regression.


RESULTS
There were no differences in concerns or learning interests based on treatment site. Between diagnostic groups, patients with SSc were more interested in learning about self-help groups. The most frequently reported concern was worsening of the illness. The majority of respondents were interested in learning more about topics that were illness specific. The physician was chosen as the preferred source of information, and the preferred format was in writing. On factor analysis, the 20 concerns were reduced to 5 factors: psychological, coping, medication, social, and financial. Three factors were identified for learning interests: the illness, traditional health management topics, and nontraditional health management topics. Stepwise multiple linear regression revealed predictors for the 5 concern and 3 learning interest factors. The concerns were best predicted by self-reported disease severity, physical disability, and psychological distress, while learning interests were best predicted by self-reported disease severity, pain, and self-help group membership.


CONCLUSIONS
Concerns and learning interests of persons with arthritis did not differ based on the center of treatment or the diagnosis, but can be predicted by the level of pain and simple measures of disability. Better understanding of the relationship between health status and patient-perceived needs will result in improved patient-centered care.
Neville
C
C
Clinical Epidemiology Unit, Arthritis Society of Canada Research Scholar, Quebec.
Fortin
P R
PR
Fitzcharles
M A
MA
Baron
M
M
Abrahamowitz
M
M
Du Berger
R
R
Esdaile
J M
JM
D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000368:Aged; D000704:Analysis of Variance; D001168:Arthritis / Q000503:physiopathology / Q000523:psychology* / Q000534:rehabilitation*; D001294:Attitude to Health; D005163:Factor Analysis, Statistical; D005260:Female; D006297:Health Services Accessibility / Q000592:standards; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment / Q000458:organization & administration*; D010353:Patient Education as Topic; D012657:Self-Help Groups; D011795:Surveys and Questionnaires