Adaptation Of The Chinese Version Of The Patient Activation Measure 13 And The Study In The Patients With Chronic Heart Failure

Objective:To revise the Taiwan version of the Patient Activation Measure 13(PAM13)and validate it's reliability and validity in local patients with chronic heart failure so as to develop the China Mainland version of the PAM13,Moreover,this study aims to measure the activation level of the patients with chronic heart failure and its influencing factors in order to develop the strategies which can improve the level of patient activation.Methods:By using the method of convenient sampling,200 inpatients with chronic heart failure,who were from two Grade A Class Three hospitals located in Jinan,Shandong Province between September,2016 and January,2017,were involved in this study and responded to the PAM 13.The data were obtained from the revised PAM 13 and the self-designed questionnaire.Then we testify the reliability and validity of the PAM13,evaluate the level of patient activation and analysize the risk factors influncing the patient activation using the SPSS 17.0.To assess the reliability of the revised PAM13,Cronbach's alpha coefficient and the retest reliability were applied.The content validity index(CVI),confirmatory factor analysis and exploratory factor analysis were used to evaluate the validity of the revised PAM13.The activation level of patients with chronic heart failure was analyzed by descriptive statistics and the influencing factors were analyzed by Logistic regression analysis.Results:1.The results of the correlation analysis and the decision value analysis showed that the correlation of items and module were significant(P<0.01).The item-module corre-lation coefficients were more than 0.4 except the item2's(0.25)and the CR value of all 13 items were more than 3.0(P<0.01).The Cronbach's a coefficient was 0.82,and the re-test validity was 0.70 which showed the good reliability of the Chinese Mainland version of PAM13.The total CVI of validity test was 0.87;the structural validity exploratory factor analysis extracted 4 characteristic roots number larger than 1 which explained the 58.20%of the total variation.The module structure of the Chinese version of PAM 13 was basically the same as the original structure.The confirmatory factor analysis showed that every goodness of fix index was perfect,which suggested the good construct validity of the China Mainland version of the PAM13.2.In the 200 inpatients with chronic heart failure,the minimum score of the activation level was 36.76 while the maximum score was 100,which illustrated the great individual difference of patient activation levels among different patients with chronic heart failure;the average score was 56.58 which located at the third level.3.The variance analysis of the patients' general data showed the significant difference based on the different degree of education,main caregivers,degree of cardiac function(NYHA)and whether they had received the health education and whether they had got self-management knowledge actively(P<0.05).4.The Logistic regression analysis showed that the degree of education,family economic status,severity of the illness,support from the family of the patients with chronic heart failure and whether they had received the health education were all the main influencing factors to the patients' activation.Conclusions:1.This study indicated that the revised Chinese version of PAM13 is reliable and valid which can be used as a good tool to evaluate the activation of patients with chronic heart failure.2.The activation of patients with chronic heart failure locates at the third level and has great individual difference.The activation was different greatly between different education degree,main caregivers,the classification of New York Heart function(NYHA)and whether they have received the health education and whether they have got self-management knowledge actively.3.The chronic heart failure patients' activation is highly related to the degree of education,family economic status,severity of the illness,support from the family and whether they have received the health education.We should develop the individual strategies for every patient which include formulating the management objectives and the intervention measure matching to the activation level according to the patient activation level.