Dartmouth College, Geisel School of Medicine, Hanover, NH, USA.
The Dartmouth Institute for Health Policy and Clinical Practice, Center for Program Design and Evaluation, Lebanon, NH, USA.
Health Expect. 2021 Apr;24(2):537-547. doi: 10.1111/hex.13196. Epub 2021 Jan 27.
Patient empowerment can improve health-related outcomes and is important in chronic conditions, such as arthritis. This study aimed to validate the Health Care Empowerment Questionnaire (HCEQ), a patient-reported experience measure of empowerment, for use with patients with arthritis and other rheumatic diseases.
The HCEQ measures Patient Information Seeking (or Involvement in Decisions) and Healthcare Interaction Results (or Involvement in Interactions) and asks respondents to answer questions in two ways: whether they feel something happened and its importance to them. Face validity was assessed through qualitative data (n = 8, nominal group technique; n = 55, focus groups). Measure structure was assessed through confirmatory factor analysis (CFA); internal consistency was also assessed (n = 9226). Test-retest reliability was assessed with sub-sample of participants (n = 182).
We found adequate face validity of the HCEQ for patients with arthritis. The CFA indicated good fit to the data for the two-factor structure of the HCEQ (RMSEA = 0.075; CFI = 0.987; TLI = 0.978; SRMR = 0.026). Internal consistency was strong (α=0.94 for both subscales). Test-retest reliability was moderate for Patient Information Seeking (ICC=0.67) and good for Healthcare Interaction Results (ICC=0.77).
The HCEQ, with modifications, demonstrated promising psychometric properties within this sample, laying the foundation for further assessment. This work supports the HCEQ as an appropriate instrument for examining experiences with and perceived importance of empowerment in individuals with arthritis and other rheumatic conditions.
Patients contributed to the assessment of face validity. As a measure of patient empowerment, the HCEQ's use can enable further participation of patients in health care.
患者赋权可以改善与健康相关的结果，在关节炎等慢性疾病中尤为重要。本研究旨在验证健康照护赋权问卷（HCEQ），这是一种衡量赋权的患者报告体验测量工具，适用于关节炎和其他风湿性疾病患者。
HCEQ 衡量患者信息寻求（或参与决策）和医疗保健互动结果（或参与互动），并要求受访者以两种方式回答问题：是否感到某事发生了以及其对他们的重要性。通过定性数据（n=8，名义群体技术；n=55，焦点小组）评估表面效度。通过验证性因素分析（CFA）评估测量结构；还评估了内部一致性（n=9226）。使用参与者的子样本（n=182）评估测试-重测信度。
我们发现 HCEQ 对于关节炎患者具有足够的表面效度。CFA 表明，HCEQ 的两因素结构数据拟合良好（RMSEA=0.075；CFI=0.987；TLI=0.978；SRMR=0.026）。内部一致性很强（两个分量表的α值均为 0.94）。信息寻求的测试-重测信度为中等（ICC=0.67），互动结果的测试-重测信度为良好（ICC=0.77）。
经过修改，HCEQ 在该样本中表现出有前途的心理测量特性，为进一步评估奠定了基础。这项工作支持 HCEQ 作为一种合适的工具，用于评估关节炎和其他风湿性疾病患者的赋权体验和感知重要性。
患者为表面效度评估做出了贡献。作为衡量患者赋权的工具，HCEQ 的使用可以使患者进一步参与医疗保健。
