Psychometric Properties of the Patient Activation Measure among Multimorbid Older Adults

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 multi-morbid 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’s alpha. 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 multi-stage theory of patient activation. Conclusions The PAM is a reliable, valid, and potentially clinically useful measure of patient activation for multi-morbid older adults.

Why Does Patient Activation Matter? An Examination of the Relationships Between Patient Activation and Health-Related Outcomes

“…eye examinations for people with diabetes, keeping diary of blood pressure readings), and control of chronic illness (e.g. HbA1c control, fewer hospitalizations) 13,14,[16][17][18][19][20] . Many of the studies are limited, however, by reliance upon self-reported health outcomes and use of relatively small samples.…”

“…Prior studies have found patient activation to be a valid measure in a number of population subgroups (e.g. Latinos, uninsured, older adults with multiple chronic conditions) [14][15][16] . This is the first examination of whether the relationships between patient activation and health-related outcomes differ across SES strata.…”

Eliciting the impact of digital consulting for young people living with long term conditions (LYNC study): which Patient Reported Outcome Measure? (Preprint)

“…Previous research has demonstrated that psychometrically, the PAM 13 has stronger and more detailed all round validity in demonstrating clear face, content, construct and criterion validity and psychometric reliability across populations (14,(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27). A large body of evidence therefore demonstrates that the PAM-13 is a valid, reliable and clinically useful measure of patient activation that can be used across diverse cultures and patient groups.…”

“…The PAM 13, a short-form version of the PAM 22, has been more extensively examined for use in additional populations and languages (14) . It offers strong psychometric evidence in people living with long term conditions (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27). The PAM; specifically the PAM-13, possesses a large body of evidence that supports its strong psychometric properties across diverse cultures and patient groups.…”

Case Management in Primary Care for Frequent Users of Health Care Services: A Mixed Methods Study

“…28,29 Psychological distress was analyzed as a dichotomous variable where scores of 13 or higher indicated the presence of psychological distress; patient activation was analyzed as a continuous variable. We also collected covariables at baseline to describe patient characteristics: (1) socioeconomic data (age, sex, marital status, education, occupation, economic status with family income, and perception of his/her economic situation); (2) health literacy, measured with the Newest Vital Sign (NVS) 30 ; (3) mental health, measured with the Hospital Anxiety and Depression Scale (HADS) 31,32 ; and (4) multimorbidity, measured with the Disease Burden Morbidity Assessment (DBMA).…”