A Study on Developing of Patient Activation Measurement and It’s Relationship with Patient Behavior Focus on Diabetes Patients
Date Issued
2005
Date
2005
Author(s)
Hsu, Yu-Wen
DOI
zh-TW
Abstract
Objectives: Patient plays a key role in patient safety. The best way to prevent medical error is that patient becomes an active member in the practice team. Several studies mentioned that patients should be active to participate in medical decision and self care. It is very important to understand “Patient Activation Measurement” regarding the topic of patient safety.
In existing theory and method, some instruments were applied to measures health locus control, self-management behavior, self-efficiency, health-related behavior etc, but these measures tend to focus on the prediction of a single behavior, not including the necessary knowledge, skill, confidence, and behavior of chronic patients.
Owing to lack of available instrument in Taiwan, this study adopted Patient Activation Measurement (PAM), developed by professor Hibbard etc, in Oregon University. The first purpose of this study is to develop Chinese version instrument of patient activation measurement. The second purpose is to explore the relationship between PAM and behavior for diabetes patients.
Method: This study obtained the authorization directly from professor Hibbard. The modification procedures included translation from English to Chinese, back- translation from Chinese to English, rated of English by professor Hibbard as gold standard, and modify the Chinese if there is low rating in previous step. The final version was decided after pretest of the draft. This is a cross-sectional study. After searching for help from hospitals joined pay for performance program in the National Health Insurance, four hospitals agreed to cooperate with the study that included one medical center and three regional hospitals. Diabetes patients in sample hospitals were treated as unit of analysis. All samples came from convenient sampling. There were 277 valid samples with collection period from 2005/5/16 to 2005/6/15.
Result: There are 22 questions in PAM instrument with high internal consistency (the coefficient of Cronbach α= 0.882). There are 13 question in patient’s behavior with moderate internal consistency (the coefficient of Cronbach α= 0.696). Exploratory factor analysis is carried out to abstract four constructs in Patient behavior including compliance behavior, control behavior, self-care behavior and diet behavior. From multiple regression analysis, the results found that diabetes knowledge, the degree of active support for patient from doctors and nurses and marital status had significant relationship with PAM.
There are many factors with significant relationship with patient behavior that included gender, education level,inhabit situation age, history of diabetes, other chronic diseases, diabetes type, treatment plan, whether patients covered by the pay for performance program, hospital as a whole, the degree of active support for patient from doctors and nurses, an diabetes knowledge.
After controlled for personal characteristics, the study found positive relationship between PAM and patient’s behavior.
Subjects
糖尿病病人行為
病人參與
病人積極度測量
自我照護
Diabetes Patient’s Behavior
Patient involvement
Patient Activation Measure
Self-Care
SDGs
Type
thesis
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