多系统老年患者患者激活度量表的心理测量学特性。

Psychometric properties of the patient activation measure among multimorbid older adults.

机构信息

Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 North Caroline Street/JHOC 5244, Baltimore, MD 21287, USA.

出版信息

Health Serv Res. 2011 Apr;46(2):457-78. doi: 10.1111/j.1475-6773.2010.01210.x. Epub 2010 Nov 19.

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.

摘要

目的

患者激活度量(PAM)量化了人们对其医疗保健的了解程度和参与程度。目的是确定 PAM 在多病共存的老年患者中的心理测量特性,并评估患者激活的理论四阶段模型。方法:采用横断面分析来评估 PAM 的心理测量特性。使用 Cronbach α 评估内部一致性。使用一般线性模型评估结构有效性,以计算 PAM 评分与健康相关行为、功能状态和医疗保健质量之间的关联。潜在类别分析用于评估患者激活的理论四阶段结构。研究设置:一项针对综合护理(Guided Care)的随机试验(N=855)的参与者,这是一种针对有慢性疾病的老年人的综合医疗保健模式,这些疾病使他们在未来一年中大量使用医疗服务的风险增加。主要发现:较高的 PAM 激活评分和阶段与较高的功能状态、医疗保健质量以及对某些健康行为的遵守呈正相关。潜在类别分析支持患者激活的多阶段理论。结论:PAM 是一种可靠、有效的、具有潜在临床应用价值的多病共存老年患者的患者激活测量工具。

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