Knee osteoarthritis (KOA) is a common disease of the knee joint, which leads to long-term joint pain, limited movement and poor quality of life in the affected patients [1]. In the United States, more than 27 million adults suffer from knee osteoarthritis [2]. It is estimated that 10% of people older than 55 years have disabling knee symptoms due to knee osteoarthritis in United Kingdom [3]. In China, the incidence of knee osteoarthritis is 13.2% in 40~70 years age group [4].

Patients’ education is an important aspect of the management of osteoarthritis. The management guidelines for patients with osteoarthritis point out that “patients should receive patient education on their first consultation with health providers” [5-6]. The purpose of patient education is to help patients manage their diseases and improve their life quality [6-7]. However, research finding shave shown that routine patient education struggle to achieve long-term impact on patients [8], therefore, individualized, needs-based educational programs which put the patient at the centre are advocated [9]. Understanding the patients’ needs for education is a prerequisite in the development of an effective patient-centered education and some studies have proposed the development of individualized self-management programs for people with osteoarthritis to improve their health status [10, 11].The European League Against Rheumatism has developed evidence-based recommendations which provide guidance on the delivery of non-pharmacological interventions of people with hip or KOA [12]. These include individualised treatment and patient education regarding lifestyle changes, exercise and other aspects of disease management.

Research on patients’ educational needs in patients with arthritis is lacking in China. In the UK, the educational needs assessment tool (ENAT) was developed over 10 years ago [13] and has been validated in various disease groups [14]. The ENAT has been shown to help nurses direct [MN1] needs-based patient education for people with RA [15]. The ENAT is a simple 39-item questionnaire used to assess educational needs of people with arthritis. It consists of seven domains: pain management (6 items), activity (5 items), feeling (4 items), arthritis course (7 items), treatment (7 items), self-care measure (6 items) and support system (4 items). Each item has a 5-point Likert scale, scored as: 0 = not important, 1 = a little important, 2 = fairly important, 3 = very important and 4 = extremely important; thus directly reflecting the patients’ educational needs[13]. In the Netherlands, the Dutch version ENAT has been used determine educational needs of patients with RA, SLE and SSc [16-18]. In Poland, the Polish version of the tool was validated and used to summarise the educational needs of patients with RA and SSc[19-21].

Nurses spend a lot of time in patient education and providing needs-based patient education ensures that this important activity is effective[6]. The ENAT is the tool with which this can be achieved. In China, research on educational needs of patients with arthritis is at an infancy stage and no tools are available for assessment of patients’ educational needs. The aim of this study was to adapt the ENAT into Chinese (CENAT) and validate it for use in knee osteoarthritis.