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Background Decision aids are evidence-based tools designed to inform people of the potential benefit and harm of treatment options, clarify their preferences and provide a shared decision-making structure for discussion at a clinic visit. For patients with rheumatoid arthritis (RA) who are considering methotrexate, we have developed a web-based patient decision aid called the ANSWER (Animated, Self-serve, Web-based Research Tool). This study aimed to: 1) assess the usability of the ANSWER prototype; 2) identify strengths and limitations of the ANSWER from the patient's perspective. Methods The ANSWER prototype consisted of: 1) six animated patient stories and narrated information on the evidence of methotrexate for RA; 2) interactive questionnaires to clarify patients' treatment preferences. Eligible participants for the usability test were patients with RA who had been prescribed methotrexate. They were asked to verbalize their thoughts (i.e., think aloud) while using the ANSWER, and to complete the System Usability Scale (SUS) to assess overall usability (range = 0-100; higher = more user friendly). Participants were audiotaped and observed, and field notes were taken. The testing continued until no new modifiable issues were found. We used descriptive statistics to summarize participant characteristics and the SUS scores. Content analysis was used to identified usability issues and navigation problems. Results 15 patients participated in the usability testing. The majority were aged 50 or over and were university/college graduates (n = 8, 53.4%). On average they took 56 minutes (SD = 34.8) to complete the tool. The mean SUS score was 81.2 (SD = 13.5). Content analysis of audiotapes and field notes revealed four categories of modifiable usability issues: 1) information delivery (i.e., clarity of the information and presentation style); 2) navigation control (i.e., difficulties in recognizing and using the navigation control buttons); 3) layout (i.e., position of the videos, text, diagrams and navigation buttons); 4) aesthetic (i.e., the colour, look and feel of the online tool). Conclusions Although the SUS score indicated high usability before and after major modification, findings from the think-aloud sessions illustrated areas that required further refinement. Our results highlight the importance of formative evaluation in usability testing. [ABSTRACT FROM AUTHOR]

This qualitative analysis identifies factors that individuals with arthritis should take into consideration prior to pursuing self-employment (SE). Subjects were recruited from a database of all patients who had used the services of a provincial, out-patient arthritis treatment program between January 1999 and December 2000. Letters screening for SE experience were sent to 4414 individuals. Of the 1695 (38% individuals who responded, 442 (26% reported current or previous SE experience and 247/442 (56%) agreed to participate and completed a mailed survey. Three open-ended questions asked respondents what advice they would give to someone with arthritis who was considering SE, and to provide their general thoughts on SE as an option for people with arthritis. Respondents provided a range of practical advice on determining the suitability of SE, choosing the type of SE in which to become engaged, and potential strategies for success. Advice for improving the chance of business success included the importance of formal and informal support, self care, maintaining close contact with one's medical team, pacing, and finally, planning the business. [ABSTRACT FROM AUTHOR]

The purpose of this pilot study was to evaluate the Readiness to Manage Arthritis Questionnaire (RMAQ), a new multibehavior measure of readiness for change in arthritis management. Data were obtained from 46 patients with chronic inflammatory arthritis admitted for intensive treatment. Test-retest reliability, correlations with clinical variables and theoretically related constructs, and responsiveness to change were assessed. Test-retest reliability indicated reasonable stability, with intraclass correlation coefficients ranging from 0.30 to 0.75. A significant association was observed between psychological well-being and readiness status. Clinical variables of disease duration, disease severity, pain, and function were not related to readiness status. Correlations between stages-of-change scores and self-efficacy for managing arthritis symptoms were mostly nonsignificant, with the exception of modest agreement between readiness to engage in physical activity and exercise self-efficacy (0.43). Significant changes were observed in mean RMAQ scores from initial assessment to 12 weeks posttreatment for the behaviors of using joint protection, dealing with frustration, learning about arthritis, engaging in physical activity, and stress management. Findings from this pilot study suggest that the RMAQ has adequate psychometric properties in patients with chronic inflammatory arthritis and can be used to assess an individual's readiness to adopt important arthritis self-management behaviors.