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Objective: Joint protection (JP) is an important part of the treatment concept for patients with rheumatoid arthritis (RA). The Joint Protection Behavior Assessment short form (JPBA-S) assesses the use of hand JP methods by patients with RA while preparing a hot drink. The purpose of this study was to develop a German version of the JPBA-S (D-JPBA-S) and to test its validity and reliability., Methods: A manual was developed through consensus with 8 occupational therapist (OT) experts as the reference for assessing patients' JP behavior. Twenty-four patients with RA and 10 healthy individuals were videotaped while performing 10 tasks reflecting the activity of preparing instant coffee. Recordings were repeated after 3 months for test-retest analysis. One rater assessed all available patient recordings (n = 23, recorded twice) for test-retest reliability. The video recordings of 10 randomly selected patients and all healthy individuals were independently assessed for interrater reliability by 6 OTs who were explicitly asked to follow the manual. Rasch analysis was performed to test construct validity and transform ordinal raw data into interval data for reliability calculations., Results: Nine of the 10 tasks fit the Rasch model. The D-JPBA-S, consisting of 9 valid tasks, had an intraclass correlation coefficient of 0.77 for interrater reliability and 0.71 for test-retest reliability., Conclusion: The D-JPBA-S provides a valid and reliable instrument for assessing JP behavior of patients with RA and can be used in German-speaking countries.

Objective: To systematically review educational or psychoeducational interventions for patients with rheumatoid arthritis focusing on long-term effects, especially health status., Methods: Two independent reviewers appraised the methodologic quality of the included randomized controlled trials, published between 1980 and July 2002., Results: Validity scores of studies ranged from 3 to 9 (of 11). The 7 educational programs mainly improved knowledge and compliance in the short and long term, but there was no improvement in health status. All 4 psychoeducational programs improved coping behavior in the short term, 2 of them showing a positive long-term effect on physical or psychological health variables., Conclusion: Methodologically better-designed studies had more difficulties demonstrating positive outcome results. Short-term effects in program targets are generally observed, whereas long-term changes in health status are not convincingly demonstrated. There is a need to find better strategies to enhance the transfer of short-term effects into gains in health status.