欧洲患者的激活度：患者激活度量表简版（PAM - 13）心理测量特性及患者得分的国际比较
Patient activation in Europe: an international comparison of psychometric properties and patients' scores on the short form Patient Activation Measure (PAM-13).
作者信息
Rademakers Jany, Maindal Helle Terkildsen, Steinsbekk Aslak, Gensichen Jochen, Brenk-Franz Katja, Hendriks Michelle
机构信息
NIVEL - Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN, Utrecht, Netherlands.
Maastricht University, CAPHRI School for Public Health and Primary Care, Maastricht, Netherlands.
出版信息
BMC Health Serv Res. 2016 Oct 12;16(1):570. doi: 10.1186/s12913-016-1828-1.
BACKGROUND
To allow better assessment of patients' individual competencies for self-management, the Patient Activation Measure (PAM) has been developed in the USA. Because the American studies have shown the PAM to be a valuable tool, several European countries have translated the instrument into their native languages (Danish, Dutch, German, Norwegian). The aim was to compare the psychometric properties in studies from the different countries and establish whether the scores on the PAM vary between the studies.
METHODS
Data from the four separate studies were subjected to the same data cleaning procedures and statistical analyses. The psychometric properties of the instruments were established with measures of data quality and scale structure. The mean patient activation score and distribution across four predefined activation levels were described and the differences between the four studies were tested with ANOVA (unadjusted and adjusted) followed by a post-hoc Tukey HSD test and the Pearson chi-squared test respectively.
RESULTS
The total N of the four studies was 5184. The percentage of missing values was low in all datasets, confirming the good quality of the datasets. Factor analyses revealed moderate to strong factor loadings on the first factor in all datasets. Cronbach's α was high for all version, ranging from .80 (German) to .88 (Dutch). Item-rest correlations varied between .32 and .66, indicating a moderate to strong correlation of the individual items to the sum scale. Both the mean PAM score and the distribution across activation levels differed between the four datasets. After adjustment of the PAM score, patients in Norway in particular had a higher patient activation level.
CONCLUSIONS
The European translations of PAM-13 (into Danish, Dutch, German and Norwegian) resulted in four instruments with good psychometric capabilities for measuring patient activation. The mean PAM score and the distribution across activation levels differed between the four datasets.
背景
为了更好地评估患者自我管理的个人能力，美国开发了患者激活度量表（PAM）。由于美国的研究表明PAM是一种有价值的工具，几个欧洲国家已将该工具翻译成各自的母语（丹麦语、荷兰语、德语、挪威语）。目的是比较不同国家研究中的心理测量特性，并确定PAM得分在不同研究之间是否存在差异。
方法
对四项独立研究的数据进行相同的数据清理程序和统计分析。通过数据质量和量表结构的测量来确定工具的心理测量特性。描述了患者激活得分的平均值以及在四个预定义激活水平上的分布情况，并分别用方差分析（未调整和调整后）、事后Tukey HSD检验和Pearson卡方检验来检验四项研究之间的差异。
结果
四项研究的总样本量为5184。所有数据集中缺失值的百分比都很低，证实了数据集的良好质量。因子分析显示所有数据集中第一个因子的因子载荷为中度到强度。所有版本的Cronbach's α都很高，范围从0.80（德语）到0.88（荷兰语）。项目与总分的相关性在0.32至0.66之间变化，表明各个项目与总量表之间存在中度到强度的相关性。四个数据集之间的PAM平均得分和激活水平分布均有所不同。调整PAM得分后，特别是挪威的患者具有较高的患者激活水平。
结论
PAM - 13的欧洲译本（丹麦语、荷兰语、德语和挪威语）产生了四种在测量患者激活方面具有良好心理测量能力工具。四个数据集之间的PAM平均得分和激活水平分布有所不同。
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