Revise And Application Of Client Empowerment Scale In Hospitalized Patients With Chronic Diseases

Client Empowerment is a form of health care for the purpose of cooperation between patients with medical care and patient self-care thinking to improve the health outcomes and quality of life of patients with chronic diseases in the field of health care.Empowerment is a contributing factor to health.Studies have shown that patient empowerment can enhance patient confidence in disease management,decision-making ability and health responsibility.Effective management of chronic disease needs to consider the patient's own life experience,as well as the patient's health empowerment.Therefore,it is very important to evaluate the level of empowerment of patients with chronic diseases.MIKKY developed client empowerment scale(CES)in 2006 for the evaluation of empowerment level of patients with chronic disease.The scale can predict the ability of self-management,evaluation effectiveness of empowerment program and have good reliability and validity.But,there is no effective validity and reliability research,and the application report about the client empowerment scale.ObjectiveEvaluate the validity and reliability of the Client Empowerment Scale(CES)and form the suitable patient empowerment scale for Chinese culture.Then,use the scale to survey hospitalized patients with chronic diseases,so as to understand their empowerment level.Examine relationship between demographic variables and empowerment level.Also,factors which may influencing empowerment were investigated,for the next step to lay the foundation for the implementation of empowerment projectsMethods1.After the authorization of the original scale,the Chinese version of the patient empowerment scale was initially formed through the process of translation,back translation,cultural adjustment and prediction.Then the content validity,exploratory factor analysis,internal consistency and test-retest reliability were used to evaluate the scale.2.By convenient sampling,300 hospitalized patients with chronic diseases are surveied by 2 measurement tools:a demographic survey and Chinese version of CES,to analyze the current situation of the influencing factors of hospitalized patients with chronic disease.Results1.There are 44 items in the Chinese version of CES,content validity of each item(I-CVI)was 0.83-1.0,K*of each item was 0.81-1.0,content validity S-CVI/UA of scale was 0.91,S-CVI/Ave was 0.98.Factor analysis yielded 6 factors,the cumulative variance contribution rate was 54.91%.The scale of Cronbach s' alpha coefficient is 0.947,the dimensions of Cronbach s' alpha coefficient is 0.698?0.899.The test-retest reliability of the scale was 0.991,and the test-retest reliability of each dimension was from 0.775 to 0.985.2.Useing the Chinese version of CES to investigate the empowerment level for hospitalized chronic patients,with mean score of all CES item being 128.90(SD= 16.40).Chinese version of patient empowerment scale score difference by single factor analysis and comparison,the results show that the different age,education level,monthly income,disease duration,participate in health education of patients in different weights on the total score was statistically significant.The difference between the total score and the scores of different age groups was statistically significant(F=53.217,P<0.05).There were significant differences in the total score and the scores of the patients with different monthly income(F=73.422,P<0.05).The scores of patients with different education levels in the total score and the scores of each dimension were statistically significant(F=119.458,P<0.05).Patients with different duration of illness in the weighted total score and the scores of each dimension difference was statistically significant(F=17.471,P<0.05),patients with short duration of disease empowerment score high.There were significant differences in the scores and scores of each dimension between the patients who participated in health education and those who were not or did not participate in the uncertainty(F=204.089,P<0.05).3.Factors that would affect the empowerment level were identified.The factors were shown as follows:age,education,income,illness time,health education.And it indicated that empowerment level has been affected by those factors,ranked in the order as age,health education,education and income by multiple liner regression analysis.Conclusions1.The Chinese version of CES has a good validity and reliability.the 6 dimensions comprehensively including the basic elements of empowerment,which can provide an effective assessment tool for patients with chronic disease self management ability level of empowerment,and evaluation the effectiveness of patient empowerment program.2.It is necessary for us to carry out effective empowerment projects,because of the high incidence of chronic diseases and the low level of empowerment.In the process of empowerment,medical personnel should pay attention to the role of the patients in the disease process,combined with the patient's personality,ability,interest,knowledge,values and beliefs,timely and appropriate to inspire their initiative and potential,to provide effective external support for patients,and improve the disease control ability so as to enhance confidence and self-management of disease.