Development And Application Of Health Empowerment Scale For Elderly With Chronic Disease

Objective The study aims to further understand the elderly chronic patient's understanding of health empowerment,and on this basis to develop the localized Health Empowerment Scale for Elderly with Chronic Disease,so as to assess the level of health empowerment of elderly with chronic diseases in our country and to explore the influencing factors,thus to make the elderly get better experience about their disease and to improve their life quality.Methods 1.Through the literature research to understand the present research situation of health empowerment in the domestic and foreign and its connotation in elderly patients with chronic diseases.2.Adopting the method of qualitative research,semi-structured interviews were conducted among 22 cases of the elderly with chronic diseases.Colaizzi 7 step analysis method was used to analyze the interview to further understand the concept of health empowerment in elderly with chronic in our country.3.Combining with literature review,qualitative interviews,panel discussion and expert consultation method,to formulate the initial health empowerment scale for elderly with chronic.4.Totally 350 elders with chronic disease in Wuhan were selected by convenience sampling for the pre-test to test the scale's validity and reliability and to develop the final Health Empowerment Scale for Elderly with Chronic Disease.5.A total of 450 elderly patients with chronic disease in Wuhan province were investigated with the Health Empowerment Scale in Elderly with Chronic Disease to analyze the status of health empowerment in elderly patients with chronic diseases and its influencing factors.Results 1.Six themes were emerged from the analysis of the health empowerment concept in old people with chronic disease,respectively is responsibility beliefs,support system,knowledge and skills,self-management,empowering others and self-reconstruction.Health empowerment is a process as well as a result.2.The initial scale consists of 30 items,including five dimensions namely responsibility belief,get support,knowledge acquisition,treatment participation and self-construction.1 ~ 5 points scoring method is used in the scale and the higher the score,the higher the level of health empowerment.3.The final Health Empowerment Scale for Elderly with Chronic Disease was developed,including 5 subscales and 26 items.The 5 factors explained 68.513%,including responsibility belief,get support,knowledge acquisition,treatment participation and self-construction.The Cronbach's ? coefficient was 0.927 and the split-half reliability was 0.842 for the total scale.Five subscales' Cronbach's ? coefficient were between 0.832 to 0.899,and five subscales' split-half reliability were between 0.842to0.904.The scale's Item-level CVI(I-CVI)ranged from 0.80 to 1.00,and the Scale-level CVI Universal Agreement(S-CVI/UA)=0.767,Scale-level CVI Average(S-CVI/AVE)=0.970.4.Data reveals that the situation of health empowerment of elderly patients with chronic diseases is at a moderate level(3.71±0.54 points).Multiple linear regression analysis showed that hometown,education level,medical reimbursement proportion and caregiver of the elderly were significant influencing factors of health empowerment level(P<0.05).Conclusions 1.The development of the Health Empowerment Scale in Elderly with Chronic Disease is based on the literature review,the qualitative interview and the expert consultation.The development process of the scale is rigorous and its reliability and validity are good,which can provide a reference for assessing the health empowerment status of the elderly with chronic diseases.2.The level of health empowerment of elderly patients with chronic diseases is affected by variety of factors,we should take measures to promote the elderly to build the faith of health responsibility,to take advantage of resource,to acquire knowledge through various ways,to participate in treatment actively and to achieve self-reconstruction,so as to improve their health empowerment status.3.In future studies,we can expand the survey area,increase the sample size,select different hospitals and nursing homes in order to analyze the health empowerment status of the elderly in different areas more objectively.