title: Patient education in rheumatoid arthritis: the effectiveness of the ARC booklet and the mind map.
abstract: OBJECTIVE
  To determine the effectiveness of a pictorial 'mind map' together with the Arthritis Research Campaign (ARC) booklet for imparting knowledge to participants with rheumatoid arthritis (RA). Also, we wished to relate this to their reading ability.
  
  
  METHODS
  We studied 363 participants with RA. Reading ability was assessed using the REALM, and knowledge was assessed using the Knowledge Scale Questionnaire (KSQ). Information on educational attainment, disease state and levels of anxiety and depression was also collected. Participants were randomly assigned to receive either the ARC booklet alone or the booklet and the mind map together.
  
  
  RESULTS
  A significant minority (15%) of participants were functionally illiterate. There was a statistically significant increase in knowledge across both groups from baseline to reassessment after they were given the literature, but there was no difference in attainment between the groups. The more literate participants gained more knowledge regardless of the information they were given. They were also significantly less anxious and less depressed.
  
  
  CONCLUSIONS
  The ARC booklet with or without the mind map was associated with a significant increase in knowledge. Poor readers had poor educational attainment and poor knowledge acquisition. The information on the mind map was not more accessible to them. Different educational strategies will be necessary to educate these patients.
authors.affiliation: Freeman Hospital, Newcastle Upon Tyne, University of Leeds, UK. David.walker@nuth.nhs.uk
authors.forename: D
authors.initials: D
authors.lastname: Walker
authors.forename: A
authors.initials: A
authors.lastname: Adebajo
authors.forename: P
authors.initials: P
authors.lastname: Heslop
authors.forename: J
authors.initials: J
authors.lastname: Hill
authors.forename: J
authors.initials: J
authors.lastname: Firth
authors.forename: P
authors.initials: P
authors.lastname: Bishop
authors.forename: P S
authors.initials: PS
authors.lastname: Helliwell
mesh_terms: D000328:Adult; D001007:Anxiety / Q000517:prevention & control; D001172:Arthritis, Rheumatoid / Q000523:psychology / Q000628:therapy*; D003863:Depression / Q000517:prevention & control; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D016743:Mental Competency; D008875:Middle Aged; D010174:Pamphlets; D010353:Patient Education as Topic / Q000379:methods*; D011932:Reading; D012648:Self Care; D013664:Teaching Materials