Psychometric properties of the patient activation measure among multimorbid older adults

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Abstract

Objectives. The Patient Activation Measure (PAM) quantifies the extent to which people are informed about and involved in their health care. Objectives were to determine the psychometric properties of PAM among multimorbid older adults and evaluate a theoretical, four-stage model of patient activation. Methods. A cross-sectional analysis was used to assess the psychometric properties of PAM. Internal consistency was assessed using Cronbach α. Construct validity was evaluated using general linear modeling to compute associations between PAM scores and health-related behaviors, functional status, and health care quality. Latent class analysis was used to evaluate the theoretical four-stage structure of patient activation. Study Setting. Participants in a randomized trial of Guided Care (N=855), a model of comprehensive health care for older adults with chronic conditions that put them at risk of using health services heavily during the coming year. Principal Findings. Higher PAM activation scores and stage were positively associated with higher functional status, health care quality, and adherence to some health behaviors. Latent class analysis supported the multistage theory of patient activation. Conclusions. The PAM is a reliable, valid, and potentially clinically useful measure of patient activation for multimorbid older adults.

Original languageEnglish (US)
Pages (from-to)457-478
Number of pages22
JournalHealth Services Research
Volume46
Issue number2
DOIs
StatePublished - Apr 2011

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Patient Participation
Psychometrics
Quality of Health Care
Comprehensive Health Care
Health Behavior
Health Services
Cross-Sectional Studies
Delivery of Health Care

Keywords

  • chronic conditions
  • Patient activation
  • self-management

ASJC Scopus subject areas

  • Health Policy

Cite this

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title = "Psychometric properties of the patient activation measure among multimorbid older adults",
abstract = "Objectives. The Patient Activation Measure (PAM) quantifies the extent to which people are informed about and involved in their health care. Objectives were to determine the psychometric properties of PAM among multimorbid older adults and evaluate a theoretical, four-stage model of patient activation. Methods. A cross-sectional analysis was used to assess the psychometric properties of PAM. Internal consistency was assessed using Cronbach α. Construct validity was evaluated using general linear modeling to compute associations between PAM scores and health-related behaviors, functional status, and health care quality. Latent class analysis was used to evaluate the theoretical four-stage structure of patient activation. Study Setting. Participants in a randomized trial of Guided Care (N=855), a model of comprehensive health care for older adults with chronic conditions that put them at risk of using health services heavily during the coming year. Principal Findings. Higher PAM activation scores and stage were positively associated with higher functional status, health care quality, and adherence to some health behaviors. Latent class analysis supported the multistage theory of patient activation. Conclusions. The PAM is a reliable, valid, and potentially clinically useful measure of patient activation for multimorbid older adults.",
keywords = "chronic conditions, Patient activation, self-management",
author = "Richard Skolasky and Ariel Green and Scharfstein, {Daniel O} and Chad Boult and Lisa Reider and Wegener, {Stephen T}",
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