Measuring patient activation in Italy: Translation, adaptation and validation of the Italian version of the patient activation measure 13 (PAM13-I)

BMC Medical Informatics and Decision Making

Research Article

Judith Hibbard¹  Guendalina Graffigna²  Edoardo Lozza²  Serena Barello³  Andrea Bonanomi⁴ 

[1] Department of Planning, Public Policy, and Management, University of Oregon, Eugene, USA;Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy;Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy;Faculty of Psychology, Università Cattolica del Sacro Cuore, L.go Gemelli 1, 20123, Milan, Italy;Department of Statistical Sciences, Università Cattolica del Sacro Cuore, Milan, Italy;

关键词: Differential Item Functioning;    Item Difficulty;    Italian Version;    Partial Credit Model;    Person Parameter;   

DOI  :  10.1186/s12911-015-0232-9

 received in 2015-03-24, accepted in 2015-12-15,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundThe Patient Activation Measure (PAM13) is an instrument that assesses patient knowledge, skills, and confidence for disease self-management. This cross-sectional study was aimed to validate a culturally-adapted Italian Patient Activation Measure (PAM13-I) for patients with chronic conditions.Methods519 chronic patients were involved in the Italian validation study and responded to PAM13-I. The PAM 13 was translated into Italian by a standardized forward-backward translation. Data quality was assessed by mean, median, item response, missing values, floor and ceiling effects, internal consistency (Cronbach's alpha and average inter-item correlation), item-rest correlations. Rasch Model and differential item functioning assessed scale properties.ResultsMean PAM13-I score was 66.2. Rasch analysis showed that the PAM13-I is a good measure of patient activation. The level of internal consistency was good (α = 0.88). For all items, the distribution of answers was left-skewed, with a small floor effect (range 1.7–4.5 %) and a moderate ceiling effect (range 27.6–55.0 %). The Italian version formed a unidimensional, probabilistic Guttman-like scale explaining 41 % of the variance.ConclusionThe PAM13-I has been demonstrated to be a valid and reliable measure of patient activation and the present study suggests its applicability to the Italian-speaking chronic patient population. The measure has good psychometric properties and appears to be consistent with the developmental nature of the patient activation phenomenon, although it presents a different ranking order of the items comparing to the American version.PAM13-I can be a useful assessment tool to evaluate interventions aimed at improving patient engagement in healthcare and to train doctors in attuning their communication to the level of patients’ activation. Future research could be conducted to further confirm the validity of the PAM13-I.

【 授权许可】

CC BY   
© Graffigna et al. 2015