In this study, scores on the sexual motivation scale (which measures the tendency to engage in sexual interaction versus the tendency to be averse to sexual interaction) were determined, by interview, in ankylosing spondylitis (AS) and rheumatoid arthritis (RA) patients and compared with the scores of healthy matched controls. AS patients did not score differently from the healthy population, but scores of men and women with RA were more in the direction of sexual aversion than those of healthy men and women. In female RA patients, some relationship was found between disease variables such as joint index and erythrocyte sedimentation rate and the score on the sexual motivation scale. In the second part of the interview, preference for certain coital positions was investigated, and the demand for help with sexual problems was explored. The percentage of RA patients expressing a need for advice was considerably greater than the percentage of AS patients.

Traditionally, patient education is based on two myths : 1) increases in patients' knowledge lead to changes in behavior and 2) changes in behavior (exercise, pain management techniques) improve health status (pain, disability, depression). There it little evidence in the arthritis patient education literature that changes in knowledge or behavior improve patients' health status. In fact, little association has been found between these changes and improved health status. Explanation:The mechanism by which patient education improves arthritis may be more psychological (giving patients a sense of control) than behavioral. For example, strong associations have been shown between improved self-efficacy for controlling arthritis symptoms and health status. Therefore, arthritis patient education programs should be designed with an emphasis on giving patients a sense of control rather than on increasing knowledge or the practice of new behaviors. Patient eduction: Selection of'patient educational strategiesE. Seydel, E. Taal*, H. Rasker**. *University of Twente; **Medisch Spectrum Twente, Department of Psychology, P.O. Box 217, 7500 AE Enschede, The Netherlands.In the last few years patient education on rheumatology is a tremendous growing field of research. It is receiving more interest from behavioral scientists, physicians, nurses, policy makers, and other people who want their patients to become more informed about their conditions, to use self-management strategies, and to prevent disability. In shaping patient education health professionals are often guided by implicit criteria, vague assumptions or by trial and error. Some of them tend to equate patient education with such information dissemination techniques as teaching, and distribution of instructional pamphlets. However, instructional techniques to increase patients' knowledge is not sufficient to change behavior. There is a growing evidence, that if patient education succeeds in influencing behavior, this will not automatically result in better self-management or better health status. Self-management is defined as a process whereby a patient functions on his/her own behalf in health enhancing behavior, disease detection and treatment'. Self-efficacy seems to be an important moderator in enhancing self-management and refers to the expectation of a person that the can perform a given behavior successfully. We suggest the use of a more systematic and encompassing paradigm based on the self-efficacy concept. This concept has been successfully applied to a broad range of clinical problems, including a.o. chronic illness and health promotion. To facilitate the shaping of a patient education program based on the self-efficacy paradigm, we will present a model of patient education analysis and a set of criteria for developing and evaluating patient education programs. Some of the criteria are (1) a firm problem analysis (2) the encouragement of client responsibility, (3) full disclosure of information pertaining to the illness, (4) training of the patient in decisi...

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