患者激活度量表（PAM13）德语版的心理计量学评估。
Psychometric evaluation of the German version of the Patient Activation Measure (PAM13).
机构信息
Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistr, 52, 20246 Hamburg, Germany.
出版信息
BMC Public Health. 2013 Oct 30;13:1027. doi: 10.1186/1471-2458-13-1027.
BACKGROUND
The Patient Activation Measure (PAM) consists of 13 items and assesses patient (or consumer) self-reported knowledge, skills, and confidence for self-management of one's health or chronic condition. The aim of this study was to translate the original American version of the PAM13 into German and to test the psychometric properties of the German version in an elderly, multimorbid population with various chronic conditions.
METHODS
Translation was performed by a standardized forward-backward translation process. The PAM13 was sent to 9.075 participants enrolled in a randomized controlled study. 4.306 participants responded to the questionnaire. Descriptive and reliability analyses were carried out. To examine scale properties, Andrich's Rasch Rating Scale Model was fitted.
RESULTS
The internal consistency is good (α = 0.88) and the item-rest-correlations were found as strong to moderate. The unidimensionality of the construct was confirmed, with a variance explanation of 40.9% and good model-fits for the Rasch model. However, the lowest response options were very rarely used across all items (below 5%) and ranking order of items according to their difficulty was substantially different from that of the American version. Differential item functioning (DIF) was found in subgroups (sex, age, health status), but differences were small.
CONCLUSION
The German version of the PAM13 showed acceptable reliability and the model-fit statistics confirmed the Rasch model. The different ranking order of the items and the unfair distribution of the response options suggest further research on validation and revision of the construct.
背景
患者激活度量表（PAM）由 13 个项目组成，评估患者（或消费者）自我报告的知识、技能和信心，以自我管理自己的健康或慢性病。本研究的目的是将原始的美国版 PAM13 翻译成德文，并在患有各种慢性病的老年、多病种人群中测试其心理测量特性。
方法
翻译采用标准化的正向-反向翻译过程。PAM13 被发送给参加一项随机对照研究的 9075 名参与者。有 4306 名参与者回答了问卷。进行了描述性和可靠性分析。为了检验量表特性，拟合了 Andrich 的 Rasch 评分量表模型。
结果
内部一致性良好（α=0.88），项目-残差相关被认为是强到中度的。结构的单维性得到了确认，构建的方差解释率为 40.9%，Rasch 模型的拟合度良好。然而，所有项目的最低反应选项都很少被使用（低于 5%），并且根据难度对项目进行的排序与美国版本的排序有很大的不同。在亚组（性别、年龄、健康状况）中发现了差异项目功能（DIF），但差异较小。
结论
PAM13 的德文版本显示出可接受的可靠性，模型拟合统计数据证实了 Rasch 模型。项目排序的不同和反应选项的不公平分布表明，需要进一步研究验证和构建的修订。
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