Psychometric properties of the Patient Activation Measure among individuals presenting for elective lumbar spine surgery

Research output: Contribution to journalArticle

Abstract

Background: An individual's propensity to engage in adaptive health and rehabilitation behaviors may account for variation in postsurgical outcome. Purpose: To determine the psychometric properties and construct validity of the recently developed Patient Activation Measure (PAM) (previously unused in spine research) in persons undergoing elective lumbar spine surgery. Methods: We prospectively used the PAM to assess activation in 283 patients undergoing elective lumbar spine surgery. Reliability statistics were computed using repeated assessment (baseline and 1-week follow-up) before surgery. Additional psychological attributes were assessed at baseline and correlated with patient activation. Factor analysis was used to confirm the theoretical structure of patient activation. Results: Repeat PAM administrations had an intraclass correlation coefficient of 0.85. The PAM showed positive correlation with optimism (r = 0.75), hope (r = 0.73), self-efficacy (r = 0.65), and internal locus of control (r = 0.65) but no correlation with comorbidity (r = 0.01). Confirmatory factor analysis of the PAM items indicated reasonable fit between observed data and a three-factor patient activation model. Conclusions: The PAM is a reliable, valid measure of patient activation for individuals undergoing elective lumbar spine surgery and may have clinical utility in identifying those at risk for poor engagement in postsurgical rehabilitation.

Original languageEnglish (US)
Pages (from-to)1357-1366
Number of pages10
JournalQuality of Life Research
Volume18
Issue number10
DOIs
StatePublished - Dec 2009

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Patient Participation
Psychometrics
Spine
Statistical Factor Analysis
Hope
Rehabilitation
Internal-External Control
Self Efficacy
Comorbidity
Psychology

Keywords

  • Lumbar spine surgery
  • Patient Activation Measure
  • Validation

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

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title = "Psychometric properties of the Patient Activation Measure among individuals presenting for elective lumbar spine surgery",
abstract = "Background: An individual's propensity to engage in adaptive health and rehabilitation behaviors may account for variation in postsurgical outcome. Purpose: To determine the psychometric properties and construct validity of the recently developed Patient Activation Measure (PAM) (previously unused in spine research) in persons undergoing elective lumbar spine surgery. Methods: We prospectively used the PAM to assess activation in 283 patients undergoing elective lumbar spine surgery. Reliability statistics were computed using repeated assessment (baseline and 1-week follow-up) before surgery. Additional psychological attributes were assessed at baseline and correlated with patient activation. Factor analysis was used to confirm the theoretical structure of patient activation. Results: Repeat PAM administrations had an intraclass correlation coefficient of 0.85. The PAM showed positive correlation with optimism (r = 0.75), hope (r = 0.73), self-efficacy (r = 0.65), and internal locus of control (r = 0.65) but no correlation with comorbidity (r = 0.01). Confirmatory factor analysis of the PAM items indicated reasonable fit between observed data and a three-factor patient activation model. Conclusions: The PAM is a reliable, valid measure of patient activation for individuals undergoing elective lumbar spine surgery and may have clinical utility in identifying those at risk for poor engagement in postsurgical rehabilitation.",
keywords = "Lumbar spine surgery, Patient Activation Measure, Validation",
author = "Richard Skolasky and Mackenzie, {Ellen J} and Riley, {Lee H} and Wegener, {Stephen T}",
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