OBJECTIVE: Patient education is a cornerstone of rheumatology care, enabling patients to effectively and safely manage their condition. Standardized patient knowledge assessments are essential for benchmarking care quality and tailoring education to individual needs. This study aimed to develop and validate Danish and German versions of a patient knowledge questionnaire (PKQ) for rheumatoid arthritis (RA). METHOD: Danish and German adaptations from the English version involved a forward-and-backward translation process. Face validity was assessed with patients with RA in Denmark and Germany. Subsequently, the generated PKQ-RA-11 versions were tested in Danish and German RA patients. RESULTS: The face-validity assessment included 20 patients (10 Danish, 10 German). Adjustments in the Danish version included rephrasing options and aligning with digital patient education content. The German version followed the refined Danish version with necessary cultural adjustments. PKQ-RA-11 comprises 11 multiple-choice questions with a scoring system to minimize guessing. The final PKQ-RA-11 was completed by 175 Danish and 174 German patients
mean completion time was 7.5 and 7.4 minutes, respectively. Mean ± sd baseline PKQ-RA-11 scores were 7.9 ± 1.6 for Danish and 6.2 ± 2.5 for German participants. Longitudinal data from Denmark indicated an increase in knowledge scores following patient education, shown by a mean score of 8.6 ± 1.5, demonstrating the tool's responsiveness to changes in patient understanding of RA. CONCLUSION: PKQ-RA-11 is a standardized tool for assessing disease-related knowledge in individuals with RA. It can be used to provide objective and transparent measures of patient understanding in educational programmes, clinical practice, or research.