The pam consists of statements relating to patients beliefs about health care, confidence in their management of health related tasks, and selfassessed knowledge of their condition. Translation, adaptation and validation of the american short. To assess the activation level of healthy or chronically ill individuals, the instrument patient activation measure pam was created in the united states, in a version with 22 items pam22. Cultural adaptation and validation of the brazilian version. The patient activation measure pam is a item instrument for measuring patient beliefs, knowledge and confidence for engaging in a wide range of health behaviors. We used the item version of the patient activation measure pam. Both can be conceptualized as either a process or an emergent state 1.
September 12, 2017 patient activation is a key concept in the push for patientcentered care, but is often conflated with the notion of driving patient engagement. To compose more individualized strategies, we aim to increase our understanding of characteristics associated with patient activation for selfmanagement and to evaluate whether these are disease. Psychometric properties of the patient activation measure. The pammhs psychometric properties equal those of the original item pam. Using the patient activation measure to improve outcomes and. Sep 06, 2017 patient activation was assessed at baseline during the index hospitalization using an adapted 8item version of the item pam, as previously described mitchell et al. They are closely linked to clinical outcomes, the costs of.
Can increasing patient activation improve the outcomes of. Using the patient activation measure to improve outcomes and control costs judith h. Activation can predict utilization and health outcomes two years into the future for diabetics % change for a 1 point change in pam score. Using activation measure to inform care protocols rooming process back pain mammograms. Measuring and documenting client engagement through the patient activation measure 10 pam 10, a tenitem survey that helps identify the knowledge, skills, and confidence level of an indiv idual towards their health and healthcare coaching individuals to increase engagement activation in their healthcare including. Individuals who measure high on this assessment typically understand the importance of taking a proactive role in managing their health and have the skills and confidence to do so. Validation of the patient activation measure in patients at discharge. So we took a closer look at hibbards pam 12 and its german version and at howies seminal patient enablement instrument pei 2,17. Development of the patient activation measure for mental. The patient activation measure is a relatively new tool that assesses a patients level of activation to more appropriately tailor healthcare interventions. Development and testing of a short form of the patient. The 22item pam was developed using rasch psychometric methods and is an interval level, unidimensional. The pam is used across the healthcare industry to determine the level at which a. Patient activation in older people with longterm conditions.
What is the patient activation measure in patientcentered. However, for pam users who are seeking the highest level of measurement precision, the pam 22 may be more desirable. The original patient activation measure pam has 22 items and a item version has also been developed pam 6. Patient activation was assessed at baseline during the index hospitalization using an adapted 8item version of the item pam, as previously described mitchell et al. A disadv antage of the pei, however, seems to be that it. Higher activated individuals are more likely to engage in positive health behaviors and to have better health outcomes activation also linked with better care experiences. A new generic item questionnaire for measuring patient enablement german version. Deidentified claims, demographic data, and serial pam scores were. To compose more individualized strategies, we aim to increase our understanding of characteristics associated with patient activation for selfmanagement and to evaluate. The pam was formulated in two versions targeting people with or without chronic disease, with few semantic differences 6. The relationship between the patient activation measure, future health outcomes, and health care utilization among patients with diabetes.
However, patient activation is its own quantifiable concept supported by the patient activation measure pam. Patient activation mediates health literacy associated with. The patient activation measure pam, developed by hibbard et al. Jul 31, 2012 the american short form patient activation measure pam is a item instrument which assesses patient or consumer selfreported knowledge, skills and confidence for selfmanagement of ones health or chronic condition. Mahoney, jean stockard, and martin tusler objective. The aim of this study was to translate the original american version of the pam into german and to test the psychometric properties of the german version in an. The item patient activation measure pam was asked of all adults age 18 and over and was selfreported. Each item is rated 14 strongly disagree 1 to strongly agree4 and a total raw score is generated 052. Understanding patient activation and adherence to nebuliser. Kaiser care management institute, phd dissertation.
A validation study in norway author links open overlay panel inger elise o. When we offer new patient programs and services, who shows up. Patient activation scores have been robustly demonstrated to predict a number of health behaviours. Methods development and testing of a short form of the patient activation measure judith h. Reliability analysis of the turkish version of the patient.
Patient activation, motivational interviewing and positive psychology. Patient activation measure pam insignia health enus. In this study, we explore the degree to which changes in patient activation measure pam levels predict health care costs among highrisk patients. The patient activation measure pam consists of items and assesses patient or consumer selfreported knowledge, skills, and confidence for selfmanagement of ones health or chronic condition.
The pam scale assesses patient selfreported knowledge, skills and confidence for selfmanagement of ones health or chronic condition. The chinese patient activation measure chinese pam. While early versions the pam comprised questions5 shortened item pam. Supporting people to manage their health kings fund. The analysis yielded a item measure that has psychometric properties similar to the original 22item version. Each item is rated 14 strongly disagree 1 to strongly agree4 and a. Two studies showed that the association between patient activation and measures of health literacy was weak, indicating that these are 2 distinct concepts. Independent evaluation of the feasibility of using the. Scores on the pam have been shown to predict adherence to health behaviours, healthrelated outcomes and health care costs. There are long 22 item and short item versions available. The items have response options ranging from 1strongly disagree to 4 strongly agree with an option to respond as not applicable. Translation and initial psychometric evaluation of the.
The patient activation measure pam is a measure that assesses patient knowledge, skill, and confidence for selfmanagement. A multidisciplinary team developed items to capture individual aspects of patient enablement pen. The aim of this study was to translate the original american version of the pam into german and to test the psychometric properties of the german version in an elderly, multimorbid population. What is the patient activation measure in patientcentered care.
Patient activation, motivational interviewing and positive psychology provides the fundamentals of three essential tools that health coaches can use to measure and monitor activation levels, elicit behavior change, move clients along the path to selfmanagement and have a positive impact on health outcomes and utilization. Psychometric properties of the patient activation measure among outpatients waiting for mental health treatment. The pam has been used in several different countries, including the uk. It helps to measure the spectrum of knowledge, skills and confidence in patients and captures the extent to which people feel engaged and confident in taking care of their condition. A pretest with 26 subjects was followed by a random sample survey of n.
A new generic item questionnaire for measuring patient enablement german version article pdf available in international journal of. Adaptation to european spanish and psychometric properties of. Validation of the german version of the patient activation measure. Randomized controlled trial of a patient activation tool. Can increasing patient activation improve the outcomes of care. A crosssectional study was conducted in a convenient sample of 270 heart clinic patients. The patient activation measure pam is a patientreported measure that has been validated in the united kingdom. The shorter version of the pam will make it more feasible to use activation scores to inform patient care plans. Laracabrera a c h 1 lilisbeth peresteloperez d e f amado riverosantana e f g lasse eriksen b h olav m. Patient activation to address chronic pain and opioid. Patient activation changes as a potential signal for. A previous publication described the development and testing of the patient activation measure pam, which assesses patient selfreported knowledge, skill, and confidence for selfmanagement of ones health or chronic condition hibbard et al. Stanford chronic disease selfmanagement program higher activated more likely to enroll patient portal use higher activated twice as likely to use portal than lower activated when we dont measure, we never know who we are are reaching. Development and testing of a short form of the patient activation.
Sep 12, 2017 september 12, 2017 patient activation is a key concept in the push for patient centered care, but is often conflated with the notion of driving patient engagement. In 2005 a item short form of the pam was developed, which has the same psychometric properties as the longer. The 22 item pam was developed using rasch psychometric methods and is an interval level. The first version, developed in 2004, comprised 22 items 8, and in 2005, a shorter version of items was developed to enhance the feasibility. Measure cspam,8 the caregiver activation measure cam,9 patient activation measure for mental health pammh10 and parentpatient activation measure ppam.
The pam scale was originally developed by hibbard with 22 items and a shortened version with items was widely used 27,28. The item version of the pam was used in all four european studies 10. To various degrees, the pam has been applied in three main ways. Have a look at development of the patient activation measure pam. Pam reliably predicts future er visits, hospital admissions and readmissions, medication adherence and more. Using the patient activation measure to improve outcomes. The patient activation measure the patient activation measure pam is a 10 or item survey that assesses a persons underlying knowledge, skills and confidence integral to managing his or her own health and healthcare. Insignia health, llc proprietary and confidential 2015 for use with a valid license only. The item patient activation measure pam was used to.
The same holds for the terms patient empowerment and patient activation. Understand the patient activation measure pam items a. Translation, adaptation and validation of the american. Patient activation changes as a potential signal for changes. In this study the pam was translated into a dutch version. The patient activation measure pam measures patients knowledge, skill, and confidence in chronic condition selfmanagement.
Patient and disease characteristics associated with. Patient activation measures in a government homeopathic. A crosssectional study was conducted in a convenient sample of 270 heart clinic. Pam activation levels are mapped to hundreds of consumer health characteristics motivators, attitudes, behaviors and outcomes for dozens of health conditions. A new generic item questionnaire for measuring patient. Measuring patient activation in chinese patients with. Cultural adaptation and validation of the brazilian. The purpose of this study was to assess the validity of pam english version among englishspeaking adults with cardiac conditions in singapore. Conclusions patient activation measure short form pam performs well in some areas, but not all. This study validates the danish translation of the item patient activation measure pam in a danish population with dysglycaemia.
Although the pam was originally designed to be used for persons with chronic conditions, a slightly modified version was developed for persons with no chronic conditions see appendix. Development testing of a short form of the patient activation measure. Programs to improve quality of care and lower costs for the highest utilizers of health services are proliferating, yet such programs have difficulty demonstrating cost savings. The patient activation measure pam is a 22item measure that assesses patient knowledge, skill, and con. A rasch partial credit model analysis was conducted on the pam instrument using a sample. For each statement patients are required to say how. It is a powerful and reliable measure of patient activation. Patient activation mediates health literacy associated. Validation of the patient activation measure pam among. We used item response theory to evaluate the psychometric properties of the pam utilized in rural settings. Each item has four response categories with scores.
In this 57page report, get background on these three health coaching essentials. Our objective was to adapt the physical health patient activation measure pam for use among people with mental health conditions pammh. License pam pam reliably predicts future er visits, hospital admissions and readmissions, medication adherence and more. The american short form patient activation measure pam is a item instrument which assesses patient or consumer selfreported knowledge, skills and confidence for selfmanagement of ones health or chronic condition. Adaptation to european spanish and psychometric properties. Psychometric evaluation of the german version of the. Oct 14, 2011 have a look at development of the patient activation measure pam. The purpose of our study was to develop and psychometrically test a germanlanguage survey instrument that measures patient enablement generically and in greater detail than previous instruments. Pam is designed to measure the level fo activation of patients suffering from chronic diseases like diabetes and hbp. The item short form patient activation measure pam, chinese version. Measure cspam,8 the caregiver activation measure cam,9 patient activation measure for mental health pammh10 and parent patient activation measure ppam.
Patient activation measures zdeveloped by judith hibbard, jean stockard, and martin tusler at the university of oregon and eldon r. Psychometric assessment of the patient activation measure. The item patient activation measure pam is an instrument that assesses peoples knowledge, skills and confidence for selfmanagement of their health and health care. A substantial proportion of chronic disease patients do not respond to selfmanagement interventions, which suggests that one size interventions do not fit all, demanding more tailored interventions.
The results indicate that the shortened item version is both reliable and valid. In general, more items need to be added to cover the upper end of the trait. A new generic item questionnaire for measuring patient enablement german version article pdf available in international journal of environmental research and public health 1623. The patient activation measure pam is a commercial product which assesses an individuals knowledge, skill, and confidence for managing ones health and healthcare. The item patient activation measure pam 16item instru measured patient activation using the short form the patient activation measure item version available gensichen j. Data came from three studies among people with chronic mental health conditions and were combined in rasch analyses. The patient activation measure short form pam assesses patients selfreported health management skills, knowledge, confidence, and motivation. The item version of the pam was used in all four european studies. Conceptualizing and measuring activation in patients and consumers 2004. Sep 19, 2016 the patient activation measure pam measures patients knowledge, skill, and confidence in chronic condition selfmanagement. Psychometric evaluation of the german version of the patient.
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