title: Promotion of health-enhancing physical activity in rheumatoid arthritis: a comparative study on healthcare providers in Italy, The Netherlands and Sweden.
abstract: The objectives of this study were to compare attitudes, practice of advice, perceived competencies and educational needs related to health-enhancing physical activity (HEPA) in rheumatoid arthritis (RA) among Dutch, Italian and Swedish healthcare providers (HCP) and to explore associations between these factors and age, gender and HEPA levels of HCP. Questionnaires were sent to 2939 HCP, members of their national rheumatology organizations. HEPA was assessed with the Short Questionnaire to Assess Health-Enhancing Physical Activity or the International Physical Activity Questionnaire; attitudes, practice of advice, perceived competencies and educational needs with a 23-item questionnaire. Overall response rate was 33 %. Ninety-five percent of HCP agreed that HEPA is an important health goal in RA. More Swedish HCP had positive attitudes to the attainability and safety of HEPA in RA. There were no differences between countries in practice of advice on HEPA to patients with RA in general or to those with recent onset disease, but more Italian HCP were reluctant to advise HEPA to patients with established disease. Of the total HCP, 36 to 60 % used public health guidelines to advise on HEPA, with Dutch HCP taking less advantage. Still they estimated a higher proportion of patients with RA to follow such advice. Italian HCP perceived their competencies the highest, but were also more interested in education to promote HEPA. Gender, age and HEPA performance had no association with attitudes toward HEPA, while a number of associations were found between these factors and practice of advice and perceived competencies. The differences found between HCP in the three countries might indicate the need for educational initiatives to improve HEPA promotion.
authors: Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 23100, 14183, Huddinge, Sweden. nina.brodin@ki.se.|Division of Physiotherapy, Department of Orthopaedics, Danderyd Hospital, Stockholm, Sweden. nina.brodin@ki.se.
authors: Nina
authors: http://orcid.org/0000-0002-3589-664X
authors: N
authors: Brodin
authors: Section Physiotherapy, Department of Health, University of Applied Sciences, FH Campus Wien, Vienna, Austria.
authors: Emalie
authors: E
authors: Hurkmans
authors: Department of Rheumatology, Local Healthcare, Pescara, Italy.
authors: Luigi
authors: L
authors: DiMatteo
authors: Department of Orthopaedics and Rheumatology, University of Milan, Milan, Italy.
authors: Tiziana
authors: T
authors: Nava
authors: Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands.
authors: Thea
authors: T
authors: Vliet Vlieland
authors: Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 23100, 14183, Huddinge, Sweden.|Department of Rheumatology, Karolinska University Hospital, Stockholm, Sweden.
authors: Christina H
authors: CH
authors: Opava
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000534:rehabilitation*; D001291:Attitude of Health Personnel; D015444:Exercise / Q000502:physiology*; D005260:Female; D015438:Health Behavior; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006293:Health Promotion; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D012219:Rheumatology; D012737:Sex Factors; D013548:Sweden
keywords: Attitude; Educational need; Health professional; Physical activity guideline; Practice of advice