Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Qual Life Res. 2009 Dec;18(10):1357-66. doi: 10.1007/s11136-009-9549-0. Epub 2009 Nov 15.
An individual's propensity to engage in adaptive health and rehabilitation behaviors may account for variation in postsurgical outcome.
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.
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.
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.
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.
个体参与适应性健康和康复行为的倾向可能是术后结果变化的原因。
确定最近开发的患者激活量表（PAM）（以前在脊柱研究中未使用过）在接受择期腰椎手术的患者中的心理测量特性和结构效度。
我们前瞻性地使用 PAM 评估了 283 例接受择期腰椎手术的患者的激活情况。在手术前使用重复评估（基线和 1 周随访）来计算可靠性统计数据。在基线时评估了其他心理属性，并与患者激活相关联。使用因子分析来确认患者激活的理论结构。
重复 PAM 管理的组内相关系数为 0.85。PAM 与乐观（r = 0.75）、希望（r = 0.73）、自我效能（r = 0.65）和内部控制源（r = 0.65）呈正相关，但与合并症（r = 0.01）无关。PAM 项目的验证性因子分析表明，观察数据与三因素患者激活模型之间具有合理的拟合度。
PAM 是一种可靠、有效的个体接受择期腰椎手术患者的患者激活测量工具，在识别那些术后康复参与度低的患者方面可能具有临床应用价值。
