50108National Healthcare Group Pte. Ltd, Singapore, Singapore.
Inquiry. 2022 Jan-Dec;59:469580221100781. doi: 10.1177/00469580221100781.
Measuring health activation in general population using valid instruments is needed to facilitate the evaluation of health education and behavioral programs in community. The 13-item Patient Activation Measure was well validated in patients with different chronic diseases but rarely validated in general population. The objective of this study was to assess the psychometric properties of the Patient Activation Measure among community-dwelling adults in Singapore.
Data of participants having valid responses to the English-version measure (N = 824) were analyzed. The psychometric properties were assessed by demonstrating evidence for uni-dimensionality using Rasch Principal Component Analysis of Residuals, known-group validity, convergent and divergent validity, and internal consistency reliability using Cronbach's alpha.
The uni-dimensionality of the Patient Activation Measure was supported by the Rasch Principal Component Analysis of Residuals results. Participants having multimorbidity or polypharmacy and being inactive in physical activity had significantly lower activation scores. The activation score was positively and moderately correlated with health confidence measured by the Health Confidence Measure (r = .38, P < .001), and negatively and weakly correlated with depressive symptoms measured by the Patient Health Questionnaire (r = - .13, P < .001). The internal reliability was good with a Cronbach's alpha of .82.
The 13-item Patient Activation Measure has acceptable construct validity and good internal consistency among community-dwelling adults. It is a potential instrument to measure health activation in this population. Further research is required to investigate the expansion of response options, validate the cut-off scores for the activation levels and examine the test-retest reliability and responsiveness.
在社区中，为了便于评估健康教育和行为项目，需要使用有效的工具来衡量一般人群的健康积极性。13 项患者激活度量表在患有不同慢性病的患者中得到了很好的验证，但在一般人群中很少得到验证。本研究的目的是评估该量表在新加坡社区居住成年人中的心理测量特性。
对具有有效英语版测量响应的参与者的数据（N=824）进行分析。使用残差的 Rasch 主成分分析来证明单维性，使用已知组有效性、收敛和发散有效性以及 Cronbach's alpha 进行内部一致性可靠性，来评估心理测量特性。
Rasch 残差主成分分析结果支持患者激活度量表的单维性。患有多种疾病或多种药物治疗且身体活动不活跃的参与者的激活评分明显较低。激活评分与健康信心量表（Health Confidence Measure）测量的健康信心呈正相关且中度相关（r =.38，P <.001），与患者健康问卷（Patient Health Questionnaire）测量的抑郁症状呈负相关且弱相关（r = -.13，P <.001）。Cronbach's alpha 为.82，内部可靠性良好。
13 项患者激活度量表在社区居住成年人中具有可接受的结构有效性和良好的内部一致性。它是衡量该人群健康积极性的潜在工具。需要进一步研究来探讨扩展响应选项、验证激活水平的截止分数以及检验测试 - 重测信度和反应性。
