Inventi Impact: Neonatal & Pediatric Nursing

Inventi:hnp/17336/15

Design and Acceptance of Rheumates@Work, A Combined Internet-based and in Person Instruction\nModel, an Interactive, Educational, and Cognitive Behavioral Program for Children with Juvenile\nIdiopathic Arthritis

Background: Juvenile idiopathic arthritis (JIA) is a chronic rheumatic disease. Patients suffer daily discomforts such\nas pain, fatigue, stiffness, and mood disturbances. Their exercise capacity is decreased to a variable degree and\nphysical activity levels may be impaired. To prevent long-term cardiovascular risks associated with JIA and\nmedication, it is important to encourage physical activity. To achieve this we developed Rheumates@Work (R@W),\na combined internet-based and in person instruction model, an interactive, educational, and cognitive behavioral\nprogram. The aim of this study is twofold: to describe the theoretical background and design of R@W based on\nPender�s Health Promotion Model, and to assess its acceptance.\nMethods: We enrolled 8 to 13-year-old JIA patients, from 3 outpatients clinics in The Netherlands, in R@W.\nInclusion criteria were a low disease activity (VAS physician <20 mm), comprehension of the Dutch language and\nabsence of relevant co-morbidity. We assessed acceptance by measuring the participants� commitment to the\nprogram, the level of interaction on patient�s initiative (f.e. mails send by the patient), technical aspects and\nsatisfaction. Commitment was defined as the percentage of participants that completed the assignments and how\nmuch encouragement the participants needed for this. Satisfaction was measured with an anonymous\nquestionnaire concerning f.e. time investment and perceived benefits. Costs were monitored.\nResults: Of the 64 patients we enrolled, 23 boys and 41 girls, 93.8 % completed the program. Participant-initiated\ninteraction was seen in 10.7 %, 24.7 % send a mail because of technical problems. Eighty-two percent of the\nparticipants and 99 % of the parents liked the program, and 85 % of the participants indicated that they had learnt\nsomething, or quite a lot. Development costs of the program were low.\nConclusion: The HPM is suitable for a behavioral intervention program such as R@W. Acceptance and satisfaction\nof R@W were high and the costs of the program were low.