Measuring patient activation in Chinese patients with hypertension and/or diabetes: reliability and validity of the PAM13

Zeng, Huijuan; Runsheng, Jiang; Wu, Linxiong; Tian, Bo; Zhang, Yao; Qu, Fanwei

doi:10.1177/0300060519868327

Cited by 12 publications

(22 citation statements)

References 30 publications

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“…PAM-13 validation studies were conducted also in a series of specific patient populations, including diabetes [37,84,85], metabolic syndrome [86], multiple sclerosis [87], neurological disorders [88,89], hypertension [37,85], cardiac conditions [90], schizophrenia [91], mental disorders [92], osteoarthritis [93][94][95], rheumatic diseases [37,96], HIV [97] or not specified chronic diseases [98][99][100], and clinical settings in different countries [101][102][103][104][105]. In some of these studies, convergent validity was assessed using generic and disease-specific measures of health-related attitudes or behaviours, such as self-efficacy [87,88,96,101], selfesteem [98], lifestyle [89] or health literacy [103,106].…”

Section: Discussionmentioning

confidence: 99%

Validation of the PAM-13 instrument in the Hungarian general population 40 years old and above

et al. 2022

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Background Patient activation comprises the skills, knowledge and motivation necessary for patients’ effective contribution to their care. We adapted and validated the 13-item Patient Activation Measure (PAM-13) in the ≥ 40 years old Hungarian general population. Methods A cross-sectional web survey was conducted among 900 respondents selected from an online panel via quota sampling. After 10 days, the survey was repeated on 100 respondents. The distribution, internal consistency, test–retest reliability, factor structure, convergent, discriminant and known-groups validity of PAM-13 were assessed according to the COSMIN guidelines. Results The sample comprised 779 respondents. Mean (± SD) age was 60.4 ± 10.6 years, 54% were female and 67% had chronic illness. Mean (± SD) PAM-13 score was 60.6 ± 10.0. We found good internal consistency (Cronbach alpha: 0.77), moderate test–retest reliability (ICC: 0.62; n = 75), a single-factor structure and good content validity: PAM-13 showed moderate correlation with the eHealth Literacy Scale (r = 0.40), and no correlation with age (r = 0.02), education (r = 0.04) or income (ρ = 0.04). Higher PAM-13 scores were associated with fewer lifestyle risks (p < 0.001), more frequent health information seeking (p < 0.001), participation in patient education (p = 0.018) and various online health-related behaviours. When controlling for health literacy, sociodemographic factors and health status, the association of higher PAM-13 scores with overall fewer lifestyle risks, normal body mass index, physical activity and adequate diet remained significant. Similar properties were observed in the subgroup of participants with chronic morbidity, but not in the age group 65+. Conclusion PAM-13 demonstrated good validity in the general population. Its properties in clinical populations and the elderly as well as responsiveness to interventions warrant further research.

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Section: Discussionmentioning

confidence: 99%

Validation of the PAM-13 instrument in the Hungarian general population 40 years old and above

et al. 2022

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“…The mean patient activation score in the present study was 56.49 ± 15.12. The Chinese PAM-13 score for chronically ill patients was 60.1 ± 15.4 (Zeng et al, 2019). This difference could be explained by Zeng et al who examined patients with high blood pressure and/or type 2 diabetes in community health centers.…”

Section: Discussionmentioning

confidence: 99%

“…The results of some studies showed that the PAM13-P was similar to other versions of the PAM-13, including Italian (Cronbach's α = 0.88) (Graffigna et al, 2015), Dutch (Cronbach's α = 0.88) (Rademakers et al, 2012), Singaporean (Cronbach's α = 0.86) (Ngooi et al, 2017), Brazilian (Cronbach's α = 0.83) (Cunha et al, 2019), American (Cronbach's α = 0.81) (Prey et al, 2016), Turkish (Cronbach's α = 0.81) (Kosar & Besen, 2019), Malay (Cronbach's α = 0.79) (Bahrom et al, 2020) and German versions (Cronbach's α = 0.79) (Bomba et al, 2018). The Spanish (Cronbach's α = 0.93) (DeCamp et al, 2016) and Chinese versions of the PAM-13 (Cronbach's α = 0.92) (Zeng et al, 2019) had lower internal consistency than other versions. The item-total correlation coefficients for the PAM-13-P ranged from 0.46 to 0.63.…”

Section: Internal Consistency and Repeatabilitymentioning

confidence: 99%

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Psychometric Evaluation of Chronic Patients Using the Persian Version of Patient Activation Measure (PAM)

et al. 2022

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The Patient Activation Measure (PAM) is a 13-item questionnaire that assesses patients’ knowledge, skills, and confidence in self-management. The current study aimed to translate the American version of the PAM-13 into Persian and test the psychometric properties of the Persian version among chronic patients. This cross-sectional study was conducted on 438 chronically ill patients in Rafsanjan, Iran from May to November 2019. The American version of the PAM-13 was translated into Persian using a standardized forward–backward translation method. Internal consistency, test-retest reliability, face and content validity, as well as construct validity (structural and convergent validity) were all assessed. The content validity index of the Patient Activation Measure-13 Persian (PAM-13-P) was 0.91. Exploratory and confirmatory factor analyses showed that the PAM-13-P had a meaningful structural validity. The PAM-13-P scores were negatively correlated with the Partner in Health Measure (PIH) (r = −0.29, p < 0.001). In addition, the PAM13-P scores were positively correlated with the Satisfaction with Life Scale (SWLS) (r = 0.31, p < 0.001). The internal consistency was 0.88, and the repeatability was excellent [Intraclass Correlation Coefficient (ICC):0.96 and confidence interval (CI): 0.94–0.98]. This study demonstrates that the PAM-13-P is a reliable and valid measure for assessing activation among chronically ill patients. The PAM-13-P scale assesses the level of self-management of chronic patients and identifies appropriate care strategies to meet their needs.

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“…The higher the score, the better the activation level. The Chinese version of the PAM-13 has shown good reliability and validity, with a Cronbach's α of 0.920 ( 28 ).…”

Section: Methodsmentioning

confidence: 99%

Association Between Patient Activation and Medication Adherence in Patients With Stroke: A Cross-Sectional Study

Sui

Wan

2021

Front. Neurol.

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Background: Medication adherence is key to secondary prevention in patients with stroke. Poor medication adherence can lead to recurrence, disability, or even death in stroke survivors. Patient activation is associated with increased healthy behaviors and improved clinical outcomes in many chronic diseases. However, the association between patient activation and medication adherence in patients with stroke remains unclear.Objective: The study aimed to explore the influence of patient activation on the medication adherence of patients with stroke and to analyze the reasons for medication nonadherence.Materials and Methods: A cross-sectional design with convenience sampling was used in this study. A total of 119 patients with stroke were recruited from a tertiary hospital in Guangzhou. A social-demographic and clinical data form, a self-developed medication adherence questionnaire, and the 13-item Patient Activation Measure (PAM-13) were used. Univariate analysis and multiple linear regression analysis with dummy variables were conducted to investigate the associations between medication adherence and patient activation. Data were analyzed with IBM® SPSS® version 25.0.Results: The mean PAM-13 score in patients with stroke was 51.56 ± 12.58. A low level of patient activation was reported by up to 66.4% of the patients. The self-reported medication adherence questionnaire score was 5.59 ± 1.52. A low level of medication adherence was reported by up to 59.7% of the patients, while a moderate level was reported by 34.4%, and a high level was reported by only 5.9%. In the multiple stepwise regression analysis, patient activation was found to be an independent influencing factor of medication adherence in patients with stroke (p < 0.05).Conclusion: Medication adherence was poor in patients in Guangzhou, China, following an ischemic stroke. Patient activation as the independent influencing factor identified in this study will support healthcare givers to develop the tailored intervention to improve medication adherence among patients with stroke in China.

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Measuring patient activation in Chinese patients with hypertension and/or diabetes: reliability and validity of the PAM13

Cited by 12 publications

References 30 publications

Validation of the PAM-13 instrument in the Hungarian general population 40 years old and above

Validation of the PAM-13 instrument in the Hungarian general population 40 years old and above

Psychometric Evaluation of Chronic Patients Using the Persian Version of Patient Activation Measure (PAM)

Association Between Patient Activation and Medication Adherence in Patients With Stroke: A Cross-Sectional Study

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