1
|
Gotowiec S, Bennett RJ, Larsson J, Ferguson M. Development of a self-report measure of empowerment along the hearing health journey: a content evaluation study. Int J Audiol 2024; 63:275-285. [PMID: 36794384 DOI: 10.1080/14992027.2023.2174456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 12/17/2022] [Accepted: 01/18/2023] [Indexed: 02/17/2023]
Abstract
OBJECTIVE To conduct the first phases in the development of a self-report measure of empowerment on the hearing health journey, specifically, item generation and content evaluation of the initial pool of items generated. DESIGN A content expert panel survey and cognitive interviews were conducted. Descriptive statistics were obtained for the quantitative data, and the cognitive interviews were analysed using thematic analysis. STUDY SAMPLE Eleven researchers and clinicians participated in the content expert surveys. Sixteen experienced hearing aid users participated in the cognitive interviews, recruited from the USA and Australia. RESULTS The items underwent five iterations based on feedback from the survey and interview data. This resulted in a set of 33 quality-tested potential survey items that were rated highly for relevance (mean = 3.96), clarity (mean = 3.70) and fit to dimensions of empowerment (mean = 3.92) (scale 0-4, where 4 was the maximum rating). CONCLUSIONS Involving stakeholders in item generation and content evaluation increased relevance, clarity, fit to dimension, comprehensiveness, and acceptability of the items. This preliminary version of the 33-item measure underwent further psychometric refinement (Rasch analysis and traditional classical test theory testing) to validate it for clinical and research use (reported separately).
Collapse
Affiliation(s)
| | - Rebecca J Bennett
- Ear Science Institute Australia, Perth, Australia
- School of Medicine, The University of Western Australia, Perth, Australia
| | | | - Melanie Ferguson
- Ear Science Institute Australia, Perth, Australia
- School of Allied Health, Curtin University, Perth, Australia
| |
Collapse
|
2
|
Bahrami MA, Tabari S, Tahmasebi S, Zangouri V, Ravangard R. Strategies to Promote Empowerment Status of Breast Cancer Women. Int J Breast Cancer 2024; 2024:3305399. [PMID: 38348180 PMCID: PMC10861285 DOI: 10.1155/2024/3305399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/01/2024] [Accepted: 01/25/2024] [Indexed: 02/15/2024] Open
Abstract
Background As the second leading cause of death in women in the world, breast cancer has several physical and psychological effects. Nowadays, nonclinical approaches such as patient empowerment have been considered by physicians along with clinical care. Given the increasing number of breast cancer women worldwide, promoting the empowerment of these patients is one of the key factors affecting their survival and quality of life. Therefore, because of no comprehensive research on the empowerment needs and related improvement strategies, this study is aimed at determining the empowerment status of breast cancer patients referred to the Shahid Motahari Breast Cancer Clinic in Iran, Shiraz, and at providing strategies to improve their empowerment in 2021. Methods This applied study was conducted in two phases. In the quantitative phase, 310 Cancer-Related Patient Empowerment Scale questionnaires (Persian format) were distributed among the studied patients selected through the random sampling method in the clinic, and the items with "unacceptable status" became the basis for determining the empowerment strategies through the scoping review and semistructured interviews with 22 medical staff and patients through the thematic analysis. The collected data were analyzed using the SPSS 20.0 and MAXQDA10 software. Results The mean score of the participants' empowerment strategies was 3.58. The results showed that trust in the physician, family support, and spiritual beliefs could affect the empowerment of the studied patients. Moreover, the participants needed empowerment strategies in 11 scale items with unacceptable status, for which 46 strategies were determined in the scoping review and interview phase. Conclusion The results of this study provided useful strategies for empowering breast cancer patients, the most important of which were classified into five categories of financial support, informational support, interaction with the physician, occupational support, and complementary therapies, the use of which by the stakeholders could help to improve the patients' quality of life while improving their empowerment.
Collapse
Affiliation(s)
- Mohammad Amin Bahrami
- Health Human Resources Research Center, Department of Health Services Management, School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahrzad Tabari
- Student Research Committee, Department of Health Services Management, School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sedigheh Tahmasebi
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Vahid Zangouri
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ramin Ravangard
- Health Human Resources Research Center, Department of Health Services Management, School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
3
|
Peiffer S, Mehl SC, Powell P, Haltom TM, Lee TC, Keswani SG, King A. Maternal Anxiety and Empowerment in Pregnancies Complicated By Fetal Surgical Anomalies: A Mixed Methods Study. J Surg Res 2023; 292:22-29. [PMID: 37572410 DOI: 10.1016/j.jss.2023.07.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 07/05/2023] [Accepted: 07/10/2023] [Indexed: 08/14/2023]
Abstract
INTRODUCTION Fetal surgical anomalies cause significant anxiety. Following the diagnosis, prenatal counseling with shared decision-making occurs. Empowerment is an essential component of shared decision-making. The purpose of this mixed-methods study was to evaluate the association between patient empowerment with depression and anxiety among patients with fetal surgical anomalies. METHODS An explanatory mixed-methods study was conducted at a large tertiary fetal center among patients with recently diagnosed surgical fetal anomalies from May, 2021 to May, 2022. Validated cross-sectional surveys were used to collect quantitative data regarding patient empowerment, depression, and anxiety. Univariate analysis was used to compare the association of maternal empowerment with depression and anxiety. Qualitative data was obtained from semistructured interviews to explore maternal anxiety and depression relative to the fetal diagnosis. Thematic analysis was performed to identify themes. RESULTS Seventy-four patients were recruited for the quantitative study. Pregnancy-related empowerment score and patient empowerment score were significantly lower for expectant mothers with high anxiety (P < 0.01). Eighteen patients participated in qualitative interviews. Participants expressed significant anxiety related to their fetal diagnosis. Exacerbating stressors included social determinants, personal history of miscarriage, and changing family dynamics. CONCLUSION Our results suggest there is an association between increased depression and anxiety with lower empowerment. These findings have important implications for prenatal counseling, as targeted interventions to improve psychosocial support to treat depression and anxiety might also improve empowerment.
Collapse
Affiliation(s)
- Sarah Peiffer
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas; Division of Pediatric Surgery, Department of Surgery, Texas Children's Hospital, Houston, Texas
| | - Steven C Mehl
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas; Division of Pediatric Surgery, Department of Surgery, Texas Children's Hospital, Houston, Texas
| | - Paulina Powell
- Division of Pediatric Surgery, Department of Surgery, Texas Children's Hospital, Houston, Texas
| | - Trenton M Haltom
- Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Baylor College of Medicine, Houston, Texas
| | - Timothy C Lee
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas; Division of Pediatric Surgery, Department of Surgery, Texas Children's Hospital, Houston, Texas
| | - Sundeep G Keswani
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas; Division of Pediatric Surgery, Department of Surgery, Texas Children's Hospital, Houston, Texas
| | - Alice King
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas; Division of Pediatric Surgery, Department of Surgery, Texas Children's Hospital, Houston, Texas.
| |
Collapse
|
4
|
Mehl SC, Peiffer S, Powell P, Belfort MA, Lee TC, Keswani SG, King A. Association of socioeconomic status with empowerment, depression, and anxiety in pregnancies complicated by fetal surgical anomalies. J Pediatr Surg 2023; 58:1111-1115. [PMID: 36918324 DOI: 10.1016/j.jpedsurg.2023.02.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 02/10/2023] [Indexed: 02/19/2023]
Abstract
BACKGROUND Women with pregnancies complicated by fetal surgical anomalies experience significant psychosocial burden. There remains a need to determine the impact that socioeconomic status has on maternal empowerment, anxiety, and depression. METHODS A survey study was conducted from 5/2021-5/2022 to quantify empowerment, anxiety, and depression in women with fetal surgical anomalies. Surveys administered included Pregnancy Related Empowerment Scale (PRES), Patient Empowerment Scale (PES), State Trait Anxiety Inventory (STAI), and Depression Anxiety and Stress Scale (DASS). Two-sample t-test was used to compare survey scores across socioeconomic groups. RESULTS Seventy-four patients were recruited. Mothers more commonly preferred English as primary language (n = 61, 82%) and were non-Hispanic (n = 43, 58%). Lower empowerment scores were observed in Hispanic mothers (PRES, p = 0.03; PES, p = 0.04) and mothers who preferred Spanish (PRES, p = 0.04; PES, p = 0.06) as primary language. Both non-Hispanic (p = 0.88) and English speaking (p = 0.75) women had higher STAI scores, but neither was significantly different. DASS was not significantly higher for Hispanic (p = 0.79) or Spanish speaking mothers (p = 0.47). CONCLUSION Hispanic and Spanish speaking women with pregnancies complicated by fetal surgical anomalies have significantly decreased empowerment scores. These findings suggest a need for development of culturally competent, targeted interventions to improve maternal empowerment in this high-risk population. LEVEL OF EVIDENCE Level II. TYPE OF STUDY Cross-Sectional Survey Study.
Collapse
Affiliation(s)
- Steven C Mehl
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA; Department of Surgery, Division of Pediatric Surgery, Texas Children's Hospital, Houston, TX, USA
| | - Sarah Peiffer
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA; Department of Surgery, Division of Pediatric Surgery, Texas Children's Hospital, Houston, TX, USA
| | - Paulina Powell
- Department of Surgery, Division of Pediatric Surgery, Texas Children's Hospital, Houston, TX, USA
| | - Michael A Belfort
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Texas Children's Hospital, Houston, TX, USA
| | - Timothy C Lee
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA; Department of Surgery, Division of Pediatric Surgery, Texas Children's Hospital, Houston, TX, USA
| | - Sundeep G Keswani
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA; Department of Surgery, Division of Pediatric Surgery, Texas Children's Hospital, Houston, TX, USA
| | - Alice King
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA; Department of Surgery, Division of Pediatric Surgery, Texas Children's Hospital, Houston, TX, USA.
| |
Collapse
|
5
|
Al-Mondhiry J, D'Ambruoso S, Pietras C, Strouse T, Benzeevi D, Arevian AC, Wells KB. Co-created Mobile Apps for Palliative Care Using Community-Partnered Participatory Research: Development and Usability Study. JMIR Form Res 2022; 6:e33849. [PMID: 35737441 PMCID: PMC9264134 DOI: 10.2196/33849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 01/28/2022] [Accepted: 05/06/2022] [Indexed: 11/22/2022] Open
Abstract
Background Open design formats for mobile apps help clinicians and stakeholders bring their needs to direct, co-creative solutions. Palliative care for patients with advanced cancers requires intensive monitoring and support and remains an area in high need for innovation. Objective This study aims to use community-partnered participatory research to co-design and pretest a mobile app that focuses on palliative care priorities of clinicians and patients with advanced cancer. Methods In-person and teleconference workshops were held with patient and family stakeholders, researchers, and clinicians in palliative care and oncology. Question prompts, written feedback, semistructured interviews, and facilitated group discussions identified the core palliative care needs. Using Chorus, a no-code app-building platform, a mobile app was co-designed with the stakeholders. A pretest with 11 patients was conducted, with semistructured interviews of clinician and patient users for feedback. Results Key themes identified from the focus groups included needs for patient advocacy and encouragement, access to vetted information, patient-clinician communication support, and symptom management. The initial prototype, My Wellness App, contained a weekly wellness journal to track patient-reported symptoms, goals, and medication use; information on self-management of symptoms; community resources; and patient and caregiver testimonial videos. Initial pretesting identified value in app-based communication for clinicians, patients, and caregivers, with suggestions for improving user interface, feedback and presentation of symptom reports, and gamification and staff coordinators to support patient app engagement. Conclusions The development of a mobile app using community-partnered participatory research is a low-technology and feasible intervention for palliative care. Iterative redesign and user interface expertise may improve implementation.
Collapse
Affiliation(s)
- Jafar Al-Mondhiry
- Division of Medical Oncology, Department of Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA, United States
| | - Sarah D'Ambruoso
- Division of Hematology & Oncology, Department of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Christopher Pietras
- Palliative Care Program, Department of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Thomas Strouse
- Department of Psychiatry and Biobehavioral Sciences, UCLA Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | - Dikla Benzeevi
- UCLA Clinical and Translational Science Institute, Los Angeles, CA, United States
| | | | - Kenneth B Wells
- Department of Psychiatry and Biobehavioral Sciences, UCLA Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| |
Collapse
|
6
|
Wu VX, Dong Y, Tan PC, Gan P, Zhang D, Chi Y, Chao FFT, Lu J, Teo BHD, Tan YQ. Development of a Community-Based e-Health Program for Older Adults With Chronic Diseases: Pilot Pre-Post Study. JMIR Aging 2022; 5:e33118. [PMID: 35037882 PMCID: PMC8804958 DOI: 10.2196/33118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 11/16/2021] [Accepted: 12/01/2021] [Indexed: 02/06/2023] Open
Abstract
Background Chronic diseases may impact older adults’ health outcomes, health care costs, and quality of life. Self-management is expected to encourage individuals to make autonomous decisions, adhere to treatment plans, deal with emotional and social consequences, and provide choices for healthy lifestyle. New eHealth solutions significantly increase the health literacy and empower patients in self-management of chronic conditions. Objective This study aims to develop a Community-Based e-Health Program (CeHP) for older adults with chronic diseases and conduct a pilot evaluation. Methods A pilot study with a 2-group pre- and posttest repeated measures design was adopted. Community-dwelling older adults with chronic diseases were recruited from senior activity centers in Singapore. A systematic 3-step process of developing CeHP was coupled with a smart-device application. The development of the CeHP intervention consists of theoretical framework, client-centric participatory action research process, content validity assessment, and pilot testing. Self-reported survey questionnaires and health outcomes were measured before and after the CeHP. The instruments used were the Self-care of Chronic Illness Inventory (SCCII), Healthy Aging Instrument (HAI), Short-Form Health Literacy Scale, 12 Items (HLS-SF 12), Patient Empowerment Scale (PES), and Social Support Questionnaire, 6 items. The following health outcomes were measured: Montreal Cognitive Assessment, Symbol Digit Modalities Test, total cholesterol (TC), high-density lipoproteins, low-density lipoproteins/very-low-density lipoproteins (LDL/VLDL), fasting glucose, glycated hemoglobin (HbA1c), and BMI. Results The CeHP consists of health education, monitoring, and an advisory system for older adults to manage their chronic conditions. It is an 8-week intensive program, including face-to-face and eHealth (Care4Senior App) sessions. Care4Senior App covers health education topics focusing on the management of hypertension, hyperlipidemia, and diabetes, brain health, healthy diet, lifestyle modification, medication adherence, exercise, and mindfulness practice. Content validity assessment indicated that the content of the CeHP is valid, with a content validity index (CVI) ranging 0.86-1 and a scale-CVI of 1. Eight participants in the CeHP group and 4 in the control group completed both baseline and post intervention assessments. Participants in the CeHP group showed improvements in fasting glucose, HbA1c, TC, LDL/VLDL, BMI, SCCII indices (Maintenance, Monitoring, and Management), HAI, and PES scores post intervention, although these changes were not significant. For the participants in the control group, the scores for SCCII (management and confidence) and HLS-SF 12 decreased post intervention. Conclusions The CeHP is feasible, and it engages and empowers community-dwelling older adults to manage their chronic conditions. The rigorous process of program development and pilot evaluation provided valid evidence to expand the CeHP to a larger-scale implementation to encourage self-management, reduce debilitating complications of poorly controlled chronic diseases, promote healthy longevity and social support, and reduce health care costs.
Collapse
Affiliation(s)
- Vivien Xi Wu
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yanhong Dong
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | | | - Peiying Gan
- Sengkang General Hospital, Singapore, Singapore
| | - Di Zhang
- Sengkang General Hospital, Singapore, Singapore
| | - Yuchen Chi
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Felicia Fang Ting Chao
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jinhua Lu
- Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Immunology Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Boon Heng Dennis Teo
- Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yue Qian Tan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| |
Collapse
|
7
|
Ziegler E, Hill J, Lieske B, Klein J, dem OV, Kofahl C. Empowerment in cancer patients: Does peer support make a difference? A systematic review. Psychooncology 2022; 31:683-704. [PMID: 34981594 DOI: 10.1002/pon.5869] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 12/16/2021] [Accepted: 12/20/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Empowerment is critical for cancer patients to make informed choices, to manage medication, and to navigate through the oncological care system. Cancer peer support provides patients with information, emotional relief and may promote empowerment. This paper provides a systematic review of the literature examining the impact of cancer peer support interventions on psychological empowerment. METHODS PubMed, Web of Science, CINAHL, Cochrane Library, PsycINFO and PSYNDEX databases were systematically searched from inception until December 2020. We included quantitative studies, published in English or German, which examined peer-led cancer support interventions and their impact on the three components of psychological empowerment (intrapersonal, interactional and behavioural) among participating cancer patients. RESULTS Database searches and screening of relevant reference lists identified 2336 potentially relevant articles. A total of 29 studies were included in the review. Active coping, self-efficacy and knowledge were the most prominent dimensions of empowerment in these studies. The majority of studies revealed that peer support led to a small to medium, significant increase in psychological empowerment, and was associated with further patient-reported benefits. CONCLUSIONS The existing evidence suggests a weak to moderate, positive association between cancer peer support and the three components of psychological empowerment among cancer patients. Peer support groups should be seen as an important element in cancer care and clinical practice and, thus, be more systematically involved in cancer care.
Collapse
Affiliation(s)
- Elâ Ziegler
- Center for Psychosocial Medicine, Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Josephine Hill
- Center for Psychosocial Medicine, Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Berit Lieske
- Center for Psychosocial Medicine, Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jens Klein
- Center for Psychosocial Medicine, Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Olaf von dem
- Center for Psychosocial Medicine, Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christopher Kofahl
- Center for Psychosocial Medicine, Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
8
|
Bicego A, Monseur J, Collinet A, Donneau AF, Fontaine R, Libbrecht D, Malaise N, Nyssen AS, Raaf M, Rousseaux F, Salamun I, Staquet C, Teuwis S, Tomasella M, Faymonville ME, Vanhaudenhuyse A. Complementary treatment comparison for chronic pain management: A randomized longitudinal study. PLoS One 2021; 16:e0256001. [PMID: 34358272 PMCID: PMC8345881 DOI: 10.1371/journal.pone.0256001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/24/2021] [Indexed: 11/18/2022] Open
Abstract
Background In chronic pain, it seems that the effect of cognitive-behavioral therapy (CBT) is boosted when it is combined with hypnosis. The aim of this study was to assess the efficacy of self-hypnosis combined with self-care (i.e., a type of CBT) compared to music/self-care, self-care and psychoeducation/CBT and to evaluate their long-term effects. Methods An open label randomized clinical trial enrolled patients with chronic pain and was carried out at the University Hospital of Liège (Belgium). Patients were randomized into four groups: self-hypnosis/self-care, music/self-care, self-care, psychoeducation/CBT (7 monthly sessions of 2 hours). Two follow-up sessions were delivered at 6- and 12-month. Levels of pain, fatigue intensity, anxiety, depression, insomnia severity, disability, health locus of control, mental and physical quality of life and attitudes (control, disability, harm, emotion, medical cure, medication, solicitude) towards pain were assessed before and after the treatments, and at follow-up. Results 203 patients were randomized: 52 in self-hypnosis/self-care, 59 in music/self-care, 47 in self-care, and 45 in psychoeducation/CBT. No group effect was found. A significant time effect was showed. Directly after the treatment, all groups decreased in pain attitudes and physical quality of life. Perceived control increased. At 6-month, all patients kept their levels of physical quality of life and perceived control, and showed decrease in pain intensity, harm, emotion and medical cure. At 12-month, scores that had change previously remained ameliorated, a decrease in insomnia severity and an increase in internal locus of control were observed. Conclusions The present findings are encouraging as they display long-term beneficial effects of complementary biopsychosocial-based treatments in chronic pain. It seems that patients continued to apply the learnt strategies as improvements were observed one year after the treatments had ended.
Collapse
Affiliation(s)
- Aminata Bicego
- Sensation and Perception Research Group, GIGA Consciousness, University of Liège, Liège, Belgium
- Cognitive Ergonomy and Work Intervention Department, University of Liège, Liège, Belgium
- * E-mail: (AB); (AV)
| | - Justine Monseur
- Public Health Department, Biostatistics, University of Liège, Liège, Belgium
| | | | | | - Robert Fontaine
- Interdisciplinary Algology Department, Hospital University of Liège, Liège, Belgium
| | - Dominique Libbrecht
- Interdisciplinary Algology Department, Hospital University of Liège, Liège, Belgium
| | - Nicole Malaise
- Interdisciplinary Algology Department, Hospital University of Liège, Liège, Belgium
| | - Anne-Sophie Nyssen
- Sensation and Perception Research Group, GIGA Consciousness, University of Liège, Liège, Belgium
- Cognitive Ergonomy and Work Intervention Department, University of Liège, Liège, Belgium
| | - Mélissa Raaf
- Interdisciplinary Algology Department, Hospital University of Liège, Liège, Belgium
| | - Floriane Rousseaux
- Sensation and Perception Research Group, GIGA Consciousness, University of Liège, Liège, Belgium
- Cognitive Ergonomy and Work Intervention Department, University of Liège, Liège, Belgium
| | - Irène Salamun
- Interdisciplinary Algology Department, Hospital University of Liège, Liège, Belgium
| | - Cécile Staquet
- Interdisciplinary Algology Department, Hospital University of Liège, Liège, Belgium
| | - Sandrine Teuwis
- Interdisciplinary Algology Department, Hospital University of Liège, Liège, Belgium
| | - Marco Tomasella
- Interdisciplinary Algology Department, Hospital University of Liège, Liège, Belgium
| | - Marie-Elisabeth Faymonville
- Sensation and Perception Research Group, GIGA Consciousness, University of Liège, Liège, Belgium
- Interdisciplinary Algology Department, Hospital University of Liège, Liège, Belgium
| | - Audrey Vanhaudenhuyse
- Sensation and Perception Research Group, GIGA Consciousness, University of Liège, Liège, Belgium
- Interdisciplinary Algology Department, Hospital University of Liège, Liège, Belgium
- * E-mail: (AB); (AV)
| |
Collapse
|
9
|
Pomey M, Clavel N, Normandin L, Del Grande C, Philip Ghadiri D, Fernandez‐McAuley I, Boivin A, Flora L, Janvier A, Karazivan P, Pelletier J, Fernandez N, Paquette J, Dumez V. Assessing and promoting partnership between patients and health-care professionals: Co-construction of the CADICEE tool for patients and their relatives. Health Expect 2021; 24:1230-1241. [PMID: 33949739 PMCID: PMC8369086 DOI: 10.1111/hex.13253] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 02/25/2021] [Accepted: 03/22/2021] [Indexed: 12/01/2022] Open
Abstract
CONTEXT Partnership between patients and health-care professionals (HCPs) is a concept that needs a valid, practical measure to facilitate its use by patients and HCPs. OBJECTIVE To co-construct a tool for measuring the degree of partnership between patients and HCPs. DESIGN The CADICEE tool was developed in four steps: (1) generate key dimensions of patient partnership in clinical care; (2) co-construct the tool; (3) assess face and content validity from patients' and HCPs' viewpoints; and (4) assess the usability of the tool and explore its measurement performance. RESULTS The CADICEE tool comprises 24 items under 7 dimensions: 1) relationship of Confidence or trust between the patient and the HCPs; 2) patient Autonomy; 3) patient participation in Decisions related to care; 4) shared Information on patient health status or care; 5) patient personal Context; 6) Empathy; and 7) recognition of Expertise. Assessment of the tool's usability and measurement performance showed, in a convenience sample of 246 patients and relatives, high face validity, acceptability and relevance for both patients and HCPs, as well as good construct validity. CONCLUSIONS The CADICEE tool is developed in co-construction with patients to evaluate the degree of partnership in care desired by patients in their relationship with HCPs. The tool can be used in various clinical contexts and in different health-care settings. PATIENT OR PUBLIC CONTRIBUTION Patients were involved in determining the importance of constructing this questionnaire. They co-constructed it, pre-tested it and were part of the entire questionnaire development process. Three patients participated in the writing of the article.
Collapse
Affiliation(s)
- Marie‐Pascale Pomey
- School of Public HealthUniversity of MontrealMontrealQCCanada
- Centre de recherche du Centre Hospitalier de l’Université de MontréalMontrealQCCanada
- Centre of Excellence on Partnership with Patients and the PublicMontrealQCCanada
| | | | - Louise Normandin
- Centre de recherche du Centre Hospitalier de l’Université de MontréalMontrealQCCanada
| | - Claudio Del Grande
- School of Public HealthUniversity of MontrealMontrealQCCanada
- Centre de recherche du Centre Hospitalier de l’Université de MontréalMontrealQCCanada
| | | | | | - Antoine Boivin
- Department of Family MedicineUniversity of MontrealMontrealQCCanada
| | - Luigi Flora
- Faculté de MédecineUniversité Nice Sophia AntipolisNiceFrance
| | - Annie Janvier
- Department of PediatricsUniversity of MontrealMontrealQCCanada
| | - Philippe Karazivan
- Centre of Excellence on Partnership with Patients and the PublicMontrealQCCanada
- Department of ManagementHEC MontréalMontrealQCCanada
| | | | - Nicolas Fernandez
- Department of EducationUniversité du Québec à MontréalMontrealQCCanada
| | - Jesseca Paquette
- Centre de recherche du Centre Hospitalier de l’Université de MontréalMontrealQCCanada
| | - Vincent Dumez
- Centre of Excellence on Partnership with Patients and the PublicMontrealQCCanada
- Faculty of MedicineUniversity of MontrealMontrealQCCanada
| |
Collapse
|
10
|
Gotowiec S, Larsson J, Incerti P, Young T, Smeds K, Wolters F, Herrlin P, Ferguson M. Understanding patient empowerment along the hearing health journey. Int J Audiol 2021; 61:148-158. [PMID: 34032531 DOI: 10.1080/14992027.2021.1915509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Related to the hearing health journey, this study aimed to: (i) explore how empowerment manifests itself from individuals' first awareness of hearing loss through to hearing aid fitting and then to becoming an active hearing aid user, (ii) identify points when the different dimensions of empowerment are most relevant, and (iii) conceptualise empowerment. DESIGN A semi-structured interview study was conducted, followed by a template analysis of the data. STUDY SAMPLE Adult hearing aid users from Sweden (n = 8) and Australia (n = 10) who had worn hearing aids for between 6 and 36 months. RESULTS The themes that emerged from the transcripts were knowledge, skills and strategies, participation, self-efficacy, and control. CONCLUSIONS This study conceptualises empowerment along the hearing health journey as the process through which individuals with hearing-related challenges acquire and use knowledge, skills, and strategies, and increase self-efficacy, participation, and the feeling of control of their hearing health care, hearing solutions, and everyday lives. There are not specific points along the hearing health journey where any dimension is uniquely relevant, instead, each dimension is a dynamic component at all stages.
Collapse
Affiliation(s)
| | | | | | - Taegan Young
- National Acoustic Laboratories, Sydney, Australia
| | | | | | | | | |
Collapse
|
11
|
Neves AL, Freise L, Laranjo L, Carter AW, Darzi A, Mayer E. Impact of providing patients access to electronic health records on quality and safety of care: a systematic review and meta-analysis. BMJ Qual Saf 2020; 29:1019-1032. [PMID: 32532814 PMCID: PMC7785164 DOI: 10.1136/bmjqs-2019-010581] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 05/12/2020] [Accepted: 05/20/2020] [Indexed: 02/02/2023]
Abstract
Objective To evaluate the impact of sharing electronic health records (EHRs) with patients and map it across six domains of quality of care (ie, patient-centredness, effectiveness, efficiency, timeliness, equity and safety). Design Systematic review and meta-analysis. Data sources CINAHL, Cochrane, Embase, HMIC, Medline/PubMed and PsycINFO, from 1997 to 2017. Eligibility criteria Randomised trials focusing on adult subjects, testing an intervention consisting of sharing EHRs with patients, and with an outcome in one of the six domains of quality of care. Data analysis The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Title and abstract screening were performed by two pairs of investigators and assessed using the Cochrane Risk of Bias Tool. For each domain, a narrative synthesis of the results was performed, and significant differences in results between low risk and high/unclear risk of bias studies were tested (t-test, p<0.05). Continuous outcomes evaluated in four studies or more (glycated haemoglobin (HbA1c), systolic blood pressure (SBP) and diastolic blood pressure (DBP)) were pooled as weighted mean difference (WMD) using random effects meta-analysis. Sensitivity analyses were performed for low risk of bias studies, and long-term interventions only (lasting more than 12 months). Results Twenty studies were included (17 387 participants). The domain most frequently assessed was effectiveness (n=14), and the least were timeliness and equity (n=0). Inconsistent results were found for patient-centredness outcomes (ie, satisfaction, activation, self-efficacy, empowerment or health literacy), with 54.5% of the studies (n=6) demonstrating a beneficial effect. Meta-analyses showed a beneficial effect in effectiveness by reducing absolute values of HbA1c (unit: %; WMD=−0.316; 95% CI −0.540 to −0.093, p=0.005, I2=0%), which remained significant in the sensitivity analyses for low risk of bias studies (WMD= −0.405; 95% CI −0.711 to −0.099), and long-term interventions only (WMD=−0.272; 95% CI −0.482 to −0.062). A significant reduction of absolute values of SBP (unit: mm Hg) was found but lost in sensitivity analysis for studies with low risk of bias (WMD= −1.375; 95% CI −2.791 to 0.041). No significant effect was found for DBP (unit: mm Hg; WMD=−0.918; 95% CI −2.078 to 0.242, p=0.121, I2=0%). Concerning efficiency, most studies (80%, n=4) found either a reduction of healthcare usage or no change. A beneficial effect was observed in a range of safety outcomes (ie, general adherence, medication safety), but not in medication adherence. The proportion of studies reporting a beneficial effect did not differ between low risk and high/unclear risk studies, for the domains evaluated. Discussion Our analysis supports that sharing EHRs with patients is effective in reducing HbA1c levels, a major predictor of mortality in type 2 diabetes (mean decrease of −0.405, unit: %) and could improve patient safety. More studies are necessary to enhance meta-analytical power and assess the impact in other domains of care. Protocol registration http://www.crd.york.ac.uk/PROSPERO (CRD42017070092).
Collapse
Affiliation(s)
- Ana Luisa Neves
- Patient Safety Translational Research Centre, Institute of Global Health Innovation, Imperial College London, London, UK .,Center for Health Technology and Services Research / Department of Community Medicine, Health Information and Decision (CINTESIS/MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
| | - Lisa Freise
- Patient Safety Translational Research Centre, Institute of Global Health Innovation, Imperial College London, London, UK
| | - Liliana Laranjo
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Centre for Health Informatics, Australian Institute of Health Innovation, Sydney, New South Wales, Australia
| | - Alexander W Carter
- Department of Health Policy, London School of Economics & Political Science, London, UK
| | - Ara Darzi
- Patient Safety Translational Research Centre, Institute of Global Health Innovation, Imperial College London, London, UK
| | - Erik Mayer
- Patient Safety Translational Research Centre, Institute of Global Health Innovation, Imperial College London, London, UK
| |
Collapse
|
12
|
Garcimartín P, Comín-Colet J, Pardo-Cladellas Y, Badosa N, Linas A, Rosenfeld L, Faraudo M, Valero O, Hidalgo E, Cainzos-Achirica M, Ruiz S, Delgado-Hito P. Validation of the Spanish version of the questionnaire on Patient Empowerment in Long-Term Conditions. PLoS One 2020; 15:e0233338. [PMID: 32530951 PMCID: PMC7292571 DOI: 10.1371/journal.pone.0233338] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Accepted: 05/05/2020] [Indexed: 12/28/2022] Open
Abstract
Background Patient empowerment is a key factor in improving health outcomes. Objective To evaluate the psychometric properties of the Spanish version of the questionnaire on Patient Empowerment in Long-Term Conditions (PELC) that evaluates the degree of empowerment of patients with chronic diseases. Methods Three measurements were made (at baseline, 2 weeks and 12 weeks) of quality of life (QoL), self-care, self-efficacy and empowerment. Reliability was evaluated as internal consistency for the entire sample. Test-retest reproducibility was evaluated for patients who were stable from baseline to week 2 (n = 70). Validity was analysed (n = 124) as baseline correlations with QoL, self-care, self-efficacy, clinical data and psychosocial variables. Sensitivity to change was analysed in terms of effect size for patients who had improved between baseline and week 12 (n = 48). Results The study was carried out with 124 patients with a diagnosis of heart failure. Cronbach’s alpha was high, at >0.9, and the interclass correlation coefficient was low, at 0.47. PELC questionnaire scores showed differences depending on New York Heart Association functional class (p<0.05) and, as posited in the a priori hypotheses, were moderately correlated with emotional dimensions of QoL (0.53) and self-efficacy (0.43). Effect size for the clinically improved subsample was moderate (0.67). Conclusions The results suggest that the Spanish version of the PELC questionnaire has appropriate psychometric properties in terms of internal consistency and validity and is low in terms of reproducibility and sensitivity to change.
Collapse
Affiliation(s)
- Paloma Garcimartín
- Cardiology Department, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
- Biomedical Research in Heart Diseases, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Escuela Superior de Enfermería del Mar, Parc de Salut Mar, Barcelona, Spain
- * E-mail: (PG); (JCC)
| | - Josep Comín-Colet
- Biomedical Research in Heart Diseases, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Cardiology Department, Community Heart Failure Program, University Hospital Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
- IDIBELL (Bellvitge Biomedical Research Institute), Hospitalet de Llobregat, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Hospitalet de Llobregat, Barcelona, Spain
- * E-mail: (PG); (JCC)
| | - Yolanda Pardo-Cladellas
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Centre for Biomedical Research Network, Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, ISCIII, Madrid, Spain
- Department of Psychiatry and Legal Medicine, School of Medicine, Universidad Autónoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Neus Badosa
- Cardiology Department, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
- Biomedical Research in Heart Diseases, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Anna Linas
- Cardiology Department, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
- Biomedical Research in Heart Diseases, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Laia Rosenfeld
- Cardiology Department, Community Heart Failure Program, University Hospital Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Merçe Faraudo
- Cardiology Department, Heart Failure Program, Hospital de Sant Joan Despí Moisès Broggi, Sant Joan Despí, Barcelona, Spain
| | - Oliver Valero
- Statistics Service, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Encarna Hidalgo
- Cardiology Department, Community Heart Failure Program, University Hospital Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Miguel Cainzos-Achirica
- Cardiology Department, Community Heart Failure Program, University Hospital Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
- IDIBELL (Bellvitge Biomedical Research Institute), Hospitalet de Llobregat, Barcelona, Spain
- Department of Cardiology, Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins Medical Institutions, Baltimore, MD, United States of America
| | - Sonia Ruiz
- Cardiology Department, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
- Biomedical Research in Heart Diseases, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Pilar Delgado-Hito
- IDIBELL (Bellvitge Biomedical Research Institute), Hospitalet de Llobregat, Barcelona, Spain
- School of Nursing, University of Barcelona, Hospitalet de Llobregat, Barcelona, Spain
| |
Collapse
|
13
|
Eskildsen NB, Ross L, Bulsara C, Dietz SM, Thomsen TG, Groenvold M, Pedersen SS, Jørgensen CR, Johnsen AT. Development and content validation of a questionnaire measuring patient empowerment in cancer follow-up. Qual Life Res 2020; 29:2253-2274. [PMID: 32519187 DOI: 10.1007/s11136-020-02483-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The aim of this study was to develop and ensure the content validity of a new patient-reported outcome measure, the Cancer Patient Empowerment Questionnaire (CPEQ), to measure the level of, desire for, and enablement of empowerment among cancer patients in follow-up. METHODS An iterative process based on: (i) empowerment theories by Zimmerman and Tengland, (ii) a systematic review of questionnaires measuring empowerment or related concepts among cancer patients, (iii) qualitative data from 18 semi-structured interviews with Danish cancer patients in follow-up, (iv) input from a group of eight cancer patients involved as co-researchers and from an expert steering group, and (v) cognitive interviews with 15 cancer patients in follow-up. RESULTS The items for the CPEQ were developed and revised and 12 versions of the questionnaire were evaluated. The final version consists of 67 items, covering three different dimensions of empowerment: (A) empowerment outcomes consisting of three components: (A1) the intrapersonal-, (A2) interactional-, and (A3) behavioral component, (B) empowerment facilitators (enablement), and (C) the value of empowerment. CONCLUSIONS This study documents the theoretical and empirical basis for the development of the CPEQ and its content validity. The CPEQ provides a tool for researchers to assess the level of, desire for, and enablement of empowerment among cancer patients. The next steps will be to use the CPEQ in a nationwide study of empowerment in cancer follow-up and subsequently shorten the CPEQ based on psychometric methods in order to make it more relevant in clinical studies.
Collapse
Affiliation(s)
| | - Lone Ross
- Department of Palliative Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Caroline Bulsara
- School of Nursing and Midwifery, The University of Notre Dame, Fremantle, WA, Australia.,Institute for Health Research, The University of Notre Dame, Fremantle, WA, Australia
| | | | - Thora Grothe Thomsen
- Zealand University Hospital, Roskilde, Denmark.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Mogens Groenvold
- Department of Palliative Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Susanne S Pedersen
- Department of Psychology, University of Southern Denmark, Odense, Denmark.,Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - Clara Rübner Jørgensen
- Department for Disability Inclusion and Special Needs, School of Education, University of Birmingham, Birmingham, UK
| | - Anna Thit Johnsen
- Department of Psychology, University of Southern Denmark, Odense, Denmark.,Department of Palliative Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| |
Collapse
|
14
|
Audrain-Pontevia AF, Menvielle L, Ertz M. Effects of Three Antecedents of Patient Compliance for Users of Peer-to-Peer Online Health Communities: Cross-Sectional Study. J Med Internet Res 2019; 21:e14006. [PMID: 31710295 PMCID: PMC6878099 DOI: 10.2196/14006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 08/06/2019] [Accepted: 08/31/2019] [Indexed: 01/02/2023] Open
Abstract
Background Over the past 50 years, patient noncompliance has appeared as a major public health concern and focus of a great deal of research because it endangers patient recovery and imposes a considerable financial burden on health care systems. Meanwhile, online health communities (OHCs) are becoming more common and are commonly used by individuals with health problems, and they may have a role in facilitating compliance. Despite this growing popularity, little is known about patient compliance predictors for OHCs’ users. Objective This study aimed to investigate the extent to which participating in OHCs may trigger higher levels of compliance. It identified 3 interrelated predictors that may affect patient compliance: patient empowerment gained through peer-to-peer OHCs, satisfaction with the physician, and commitment to the physician. Methods A Web-based survey tested the conceptual model and assessed the effects of patient empowerment gained through OHCs on patient satisfaction and commitment to the physician, as well as the effects of these 3 predictors on patient compliance with the proposed treatment. Members of peer-to-peer OHCs were asked to answer an online questionnaire. A convenience sample of 420 patients experiencing chronic illness and using peer-to-peer OHCs was surveyed in August 2018 in Québec, Canada. A path analysis using structural equation modeling tested the proposed relationships between the predictors and their respective paths on patient compliance. The mediation effects of these predictor variables on patient compliance were estimated with the PROCESS macro in SPSS. Results The findings indicated that patient empowerment gained through OHCs was positively related to patient commitment to the physician (beta=.69; P<.001) and patient compliance with the proposed treatment (beta=.35; P<.001). Patient commitment also positively influenced patient compliance (beta=.74; P<.001). Patient empowerment did not exert a significant influence on patient satisfaction with the physician (beta=.02; P=.76), and satisfaction did not affect compliance (beta=−.07; P=.05); however, patient satisfaction was positively related to patient commitment to the physician (beta=.14; P<.01). The impact of empowerment on compliance was partially mediated by commitment to the physician (beta=.32; 95% CI 0.22-0.44) but not by satisfaction. Conclusions This study highlights the importance of peer-to-peer OHCs for two main reasons. The primary reason is that patient empowerment gained through peer-to-peer OHCs both directly and indirectly enhances patient compliance with the proposed treatment. The underlying mechanisms of these effects were shown. Second, commitment to the physician was found to play a more critical role than satisfaction with the physician in determining patient-physician relationship quality. Overall, our findings support the assumption that health care stakeholders should encourage the use of peer-to-peer OHCs to favor patient empowerment and patient commitment to the physician to increase patient compliance with the proposed treatment.
Collapse
Affiliation(s)
| | | | - Myriam Ertz
- Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
| |
Collapse
|
15
|
Pereyra-Rodriguez JJ, Dominguez-Cruz JJ, Hernandez-Montoya C, Galan-Gutiérrez M, Carrasco PM, Luna SA, Navarro-Triviño FJ, Del Pozo J, Ruiz-Villaverde R. Development and validation of a questionnaire to measure empowerment in adult patients with atopic dermatitis. The DATEMP questionnaire. J Dtsch Dermatol Ges 2019; 17:923-931. [PMID: 31487109 DOI: 10.1111/ddg.13934] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 03/18/2019] [Indexed: 01/29/2023]
Abstract
BACKGROUND AND OBJECTIVES In recent years, the hypothesis that increasing the empowerment of patients can help to improve health outcomes and rationalize the use of health services has become relevant, especially for chronic diseases. Developing validated measurement tools is necessary to achieve this goal. In the field of dermatology, there are few studies related to empowerment of the patient. The aim of the present research is to develop and validate a self-administered questionnaire for adult patients diagnosed with atopic dermatitis (AD) in order to measure their level of empowerment. METHODS After a literature review and the establishment of consulting groups of patients and dermatologists, a large battery of 35 items was generated, based on the dimensions included in previous empowerment descriptions. A multidisciplinary group selected the 20 most suitable items to include in the questionnaire. A cross-sectional study was carried out with the items included in the questionnaire as well as demographic and clinical characteristics. To reduce the number of items and measure the construct validity, an exploratory factorial analysis (EFA) of the primary components and varimax rotation were used. Cronbach's α was used to measure the reliability of the individual scales and the global questionnaire. RESULTS 242 valid questionnaires were included. After completion of the EFA, the final Dermatitis Atópica EMPoderamiento (DATEMP) questionnaire was composed of 17 items that converged on four factors. The four scales had adequate reliability: "Knowledge" (Cronbach's alpha = 0.808), "Abilities" (Cronbach's alpha = 0.744), "Intention to change" (Cronbach's alpha = 0.798) and "Coping skills" (Cronbach's alpha = 0.772). The overall Cronbach's α of the questionnaire was 0.764. CONCLUSIONS The DATEMP questionnaire is the first specific empowerment measurement instrument developed for patients with AD that has demonstrated adequate levels of reliability and construct validity. It is a self-administered questionnaire that is simple and quick to answer.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Jesús Del Pozo
- Complejo Hospitalario Universitario A Coruña, Coruña, Spain
| | | |
Collapse
|
16
|
Pereyra‐Rodriguez JJ, Dominguez‐Cruz JJ, Hernandez‐Montoya C, Galan‐Gutiérrez M, Martín Carrasco P, Alcántara Luna S, Navarro‐Triviño FJ, Pozo J, Ruiz‐Villaverde R. Entwicklung und Validierung eines Fragebogens zur Messung des Empowerments bei erwachsenen Patienten mit atopischer Dermatitis. Der DATEMP‐Fragebogen. J Dtsch Dermatol Ges 2019; 17:923-932. [DOI: 10.1111/ddg.13934_g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 03/18/2019] [Indexed: 11/30/2022]
Affiliation(s)
| | | | | | | | | | | | | | - Jesús Pozo
- Complejo Hospitalario Universitario A Coruña Coruña Spanien
| | | |
Collapse
|
17
|
Abstract
Extensive literature suggests that a solution to the current problems of healthcare sustainability is the active involvement of patients in health management through the empowerment of their abilities. Latest marketing frameworks suggest that patients are important resources for co-creating health value together with operators. This research aims to analyze the effects of patient empowerment on patients’ value co-creation behaviors. An empirical survey was conducted on 250 patients with chronic diseases in Italy. The results, analyzed using the structural equation modeling, showed that their empowerment enhanced value co-creation behaviors. Patients apply their health competencies and resources in their co-creation of health service with operators. It is, therefore, important to empower patients in their transformation from passive to active stakeholders, working with providers for the most optimal health outcomes. This research provides practitioners with suggestions for patient involvement which utilizes their knowledge, capabilities and responsibility to improving healthcare services.
Collapse
|
18
|
Jaana M, Sherrard H, Paré G. A prospective evaluation of telemonitoring use by seniors with chronic heart failure: Adoption, self-care, and empowerment. Health Informatics J 2018; 25:1800-1814. [DOI: 10.1177/1460458218799458] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Telemonitoring leverages technology for the follow-up of patients with heart failure. Limited evidence exists on how telemonitoring influences senior patients’ attitudes and self-care practices. This study examines telemonitoring impacts on patient empowerment and self-care, and explores adoption factors among senior patients. A longitudinal study design was used, involving three surveys of elderly with chronic heart failure (n = 23) 1 week, 3 months, and 6 months after beginning telemonitoring use. Self-care, patient empowerment, and adoption factors were assessed using existing scales. The patients involved in this study perceived value of using telemonitoring, did not expect it to be difficult to use, and did not encounter adoption barriers. There was a significant improvement in patients’ confidence in their ability to evaluate their symptoms, address them, and evaluate the effectiveness of the measures taken to address these symptoms. Yet, patients performed less self-care maintenance activities, and the capability of involvement in the decision-making related to their condition decreased. Telemonitoring can improve seniors’ confidence in evaluating and addressing their symptoms in relation to heart failure. This patient management approach should be coupled with targeted education geared toward self-maintenance and self-management practices.
Collapse
|
19
|
Wakefield D, Bayly J, Selman LE, Firth AM, Higginson IJ, Murtagh FE. Patient empowerment, what does it mean for adults in the advanced stages of a life-limiting illness: A systematic review using critical interpretive synthesis. Palliat Med 2018; 32:1288-1304. [PMID: 29956568 PMCID: PMC6088522 DOI: 10.1177/0269216318783919] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Patient empowerment, defined as 'a process through which people gain greater control over decisions and actions affecting their health' (World Health Organization) is a key theme within global health and social care strategies. The benefits of incorporating empowerment strategies in care are well documented, but little is known about their application or impact for patients with advanced, life-limiting illness(s). AIM To identify and synthesise the international evidence on patient empowerment for adults with advanced, life-limiting illness(s). DESIGN Systematic review (PROSPERO no. 46113) with critical interpretive synthesis methodology. DATA SOURCES Five databases (MEDLINE, Embase, CINHAL, PsycINFO and Cochrane) were searched from inception to March 2018. Grey literature and reference list/citation searches of included papers were undertaken. INCLUSION CRITERIA empirical research involving patients with advanced life-limiting illness including descriptions of, or references to, patient empowerment within the study results. RESULTS In all, 13 papers met inclusion criteria. Two qualitative studies explored patient empowerment as a study objective. Six papers evaluated interventions, referencing patient empowerment as an incidental outcome. The following themes were identified from the interpretive synthesis: self-identity, personalised knowledge in theory and practice, negotiating personal and healthcare relationships, acknowledgement of terminal illness, and navigating continued losses. CONCLUSION There are features of empowerment, for patients with advanced life-limiting illness distinct to those of other patient groups. Greater efforts should be made to progress the empowerment of patients nearing the end of their lives. We propose that the identified themes may provide a useful starting point to guide the assessment of existing or planned services and inform future research.
Collapse
Affiliation(s)
- Dominique Wakefield
- 1 Department of Palliative Care, Policy & Rehabilitation, Cicely Saunders Institute, King's College London, London, UK
| | - Jo Bayly
- 1 Department of Palliative Care, Policy & Rehabilitation, Cicely Saunders Institute, King's College London, London, UK
| | - Lucy Ellen Selman
- 2 Bristol Randomised Trials Collaboration (BRTC), School of Social and Community Medicine, Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - Alice M Firth
- 1 Department of Palliative Care, Policy & Rehabilitation, Cicely Saunders Institute, King's College London, London, UK
| | - Irene J Higginson
- 1 Department of Palliative Care, Policy & Rehabilitation, Cicely Saunders Institute, King's College London, London, UK
| | - Fliss Em Murtagh
- 3 Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK
| |
Collapse
|
20
|
Acuña Mora M, Luyckx K, Sparud-Lundin C, Peeters M, van Staa A, Sattoe J, Bratt EL, Moons P. Patient empowerment in young persons with chronic conditions: Psychometric properties of the Gothenburg Young Persons Empowerment Scale (GYPES). PLoS One 2018; 13:e0201007. [PMID: 30028863 PMCID: PMC6054395 DOI: 10.1371/journal.pone.0201007] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 07/07/2018] [Indexed: 11/19/2022] Open
Abstract
PURPOSE Empowerment in patients can lead to a higher participation in care and self-management skills. However, there are a limited number of high-quality instruments to assess empowerment and its various dimensions in young persons. The aim was to develop and assess the psychometric properties of the Gothenburg Young Persons Empowerment Scale (GYPES). METHODS The GYPES is a 15-item questionnaire designed to measure patient empowerment in young persons with chronic conditions. Three studies were conducted to evaluate the psychometric properties of the scale. Studies I and II assessed face, content and factorial validity, as well as responsiveness and reliability in young persons with congenital heart disease and diabetes. After these studies problematic items were identified and reworded and the final version of the GYPES was tested in young persons with diabetes in study III. RESULTS The content and face validity of the scale was confirmed in study I. Confirmatory factor analyses (CFA) in study II supported the five-factor structure of the GYPES. However, one item had a low factor loading. The scale was revised and evaluated in study III. CFA of this version supported adequate model fit with factor loadings ranging from 0.385-0.941. A second-order model had an adequate fit to the data. Cronbach's alpha for the overall scale was 0.858 and for each subscale, alphas range from 0.609-0.858. CONCLUSIONS GYPES was developed to measure patient empowerment in young persons with chronic conditions. Preliminary evidence supports that the GYPES may be a valid and reliable tool for assessing young persons' empowerment.
Collapse
Affiliation(s)
- Mariela Acuña Mora
- Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
- KU Leuven Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Koen Luyckx
- School Psychology and Development in Context, KU Leuven, Leuven, Belgium
| | - Carina Sparud-Lundin
- Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Mariëlle Peeters
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, The Netherlands
| | - AnneLoes van Staa
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, The Netherlands
| | - Jane Sattoe
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, The Netherlands
| | - Ewa-Lena Bratt
- Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
- Department of Pediatric Cardiology, The Queen Silvia Children’s Hospital, Gothenburg, Sweden
| | - Philip Moons
- Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
- KU Leuven Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Department of Paediatrics and Child Health, University of Cape Town, South Africa
| |
Collapse
|
21
|
Liska CM, Morash R, Paquet L, Stacey D. Empowering cancer survivors to meet their physical and psychosocial needs: An implementation evaluation. Can Oncol Nurs J 2018; 28:76-81. [PMID: 31148752 DOI: 10.5737/236880762827681] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Our Wellness Beyond Cancer Survivorship Program was established and evaluated as a quality improvement project. Individualized survivorship care plans for survivors and primary care providers included cancer surveillance recommendations and survivors' self-reported physical and psychosocial needs. At the discharge visit, an oncology nurse reviewed the care plan and symptom management strategies with survivors. We assessed the physical and psychosocial needs and feelings of empowerment of 70 breast and 53 colorectal cancer survivors on entry into the program and one year after discharge to primary care. Survivors were months to 10 or more years since the end of active treatment, with colorectal cancer survivors referred sooner (average 1.2 years). At baseline, colorectal cancer survivors reported little concern about their needs (scores <1.0 out of 5.0) and breast cancer survivors reported some concern about sleep disturbances, weight changes, memory/concentration changes, and fear of recurrence (scores 1.0 to 1.5 out of 5.0). All survivors reported feeling empowered (>3.0 out of 4.0). Needs and empowerment levels were mostly unchanged one year later. Colorectal cancer survivors showed a statistically significantly increased fear of recurrence at one year. In summary, cancer survivors with a survivorship care plan continued to feel empowered one year following discharge.
Collapse
|
22
|
|
23
|
Jørgensen CR, Thomsen TG, Ross L, Dietz SM, Therkildsen S, Groenvold M, Rasmussen CL, Johnsen AT. What Facilitates "Patient Empowerment" in Cancer Patients During Follow-Up: A Qualitative Systematic Review of the Literature. QUALITATIVE HEALTH RESEARCH 2018; 28:292-304. [PMID: 28758544 DOI: 10.1177/1049732317721477] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Empowerment is a concept of growing importance in cancer care, but little is known about cancer patients' experiences of empowerment during follow-up. To explore this area, a qualitative systematic literature review was conducted in PubMed, CINAHL, and PsycINFO. A total of 2,292 papers were identified and 38 articles selected and included in the review. The thematic synthesis of the papers resulted in seven analytical themes being identified: empowerment as an ongoing process, knowledge is power, having an active role, communication and interaction between patients and health care professionals, support from being in a group, religion and spirituality, and gender. Very few articles explicitly explored the empowerment of cancer patients during follow-up, and the review identified a lack of attention to patients' own understandings of empowerment, a lack of specific focus on empowerment during follow-up, and insufficient attention to collective empowerment, as well as ethnic, social, and gender differences.
Collapse
Affiliation(s)
- Clara R Jørgensen
- 1 University of Warwick, Coventry, United Kingdom
- 2 University of Birmingham, Birmingham, United Kingdom
| | - Thora G Thomsen
- 3 Zealand University Hospital, Roskilde, Denmark
- 4 University of Southern Denmark, Odense, Denmark
| | - Lone Ross
- 5 Bispebjerg Hospital, Copenhagen, Denmark
| | - Susanne M Dietz
- 6 Patient and Public (PPI) Representative, Copenhagen, Denmark
| | | | - Mogens Groenvold
- 5 Bispebjerg Hospital, Copenhagen, Denmark
- 7 University of Copenhagen, Copenhagen, Denmark
| | | | - Anna T Johnsen
- 4 University of Southern Denmark, Odense, Denmark
- 5 Bispebjerg Hospital, Copenhagen, Denmark
| |
Collapse
|
24
|
[Transcultural adaptation into Spanish of the Patient empowerment in long-term conditions questionnaire]. Aten Primaria 2017; 51:24-31. [PMID: 29277376 PMCID: PMC6836925 DOI: 10.1016/j.aprim.2017.09.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 09/21/2017] [Accepted: 09/26/2017] [Indexed: 11/22/2022] Open
Abstract
Objetivo Describir el proceso de traducción y adaptación transcultural del instrumento Patient empowerment in long-term condition al español. Diseño Traducción, adaptación transcultural y análisis de la comprensibilidad mediante entrevistas cognitivas. Emplazamiento Asistencia primaria y hospitalaria. Participantes Diez pacientes ingresados en un servicio de cardiología de un hospital universitario. Mediciones principales 1) Traducción directa; 2) síntesis y conciliación de las versiones por un comité de expertos; 3) traducción inversa; 4) conciliación de la traducción inversa con la autora del cuestionario original, y 5) análisis de la comprensibilidad mediante entrevistas cognitivas a una muestra de pacientes. Resultados Las versiones de traducción directa no presentaron grandes diferencias entre ellas. De los 47 ítems que componen el cuestionario, el comité de expertos introdujo cambios en 23 ítems. La versión de la traducción inversa fue aceptada por la autora del cuestionario original. En las entrevistas cognitivas, los pacientes señalaron una dificultad alta en un ítem y baja en 4. Conclusiones La versión española del cuestionario Patient Empowerment in long-term conditions es equivalente semántica y conceptualmente al instrumento original. En una fase posterior se procederá a un proceso de validación en el que se establecerán las propiedades psicométricas.
Collapse
|
25
|
Empowerment in Dermatology. ACTAS DERMO-SIFILIOGRAFICAS 2017; 109:133-139. [PMID: 29183620 DOI: 10.1016/j.ad.2017.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 09/18/2017] [Accepted: 09/30/2017] [Indexed: 02/03/2023] Open
Abstract
The term empowerment refers to any process that facilitates behavioral changes and encourages responsibility and making informed choices. The concept has been applied mainly to help patients with chronic conditions achieve therapeutic goals. The aim of the approach in health care is to enhance self-caring and self-efficacy. The term derives from the English verb to empower meaning "to give (someone) the authority or power to do something" or "to make an individual or a group stronger or more powerful". One of the responsibilities of health professionals is to improve patients' knowledge and their ability to choose between the different alternatives available to them so that they can act accordingly. In this article, we review the various definitions of the term empowerment, the tools used to measure patient empowerment, the implications of the concept for the management of chronic disease, and its use in dermatological conditions.
Collapse
|
26
|
Transcultural adaptation and validation of the patient empowerment in long-term conditions questionnaire. BMC Health Serv Res 2017; 17:324. [PMID: 28472988 PMCID: PMC5418845 DOI: 10.1186/s12913-017-2271-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Accepted: 04/26/2017] [Indexed: 12/28/2022] Open
Abstract
Background Patient empowerment is a key element to improve the results in health, increase satisfaction amongst users and obtain higher treatment compliance. The main objective of this study is to validate the Spanish version of the questionnaire “Patient empowerment in long-term conditions” which evaluates the patients’ level of empowerment of chronic diseases. The secondary objective is to identify factors which predict basal empowerment and changes (improvement or deterioration) in patients with Heart Failure (HF). Methods An observational and prospective design of psychometric type to validate a questionnaire (aim 1) and a prospective study of cohorts (aim 2). The study will include 121 patients with confirmed diagnosis of HF. Three measurements (basal, at 15 days and at 3 months) will be carried out: quality of life, self-care and empowerment. Descriptive and inferential analyses will be used. For the first aim of the study (validation), the test-retest reproducibility will be assessed through intraclass correlation coefficient; internal consistency will be assessed through Cronbach’s alpha coefficient; construct validity through Pearson’s correlation coefficient; and sensibility to change through effect size coefficient. Discussion Set a valid questionnaire to measure the level of empowerment of patients with chronic diseases could be an effective tool to assess the results from the provision of the health care services. It will also allow us to identify at an early stage, those groups of patients with a low level of empowerment. Hence, they could become a risk group due to poor management of the disease, with a high rate of decompensation and a higher use rate of the health system resources.
Collapse
|
27
|
Eskildsen NB, Joergensen CR, Thomsen TG, Ross L, Dietz SM, Groenvold M, Johnsen AT. Patient empowerment: a systematic review of questionnaires measuring empowerment in cancer patients. Acta Oncol 2017; 56:156-165. [PMID: 28077053 DOI: 10.1080/0284186x.2016.1267402] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND There is an increased attention to and demand for patient empowerment in cancer treatment and follow-up programs. Patient empowerment has been defined as feeling in control of or having mastery in relation to cancer and cancer care. This calls for properly developed questionnaires assessing empowerment from the user perspective. The aim of this review was to identify questionnaires and subscales measuring empowerment and manifestations of empowerment among cancer patients. MATERIALS AND METHODS We conducted a systematic search of the PubMed, PsycINFO and CINAHL databases. Empowerment and multiple search terms associated with empowerment were included. We included peer-reviewed articles published in English, which described questionnaires measuring empowerment or manifestations of empowerment in a cancer setting. In addition, the questionnaire had to be a patient-reported outcome measure for adult cancer patients. RESULTS Database searches identified 831 records. Title and abstract screening resulted in 482 records being excluded. The remaining 349 full text articles were retrieved and assessed for eligibility. This led to the inclusion of 33 individual instruments measuring empowerment and manifestations of empowerment. Of these, only four were specifically developed to measure empowerment, and two were originally developed for the cancer setting, whereas the remaining two were developed elsewhere, but adapted to the cancer setting. The other 29 questionnaires were not intended to measure the concept of empowerment, but focused on patient-centered care, patient competence, self-efficacy, etc. However, they were included because part of the instrument (at least five items) was considered to measure empowerment or manifestations of empowerment. CONCLUSION Our study provides an overview of the available questionnaires, which can be used by researchers and practitioners who wish to measure the concept of empowerment among cancer patients. Very few questionnaires were explicitly developed to explore empowerment, and the review brings to light a significant lack of questionnaires that measure patient empowerment comprehensively.
Collapse
Affiliation(s)
| | | | - Thora Grothe Thomsen
- Zealand University Hospital, Roskilde, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Lone Ross
- Department of Palliative Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | | | - Mogens Groenvold
- Department of Palliative Medicine, Bispebjerg Hospital, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anna Thit Johnsen
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Department of Palliative Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| |
Collapse
|
28
|
Johnsen AT, Eskildsen NB, Thomsen TG, Grønvold M, Ross L, Jørgensen CR. Conceptualizing patient empowerment in cancer follow-up by combining theory and qualitative data. Acta Oncol 2017; 56:232-238. [PMID: 28080181 DOI: 10.1080/0284186x.2016.1267403] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Patient empowerment (PE) may be defined as the opportunity for patients to master issues important to their own health. The aim of this study was to conceptualize PE and how the concept manifests itself for cancer patients attending follow-up, in order to develop a relevant and sensitive questionnaire for this population. MATERIAL AND METHODS A theoretical model of PE was made, based on Zimmerman's theory of psychological empowerment. Patients who were in follow-up after first line treatment for their cancer (n = 16) were interviewed about their experiences with follow-up. A deductive thematic analysis was conducted to contextualize the theory and find concrete manifestations of empowerment. Data were analyzed to find situations that expressed empowerment or lack of empowerment. We then analyzed what abilities these situations called for and we further analyzed how these abilities fitted Zimmerman's theory. RESULTS In all, 16 patients from two different hospitals participated in the interviews. PE in cancer follow-up was conceptualized as: (1) the perception that one had the possibility of mastering treatment and care (e.g. the possibility of 'saying no' to treatment and getting in contact with health care when needed); (2) having knowledge and skills regarding, for example treatment, care, plan of treatment and care, normal reactions and late effects, although knowledge and information was not always considered positively; and (3) being able to make the health care system address one's concerns and needs and, for some patients, also being able to monitor one's treatment, tests and care. CONCLUSION We conceptualized PE based on Zimmerman's theory and empirical data to contextualize the concept in cancer follow-up. When developing a patient reported outcome measure measuring PE for this group of patients, one needs to be attentive to differences in wishes regarding mastery.
Collapse
Affiliation(s)
- Anna Thit Johnsen
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Department of Palliative Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | | | - Thora Grothe Thomsen
- Zealand University Hospital, Roskilde, Denmark
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Mogens Grønvold
- Department of Palliative Medicine, Bispebjerg Hospital, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Lone Ross
- Department of Palliative Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | | |
Collapse
|
29
|
Castro EM, Van Regenmortel T, Vanhaecht K, Sermeus W, Van Hecke A. Patient empowerment, patient participation and patient-centeredness in hospital care: A concept analysis based on a literature review. PATIENT EDUCATION AND COUNSELING 2016; 99:1923-1939. [PMID: 27450481 DOI: 10.1016/j.pec.2016.07.026] [Citation(s) in RCA: 473] [Impact Index Per Article: 59.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 07/14/2016] [Accepted: 07/16/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES The concepts of patient empowerment, patient participation and patient-centeredness have been introduced as part of the trend towards a more participatory health care and have largely been used interchangeably. Although these concepts have been discussed for a number of years, their exact meaning in hospital care remains somewhat unclear. This absence of theoretical and conceptual clarity has led to (1) poor understanding and communication among researchers, health practitioners and policy makers and (2) problems in measurement and comparison between studies across different hospitals. METHODS This paper examines all three concepts through a concept analysis based on the method of Avant and Walker (2005) [1] and the simultaneous concept analysis of Haase et al. (1992) [2]. RESULTS Through these methods, the antecedents, attributes, consequences and empirical referents of each concept are determined. In addition, similarities and differences between the three concepts are identified and a definition offered for each concept. Furthermore, the interrelatedness between the key concepts is mapped, and definitions are proposed. CONCLUSIONS It can be concluded that patient empowerment is a much broader concept than just patient participation and patient-centeredness. PRACTICE IMPLICATIONS The present study may provide a useful framework that researchers, policy makers and health care providers can use to facilitate patient empowerment.
Collapse
Affiliation(s)
| | - Tine Van Regenmortel
- Faculty of Social Sciences - HIVA, University of Leuven, Leuven, Belgium, Belgium; Tilburg University, Tilburg School of Social and Behavioral Sciences, Tranzo, Tilburg, Netherlands
| | - Kris Vanhaecht
- Leuven Institute for Healthcare Policy, Department of Public Health & Primary Care, University of Leuven, Leuven, Belgium; Department of Quality Management, University Hospitals Leuven, Leuven, Belgium
| | - Walter Sermeus
- Leuven Institute for Healthcare Policy, Department of Public Health & Primary Care, University of Leuven, Leuven, Belgium
| | - Ann Van Hecke
- Faculty of Medicine and Health Sciences, Department of Public Health - University Center for Nursing and Midwifery, Ghent University, Ghent, Belgium
| |
Collapse
|
30
|
Zhou C, Ji X, Tan J, Wu Y. Psychometric properties of the Chinese version of the Client Empowerment Scale in chronic patients. SPRINGERPLUS 2016; 5:1636. [PMID: 27722054 PMCID: PMC5031582 DOI: 10.1186/s40064-016-3183-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 08/31/2016] [Indexed: 11/10/2022]
Abstract
Objective The objective of the study was to evaluate the psychometric properties of the Chinese version of the Client Empowerment Scale (CCES). Methods In this cross-sectional survey, content validity was examined based on the reviews of a panel of five experts; test–retest was conducted to assess the item reliabilities of the scale. A convenience sample of 317 patients with chronic diseases were recruited from three level-3 hospitals were selected to explore the factorial structure of the CCES using exploratory factor analysis. Results The Chinese Client Empowerment Scale was developed by modifying seven items. Results indicated that the CCES demonstrated good internal consistency and test–retest reliability. Principal component analysis supported the six-factor structure of the original instrument (Informed Confidence, Client–Provider Relationship, Social Advocacy, Awareness, Control and Client–Client Support) were identified and confirmed in the CCES. There were significant correlations among the six factors, which demonstrated the good construct validity of the Chinese version of this scale. Conclusion The findings support the reliability and validity of the CCES, and the 44-item six-factor Chinese version of the CES is a self-completion scale.
Collapse
Affiliation(s)
- Chunlan Zhou
- Nanfang Hospital, Southern Medical University, 1838 Guangzhou Rd, Guangzhou, 510515 China
| | - Xue Ji
- Nanfang Hospital, Southern Medical University, 1838 Guangzhou Rd, Guangzhou, 510515 China
| | - Jian Tan
- Nanfang Hospital, Southern Medical University, 1838 Guangzhou Rd, Guangzhou, 510515 China
| | - Yanni Wu
- Nanfang Hospital, Southern Medical University, 1838 Guangzhou Rd, Guangzhou, 510515 China
| |
Collapse
|
31
|
Yeo Y. Indirect effects of contextual factors on patients' consultations with healthcare professionals about health information found online. BMC Health Serv Res 2016; 16:447. [PMID: 27576443 PMCID: PMC5006620 DOI: 10.1186/s12913-016-1713-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 08/25/2016] [Indexed: 11/10/2022] Open
Abstract
Background E-health users are encouraged to consult healthcare professionals about the health information they found online because it facilitates e-health users to participate in an informed decision-making process with healthcare professionals on treatment options. However, few studies have examined the path of how e-health users consult healthcare professionals about the health information. Using psychological empowerment, which claims that empowering individuals requires understanding contextual factors that interact with the individuals’ intrapsychic factors, this study tested a hypothesis: the contextual factors play an indirect role between patients’ perceived poor health and their consultations with healthcare professionals about the health information found online, holding predisposing factors constant. Methods The data were collected from the Health Information National Trends Survey and used a subsample of e-health users who used healthcare services during the past year. The subsample (N = 2,297) was analyzed using structural equation modeling (SEM). Results The SEM analysis supported the hypothesized indirect model. Meanwhile, patients with low socioeconomic statuses tended to score high in the outcome measurement of the contextual factors; however, they tended not to consult professionals. Conclusions It is important to acknowledge contextual factors, which encompass communication and relational aspects as well as the process and outcomes of treatments, when empowering e-health users to use e-health tools meaningfully and become empowered in caring for their own health. Particularly, those with low income and education levels were the less powered or powerless patients: they tended not to be competent in having a voice and discussing the health information that they found online with professionals. Electronic supplementary material The online version of this article (doi:10.1186/s12913-016-1713-y) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Younsook Yeo
- Department of Social Work, St. Cloud State University, 720 Fourth Avenue South, St. Cloud, MN, 56301-4498, USA.
| |
Collapse
|
32
|
Cerezo PG, Juvé-Udina ME, Delgado-Hito P. Concepts and measures of patient empowerment: a comprehensive review. Rev Esc Enferm USP 2016; 50:667-674. [DOI: 10.1590/s0080-623420160000500018] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 06/30/2016] [Indexed: 02/03/2023] Open
Abstract
Abstract OBJECTIVE Analyze the definitions and dimensions of empowerment. Identify the strengths and weaknesses of empowerment measures based on the conceptual model. METHOD This was a comprehensive literature review of publications on the MEDLINE and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. RESULTS Twenty-nine articles were selected. Seventeen definitions and seven dimensions of empowerment, and 10 empowerment measures were selected. Empowerment can be seen as an enabling process involving a shift in the balance of power, or as an outcome of this process. The dimensions reflect outcome indicators, such as participation in decision-making and control, and process indicators, such as knowledge acquisition and coping skills. Six of the tools analyzed by this study could be said to provide a robust measure of patient empowerment. CONCLUSION we propose a definition of empowerment that helps to deepen understanding of the term and, therefore, its operationalization.
Collapse
Affiliation(s)
| | | | - Pilar Delgado-Hito
- Universidad de Barcelona, España; Instituto de Investigación Biomédica de Bellvitge, España
| |
Collapse
|
33
|
Jerofke T, Weiss M. Development and psychometric analysis of the Patient Perceptions of Patient-Empowering Nurse Behaviours Scale (PPPNBS). J Adv Nurs 2016; 72:2923-2936. [DOI: 10.1111/jan.13060] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Teresa Jerofke
- College of Nursing; Marquette University; Milwaukee Wisconsin USA
| | - Marianne Weiss
- College of Nursing; Marquette University; Milwaukee Wisconsin USA
| |
Collapse
|
34
|
Groen WG, Kuijpers W, Oldenburg HS, Wouters MW, Aaronson NK, van Harten WH. Empowerment of Cancer Survivors Through Information Technology: An Integrative Review. J Med Internet Res 2015; 17:e270. [PMID: 26614438 PMCID: PMC4704924 DOI: 10.2196/jmir.4818] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 07/28/2015] [Accepted: 10/26/2015] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Patient empowerment may be an effective approach to strengthen the role of cancer survivors and to reduce the burden on health care. However, it is not well conceptualized, notably in oncology. Furthermore, it is unclear to what extent information technology (IT) services can contribute to empowerment of cancer survivors. OBJECTIVE We aim to define the conceptual components of patient empowerment of chronic disease patients, especially cancer survivors, and to explore the contribution of existing and new IT services to promote empowerment. METHODS Electronic databases were searched to identify theoretical and empirical articles regarding empowerment. We extracted and synthesized conceptual components of patient empowerment (ie, attributes, antecedents, and consequences) according to the integrated review methodology. We identified recent IT services for cancer survivors by examining systematic reviews and a proposed inventory of new services, and we related their features and effects to the identified components of empowerment. RESULTS Based on 26 articles, we identified five main attributes of patient empowerment: (1) being autonomous and respected, (2) having knowledge, (3) having psychosocial and behavioral skills, (4) perceiving support from community, family, and friends, and (5) perceiving oneself to be useful. The latter two were specific for the cancer setting. Systematic reviews of IT services and our additional inventory helped us identify five main categories: (1) educational services, including electronic survivorship care plan services, (2) patient-to-patient services, (3) electronic patient-reported outcome (ePRO) services, (4) multicomponent services, and (5) portal services. Potential impact on empowerment included knowledge enhancement and, to a lesser extent, enhancing autonomy and skills. Newly developed services offer promising and exciting opportunities to empower cancer survivors, for instance, by providing tailored advice for supportive or follow-up care based on patients' input. CONCLUSIONS We identified five main components of empowerment and showed that IT services may especially contribute to empowerment by providing knowledge. The components of empowerment could be used to develop IT services for cancer survivors. It is important to take into account patients' needs, follow up on these needs, and create a service that is attractive and easy to use.
Collapse
Affiliation(s)
- Wim G Groen
- The Netherlands Cancer Institute, Division of Psychosocial Research and Epidemiology, Amsterdam, Netherlands
| | | | | | | | | | | |
Collapse
|
35
|
Johnson CE, Saunders CM, Phillips M, Emery JD, Nowak AK, Overheu K, Ward AM, Joske DJ. Randomized Controlled Trial of Shared Care for Patients With Cancer Involving General Practitioners and Cancer Specialists. J Oncol Pract 2015; 11:349-55. [DOI: 10.1200/jop.2014.001569] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Little benefit was seen for a shared care model in the majority of domains including empowerment, symptom prevalence, and psychological adjustment to cancer. The shared care model showed efficacy in clinically anxious patients.
Collapse
Affiliation(s)
- Claire E. Johnson
- The University of Western Australia; Harry Perkins Institute of Medical Research, The University of Western Australia; School of Primary, Aboriginal and Rural Health Care, The University of Western Australia; School of Medicine and Pharmacology, The University of Western Australia, Crawley; Royal Perth Hospital, Perth; General Practice and Primary Care Academic Centre, University of Melbourne, Carlton; Sir Charles Gairdner Hospital; Haematology Care Centre, Sir Charles Gairdner Hospital, Nedlands,
| | - Christobel M. Saunders
- The University of Western Australia; Harry Perkins Institute of Medical Research, The University of Western Australia; School of Primary, Aboriginal and Rural Health Care, The University of Western Australia; School of Medicine and Pharmacology, The University of Western Australia, Crawley; Royal Perth Hospital, Perth; General Practice and Primary Care Academic Centre, University of Melbourne, Carlton; Sir Charles Gairdner Hospital; Haematology Care Centre, Sir Charles Gairdner Hospital, Nedlands,
| | - Michael Phillips
- The University of Western Australia; Harry Perkins Institute of Medical Research, The University of Western Australia; School of Primary, Aboriginal and Rural Health Care, The University of Western Australia; School of Medicine and Pharmacology, The University of Western Australia, Crawley; Royal Perth Hospital, Perth; General Practice and Primary Care Academic Centre, University of Melbourne, Carlton; Sir Charles Gairdner Hospital; Haematology Care Centre, Sir Charles Gairdner Hospital, Nedlands,
| | - Jon D. Emery
- The University of Western Australia; Harry Perkins Institute of Medical Research, The University of Western Australia; School of Primary, Aboriginal and Rural Health Care, The University of Western Australia; School of Medicine and Pharmacology, The University of Western Australia, Crawley; Royal Perth Hospital, Perth; General Practice and Primary Care Academic Centre, University of Melbourne, Carlton; Sir Charles Gairdner Hospital; Haematology Care Centre, Sir Charles Gairdner Hospital, Nedlands,
| | - Anna K. Nowak
- The University of Western Australia; Harry Perkins Institute of Medical Research, The University of Western Australia; School of Primary, Aboriginal and Rural Health Care, The University of Western Australia; School of Medicine and Pharmacology, The University of Western Australia, Crawley; Royal Perth Hospital, Perth; General Practice and Primary Care Academic Centre, University of Melbourne, Carlton; Sir Charles Gairdner Hospital; Haematology Care Centre, Sir Charles Gairdner Hospital, Nedlands,
| | - Kate Overheu
- The University of Western Australia; Harry Perkins Institute of Medical Research, The University of Western Australia; School of Primary, Aboriginal and Rural Health Care, The University of Western Australia; School of Medicine and Pharmacology, The University of Western Australia, Crawley; Royal Perth Hospital, Perth; General Practice and Primary Care Academic Centre, University of Melbourne, Carlton; Sir Charles Gairdner Hospital; Haematology Care Centre, Sir Charles Gairdner Hospital, Nedlands,
| | - Alison M. Ward
- The University of Western Australia; Harry Perkins Institute of Medical Research, The University of Western Australia; School of Primary, Aboriginal and Rural Health Care, The University of Western Australia; School of Medicine and Pharmacology, The University of Western Australia, Crawley; Royal Perth Hospital, Perth; General Practice and Primary Care Academic Centre, University of Melbourne, Carlton; Sir Charles Gairdner Hospital; Haematology Care Centre, Sir Charles Gairdner Hospital, Nedlands,
| | - David J.L. Joske
- The University of Western Australia; Harry Perkins Institute of Medical Research, The University of Western Australia; School of Primary, Aboriginal and Rural Health Care, The University of Western Australia; School of Medicine and Pharmacology, The University of Western Australia, Crawley; Royal Perth Hospital, Perth; General Practice and Primary Care Academic Centre, University of Melbourne, Carlton; Sir Charles Gairdner Hospital; Haematology Care Centre, Sir Charles Gairdner Hospital, Nedlands,
| |
Collapse
|
36
|
Egan R, Llewellyn R, Wood S, Doherty J, Albert T, Walsh C, Atkinson K, Kerslake P. The Cancer Stories Project: narratives of encounters with cancer in Aotearoa, New Zealand. Psychooncology 2015. [DOI: 10.1002/pon.3914] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Richard Egan
- University of Otago, Cancer Society Social and Behavioural Research Unit; Department of Preventive and Social Medicine; New Zealand
| | - Rebecca Llewellyn
- University of Otago, Cancer Society Social and Behavioural Research Unit; Department of Preventive and Social Medicine; New Zealand
| | - Sarah Wood
- University of Otago, Cancer Society Social and Behavioural Research Unit; Department of Preventive and Social Medicine; New Zealand
| | | | - Tira Albert
- Mana Wahine, Kokiri Marae Health and Social Services; Wellington New Zealand
| | - Chris Walsh
- Health Quality and Safety Commission; New Zealand
| | - Kelly Atkinson
- Cancer Society of New Zealand; Relay For Life and Community Development; New Zealand
| | | |
Collapse
|
37
|
Bravo P, Edwards A, Barr PJ, Scholl I, Elwyn G, McAllister M. Conceptualising patient empowerment: a mixed methods study. BMC Health Serv Res 2015; 15:252. [PMID: 26126998 PMCID: PMC4488113 DOI: 10.1186/s12913-015-0907-z] [Citation(s) in RCA: 176] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 06/05/2015] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND In recent years, interventions and health policy programmes have been established to promote patient empowerment, with a particular focus on patients affected by long-term conditions. However, a clear definition of patient empowerment is lacking, making it difficult to assess effectiveness of interventions designed to promote it. The aim in this study was to develop a conceptual map of patient empowerment, including components of patient empowerment and relationships with other constructs such as health literacy, self-management and shared decision-making. METHODS A mixed methods study was conducted comprising (i) a scoping literature review to identify and map the components underpinning published definitions of patient empowerment (ii) qualitative interviews with key stakeholders (patients, patient representatives, health managers and health service researchers) to further develop the conceptual map. Data were analysed using qualitative methods. A combination of thematic and framework analysis was used to integrate and map themes underpinning published definitions of patient empowerment with the views of key UK stakeholders. RESULTS The scoping literature review identified 67 articles that included a definition of patient empowerment. A range of diverse definitions of patient empowerment was extracted. Thematic analysis identified key underpinning themes, and these themes were used to develop an initial coding framework for analysis of interview data. 19 semi-structured interviews were conducted with key stakeholders. Transcripts were analysed using the initial coding framework, and findings were used to further develop the conceptual map. The resulting conceptual map describes that patient empowerment can be conceived as a state ranging across a spectrum from low to high levels of patient empowerment, with the level of patient empowerment potentially measurable using a set of indicators. Five key components of the conceptual map were identified: underpinning ethos, moderators, interventions, indicators and outcomes. Relationships with other constructs such as health literacy, self-management and shared decision-making are illustrated in the conceptual map. CONCLUSION A novel conceptual map of patient empowerment grounded in published definitions of patient empowerment and qualitative interviews with UK stakeholders is described, that may be useful to healthcare providers and researchers designing, implementing and evaluating interventions to promote patient empowerment.
Collapse
Affiliation(s)
- Paulina Bravo
- Institute of Cancer & Genetics, Cardiff University, Heath Park, Cardiff, CF14 4XN, UK.
- School of Nursing, Pontificia Universidad Católica de Chile, Avenida Vicuña Mackenna 4860, Macul, Santiago, Chile.
| | - Adrian Edwards
- Cochrane Institute of Primary Care & Public Health, Neuadd Merionnydd, Cardiff University, Heath Park, Cardiff, UK CF14 4YS, UK.
| | - Paul James Barr
- The Dartmouth Center for Health Care Delivery Science, Dartmouth College, 37 Dewey Field Road, 4th Floor, Hinman Box 7256, Hanover, NH, 03755, USA.
| | - Isabelle Scholl
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Glyn Elwyn
- The Dartmouth Center for Health Care Delivery Science, Dartmouth College, 37 Dewey Field Road, 4th Floor, Hinman Box 7256, Hanover, NH, 03755, USA.
| | - Marion McAllister
- Institute of Cancer & Genetics, Cardiff University, Heath Park, Cardiff, CF14 4XN, UK.
| |
Collapse
|
38
|
Barr PJ, Scholl I, Bravo P, Faber MJ, Elwyn G, McAllister M. Assessment of patient empowerment--a systematic review of measures. PLoS One 2015; 10:e0126553. [PMID: 25970618 PMCID: PMC4430483 DOI: 10.1371/journal.pone.0126553] [Citation(s) in RCA: 119] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 04/03/2015] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Patient empowerment has gained considerable importance but uncertainty remains about the best way to define and measure it. The validity of empirical findings depends on the quality of measures used. This systematic review aims to provide an overview of studies assessing psychometric properties of questionnaires purporting to capture patient empowerment, evaluate the methodological quality of these studies and assess the psychometric properties of measures identified. METHODS Electronic searches in five databases were combined with reference tracking of included articles. Peer-reviewed articles reporting psychometric testing of empowerment measures for adult patients in French, German, English, Portuguese and Spanish were included. Study characteristics, constructs operationalised and psychometric properties were extracted. The quality of study design, methods and reporting was assessed using the COSMIN checklist. The quality of psychometric properties was assessed using Terwee's 2007 criteria. FINDINGS 30 studies on 19 measures were included. Six measures are generic, while 13 were developed for a specific condition (N=4) or specialty (N=9). Most studies tested measures in English (N=17) or Swedish (N=6). Sample sizes of included studies varied from N=35 to N=8261. A range of patient empowerment constructs was operationalised in included measures. These were classified into four domains: patient states, experiences and capacities; patient actions and behaviours; patient self-determination within the healthcare relationship and patient skills development. Quality assessment revealed several flaws in methodological study quality with COSMIN scores mainly fair or poor. The overall quality of psychometric properties of included measures was intermediate to positive. Certain psychometric properties were not tested for most measures. DISCUSSION Findings provide a basis from which to develop consensus on a core set of patient empowerment constructs and for further work to develop a (set of) appropriately validated measure(s) to capture this. The methodological quality of psychometric studies could be improved by adhering to published quality criteria.
Collapse
Affiliation(s)
- Paul J. Barr
- Dartmouth College, Lebanon, United States of America
| | - Isabelle Scholl
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Paulina Bravo
- Cardiff University, Cardiff, United Kingdom
- Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Marjan J. Faber
- Radboud University Medical Center, Scientific Institute for Quality of Healthcare, Nijmegen, The Netherlands
| | - Glyn Elwyn
- Dartmouth College, Lebanon, United States of America
| | | |
Collapse
|
39
|
Li H, Liu YL, Qiu L, Chen QL, Wu JB, Chen LL, Li N. Nurses' Empowerment Scale for ICU patients' families: an instrument development study. Nurs Crit Care 2014; 21:e11-21. [PMID: 25040509 DOI: 10.1111/nicc.12106] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 04/08/2014] [Accepted: 05/09/2014] [Indexed: 12/01/2022]
Abstract
BACKGROUND Family members provide essential support for ICU patients, contributing to their mental and physical recovery. Empowering ICU patients' families may help them overcome inadequacies and meet their own and patients' acknowledged needs. Nursing should understand and address patients' families' empowerment status. AIMS AND OBJECTIVES To develop a tool, the Nurses' Empowerment Scale for Intensive Care Unit (ICU) Patients' Families (NESIPF), to help ICU nursing staff assess the empowerment status of patients' families. DESIGN Four-phase instrument development study. METHODS A 19-item instrument was initially generated based on literature review and interviews with family members of ICU patients. The Delphi research method was applied to gain expert opinion and consensus via rounds of questionnaires. A panel of 27 experts experienced in critical care medicine, nursing and psychology participated in two Delphi rounds and their input helped formulate an 18-item pretest instrument. Families of 20 patients were recruited to examine instrument readability. After a 2-week interval, another 20 patients' families were recruited to examine test-retest reliability. Two hundred questionnaires were then administered and analysed to examine the instrument's construct validity, criterion-related validity and internal consistency. RESULTS Expert authority coefficients of two Delphi rounds reached 0·89 and 0·91. Kendall' W coefficients of 0·113 (P < 0·001) in round 1 and 0·220 (P < 0·001) in round 2 indicated slight to fair agreement among experts. Content validity index (CVI) reached 1·0 for 12 items; the CVI for item 13 was <0·7 so it was excluded. Cronbach's α coefficient was 0·92, indicating acceptable internal consistency reliability. The coefficient of internal consistency of each dimension was 0·717-0·921. The Pearson correlation coefficient >0·9 (P < 0·05) showed an acceptable test-retest reliability. CONCLUSIONS The instrument has acceptable reliability and validity and can assess the empowerment status of families of critically ill patients. RELEVANCE TO CLINICAL PRACTICE Knowledge of families' empowerment status may help to address their psychological needs and their ability to provide family support.
Collapse
Affiliation(s)
- Hong Li
- Nursing department, Fujian Provincial Hospital, Fujian Medical University Affiliated Clinical Medical Institute, Nursing School of Fujian Medical University, Fuzhou City, 350001 Fujian Province, China
| | - Ya-Lan Liu
- Nursing department, Qingdao University Medical School Affiliated Hospital Haiyang Sorting, Qingdao City, 265100 Shandong Province, China
| | - Li Qiu
- Department of surgical, Fujian University of Traditional Chinese Medicine, Fuzhou City, 350003 Fujian Province, China
| | - Qiao-Ling Chen
- Department of Critical Care Medicine, Fujian Provincial Hospital, Fujian Medical University Affiliated Clinical Medical Institute, Nursing School of Fujian Medical University, Fuzhou City, 350001 Fujian Province, China
| | - Jing-Bing Wu
- Department of Critical Care Medicine, Fujian Provincial Hospital, Fujian Medical University Affiliated Clinical Medical Institute, Nursing School of Fujian Medical University, Fuzhou City, 350001 Fujian Province, China
| | - Li-Li Chen
- Nursing department, Fujian Provincial Hospital, Fujian Medical University Affiliated Clinical Medical Institute, Nursing School of Fujian Medical University, Fuzhou City, 350001 Fujian Province, China
| | - Na Li
- Department of Critical Care Medicine, Fujian Provincial Hospital, Fujian Medical University Affiliated Clinical Medical Institute, Nursing School of Fujian Medical University, Fuzhou City, 350001 Fujian Province, China
| |
Collapse
|
40
|
Maunsell E, Lauzier S, Brunet J, Pelletier S, Osborne RH, Campbell HS. Health-related empowerment in cancer: validity of scales from the Health Education Impact Questionnaire. Cancer 2014; 120:3228-36. [PMID: 24988944 DOI: 10.1002/cncr.28847] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 03/21/2014] [Accepted: 03/25/2014] [Indexed: 11/08/2022]
Abstract
BACKGROUND Empowerment refers to an individual's feelings of being able to manage the challenges of the cancer experience and of having a sense of control over one's life. However, empowerment questionnaires that have been validated for the cancer setting are lacking. The objective of this study was to validate scales from the Health Education Impact Questionnaire (heiQ), which assesses the effects of health education programs among individuals with chronic conditions. The heiQ scales Social integration and support, Health service navigation, Constructive attitudes and approaches, Skill and technique acquisition, and Emotional distress were identified as key dimensions of empowerment for the cancer context. METHODS Adults who were diagnosed with cancer < 3 years earlier were recruited from a population-based cancer registry and from the Canadian Cancer Society's information and peer-support programs. The 731 participants completed a mailed questionnaire, which included the heiQ scales, related constructs, and demographics. Reliability was assessed using Cronbach α values, and validity was determined using confirmatory factor analysis and scale correlations with related constructs (self-efficacy, intrusive thoughts about cancer, and mental and physical health). RESULTS The hypothesized 5-factor model fit the data adequately (chi-square statistic, 528.17; degrees of freedom, 265; root mean square error of approximation, .04; non-normed fit index, .99; comparative fit index, 1.00; standardized root mean residual, .05). Factor loadings were high (23 of 25 were ≥ .70), and the factor correlations indicated separate but related constructs. Cronbach α values ranged from .75 to .90. A priori hypotheses about the correlations between heiQ scales and related constructs all were supported. CONCLUSIONS The current results support the validity of these 5 heiQ scales as generic measures of health-related empowerment in the cancer setting. These scales could fill an important gap in the measures currently available to evaluate proximal effects of support interventions.
Collapse
Affiliation(s)
- Elizabeth Maunsell
- Research Center, Centre hospitalier universitaire (CHU) de Québec, Québec, Québec, Canada; Deschenes-Fabia Breast Disease Center, Centre hospitalier universitaire (CHU) de Québec, Québec, Québec, Canada; Departement of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Québec, Québec, Canada
| | | | | | | | | | | |
Collapse
|
41
|
Lauzier S, Campbell HS, Livingston PM, Maunsell E. Indicators for evaluating cancer organizations' support services: Performance and associations with empowerment. Cancer 2014; 120:3219-27. [DOI: 10.1002/cncr.28846] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 03/13/2014] [Accepted: 03/13/2014] [Indexed: 11/08/2022]
Affiliation(s)
- Sophie Lauzier
- Faculty of Pharmacy; Université Laval; Québec Québec Canada
- Research Center; Centre hospitalier universitaire (CHU) de; Québec Québec, Québec Canada
- Chair on adherence to treatments; Université Laval; Québec Québec Canada
| | - H. Sharon Campbell
- Propel Center for Population Health Impact; University of Waterloo; Waterloo Ontario Canada
- School of Public Health and Health Systems, Faculty of Applied Health Sciences; University of Waterloo; Waterloo Ontario Canada
| | | | - Elizabeth Maunsell
- Research Center; Centre hospitalier universitaire (CHU) de; Québec Québec, Québec Canada
- Department of Social and Preventive Medicine, Faculty of Medicine; Université Laval; Québec Québec Canada
- Deschênes-Fabia Breast Disease Center; Centre hospitalier universitaire (CHU) de Québec; Québec Québec Canada
| |
Collapse
|
42
|
Psychometric evaluation of the Chinese version of the Patient Perceptions of Empowerment Scale (PPES). BIOMED RESEARCH INTERNATIONAL 2014; 2014:867451. [PMID: 24971354 PMCID: PMC4058164 DOI: 10.1155/2014/867451] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 04/28/2014] [Accepted: 05/01/2014] [Indexed: 12/31/2022]
Abstract
Objectives. To evaluate the psychometric properties of the Chinese version of the Patient Perceptions of Empowerment Scale (PPES) and to perform a cross-cultural validity assessment. Methods. In this cross-sectional survey, 554 inpatients in three general hospitals in northern Taiwan were recruited. Principal component analysis was used to examine the factor structure of the scale. Confirmatory factor analyses were conducted on the measurement model of the Chinese version of the PPES. Results. Confirmatory factor analyses supported the presence of a second-order four-factor model (information, decision, individual, and self-management) of the Chinese version of the PPES when used with a Taiwanese inpatient population. The results indicate that the 11-item, second-order, four-factor Chinese version of the PPES provided best goodness-of-fit for the data in this study. Conclusion. The 11-item four-factor Chinese version of the PPES is a self-completion scale. This study demonstrated that the Chinese version of the PPES is a reliable and valid self-report instrument for the assessment of patient perceptions of empowerment in clinical practice. Further adaptation and evaluation of the scale will hopefully stimulate further studies on PPES in the fields of psychometrics in Taiwan.
Collapse
|
43
|
Lau AYS, Gabarron E, Fernandez-Luque L, Armayones M. Social media in health--what are the safety concerns for health consumers? Health Inf Manag 2014; 41:30-5. [PMID: 23705132 DOI: 10.1177/183335831204100204] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Recent literature has discussed the unintended consequences of clinical information technologies (IT) on patient safety, yet there has been little discussion about the safety concerns in the area of consumer health IT. This paper presents a range of safety concerns for consumers in social media, with a case study on YouTube. We conducted a scan of abstracts on 'quality criteria' related to YouTube. Five areas regarding the safety of YouTube for consumers were identified: (a) harmful health material targeted at consumers (such as inappropriate marketing of tobacco or direct-to-consumer drug advertising); (b) public display of unhealthy behaviour (such as people displaying self-injury behaviours or hurting others); (c) tainted public health messages (i.e. the rise of negative voices against public health messages); (d) psychological impact from accessing inappropriate, offensive or biased social media content; and (e) using social media to distort policy and research funding agendas. The examples presented should contribute to a better understanding about how to promote a safe consumption and production of social media for consumers, and an evidence-based approach to designing social media interventions for health. The potential harm associated with the use of unsafe social media content on the Internet is a major concern. More empirical and theoretical studies are needed to examine how social media influences consumer health decisions, behaviours and outcomes, and devise ways to deter the dissemination of harmful influences in social media.
Collapse
Affiliation(s)
- Annie Y S Lau
- Centre for Health Informatics, Australian Institute of Health Innovation, University of New South Wales, Australia.
| | | | | | | |
Collapse
|
44
|
van den Berg SW, van Amstel FKP, Ottevanger PB, Gielissen MFM, Prins JB. The Cancer Empowerment Questionnaire: Psychological Empowerment in Breast Cancer Survivors. J Psychosoc Oncol 2013; 31:565-83. [DOI: 10.1080/07347332.2013.825361] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
|
45
|
Small N, Bower P, Chew-Graham CA, Whalley D, Protheroe J. Patient empowerment in long-term conditions: development and preliminary testing of a new measure. BMC Health Serv Res 2013; 13:263. [PMID: 23835131 PMCID: PMC3725177 DOI: 10.1186/1472-6963-13-263] [Citation(s) in RCA: 117] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Accepted: 06/21/2013] [Indexed: 11/10/2022] Open
Abstract
Background Patient empowerment is viewed by policy makers and health care practitioners as a mechanism to help patients with long-term conditions better manage their health and achieve better outcomes. However, assessing the role of empowerment is dependent on effective measures of empowerment. Although many measures of empowerment exist, no measure has been developed specifically for patients with long-term conditions in the primary care setting. This study presents preliminary data on the development and validation of such a measure. Methods We conducted two empirical studies. Study one was an interview study to understand empowerment from the perspective of patients living with long-term conditions. Qualitative analysis identified dimensions of empowerment, and the qualitative data were used to generate items relating to these dimensions. Study two was a cross-sectional postal study involving patients with different types of long-term conditions recruited from general practices. The survey was conducted to test and validate our new measure of empowerment. Factor analysis and regression were performed to test scale structure, internal consistency and construct validity. Results Sixteen predominately elderly patients with different types of long-term conditions described empowerment in terms of 5 dimensions (identity, knowledge and understanding, personal control, personal decision-making, and enabling other patients). One hundred and ninety seven survey responses were received from mainly older white females, with relatively low levels of formal education, with the majority retired from paid work. Almost half of the sample reported cardiovascular, joint or diabetes long-term conditions. Factor analysis identified a three factor solution (positive attitude and sense of control, knowledge and confidence in decision making and enabling others), although the structure lacked clarity. A total empowerment score across all items showed acceptable levels of internal consistency and relationships with other measures were generally supportive of its construct validity. Conclusion Initial analyses suggest that the new empowerment measure meets basic psychometric criteria. Reasons concerning the failure to confirm the hypothesized factor structure are discussed alongside further developments of the scale.
Collapse
Affiliation(s)
- Nicola Small
- Centre for Primary Care, Institute of Population Health, Manchester Academic Health Science Centre, University of Manchester, Oxford Road Williamson Building, Manchester, UK.
| | | | | | | | | |
Collapse
|
46
|
Payne K, McAllister M, Davies LM. Valuing the economic benefits of complex interventions: when maximising health is not sufficient. HEALTH ECONOMICS 2013; 22:258-71. [PMID: 22308053 DOI: 10.1002/hec.2795] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2010] [Revised: 10/28/2011] [Accepted: 12/21/2011] [Indexed: 05/07/2023]
Abstract
Complex interventions, involving interlinked packages of care, challenge the application of current methods of economic evaluation that focus on measuring only health gain. Complex interventions may be problematic on two levels. The complexity means the intervention may not fit into one of the current appraisal systems, and/or maximising health is not the only objective. This paper discusses the implications of a programme of work that focused on clinical genetics services, as an example of a complex intervention, and aimed to identify the following: the attributes that comprise both health and non-health aspects of benefits and whether it is possible to evaluate such an intervention using current National Institute for Health and Clinical Excellence appraisal processes. Genetic services and tests are a good example of a complex intervention and have broader objectives than just health gain, which may usefully be measured using the concept related to capability, which we have called 'empowerment'. Further methodological work is required to identify the trade-off between non-health (empowerment) and health benefits for other complex interventions. We do not advocate a move away from QALY maximisation but do suggest that there is a need for a more considered approach that can take account of the perceived value for non-health attributes for some complex interventions.
Collapse
Affiliation(s)
- Katherine Payne
- Health Sciences-Economics, The University of Manchester, Manchester, UK.
| | | | | |
Collapse
|
47
|
McAllister M, Dunn G, Payne K, Davies L, Todd C. Patient empowerment: the need to consider it as a measurable patient-reported outcome for chronic conditions. BMC Health Serv Res 2012; 12:157. [PMID: 22694747 PMCID: PMC3457855 DOI: 10.1186/1472-6963-12-157] [Citation(s) in RCA: 152] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Accepted: 05/29/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health policy in the UK and elsewhere is prioritising patient empowerment and patient evaluations of healthcare. Patient reported outcome measures now take centre-stage in implementing strategies to increase patient empowerment. This article argues for consideration of patient empowerment itself as a directly measurable patient reported outcome for chronic conditions, highlights some issues in adopting this approach, and outlines a research agenda to enable healthcare evaluation on the basis of patient empowerment. DISCUSSION Patient empowerment is not a well-defined construct. A range of condition-specific and generic patient empowerment questionnaires have been developed; each captures a different construct e.g. personal control, self-efficacy/self-mastery, and each is informed by a different implicit or explicit theoretical framework. This makes it currently problematic to conduct comparative evaluations of healthcare services on the basis of patient empowerment. A case study (clinical genetics) is used to (1) illustrate that patient empowerment can be a valued healthcare outcome, even if patients do not obtain health status benefits, (2) provide a rationale for conducting work necessary to tighten up the patient empowerment construct (3) provide an exemplar to inform design of interventions to increase patient empowerment in chronic disease. Such initiatives could be evaluated on the basis of measurable changes in patient empowerment, if the construct were properly operationalised as a patient reported outcome measure. To facilitate this, research is needed to develop an appropriate and widely applicable generic theoretical framework of patient empowerment to inform (re)development of a generic measure. This research should include developing consensus between patients, clinicians and policymakers about the content and boundaries of the construct before operationalisation. This article also considers a number of issues for society and for healthcare providers raised by adopting the patient empowerment paradigm. SUMMARY Healthcare policy is driving the need to consider patient empowerment as a measurable patient outcome from healthcare services. Research is needed to (1) tighten up the construct (2) develop consensus about what is important to include (3) (re)develop a generic measure of patient empowerment for use in evaluating healthcare (4) understand if/how people make trade-offs between empowerment and gain in health status.
Collapse
Affiliation(s)
- Marion McAllister
- Institute of Cancer & Genetics, Cardiff University, Heath Park, Cardiff CF14 4XN, UK.
| | | | | | | | | |
Collapse
|
48
|
Fillion L, Cook S, Veillette AM, Aubin M, de Serres M, Rainville F, Fitch M, Doll R. Professional Navigation Framework: Elaboration and Validation in a Canadian Context. Oncol Nurs Forum 2011; 39:E58-69. [DOI: 10.1188/12.onf.e58-e69] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
49
|
McAllister M, Wood AM, Dunn G, Shiloh S, Todd C. The Genetic Counseling Outcome Scale: a new patient-reported outcome measure for clinical genetics services. Clin Genet 2011; 79:413-24. [PMID: 21255005 DOI: 10.1111/j.1399-0004.2011.01636.x] [Citation(s) in RCA: 116] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The aim of this study was to develop a patient-reported outcome measure (PROM) for clinical genetics services. Previous research was used to develop a draft 84-item questionnaire, which was completed by 527 members of patient support groups. Responses were subjected to exploratory factor analysis (EFA). Parallel analysis was used to identify the number of factors to extract using oblique rotation. Twenty-four questions were selected to form the Genetic Counseling Outcome Scale (GCOS-24). Two hundred and forty-one patients completed a questionnaire pack before and after attendance at a genetics clinic that included the GCOS-24, and validated measures of health locus of control, perceived personal control, anxiety, depression, satisfaction with life and authenticity. Concurrent validity of the GCOS-24 was assessed using bivariate correlation. Sensitivity to change of the GCOS-24 was assessed using analysis of variance. EFA identified a single overarching construct consisting of seven dimensions. Internal consistency (α = 0.87) and test-retest reliability (r = 0.86) are good. The GCOS-24 shows convergent and divergent validities, and sensitivity to change over time with a medium-to-large effect size (Cohen's d = 0.70). The GCOS-24 has potential as a clinical genetics-specific PROM.
Collapse
Affiliation(s)
- M McAllister
- Medical Genetics Research Group, School of Biomedicine, The University of Manchester, Manchester, UK.
| | | | | | | | | |
Collapse
|
50
|
Hudon C, St-Cyr Tribble D, Légaré F, Bravo G, Fortin M, Almirall J. Assessing enablement in clinical practice: a systematic review of available instruments. J Eval Clin Pract 2010; 16:1301-8. [PMID: 20727059 PMCID: PMC3023028 DOI: 10.1111/j.1365-2753.2009.01332.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/10/2009] [Indexed: 12/30/2022]
Abstract
RATIONALE, AIMS AND OBJECTIVES Enablement is an intervention by which the health care provider recognizes, promotes and enhances patients' ability to control their health and life. An abundant health literature suggests that enablement is associated with good outcomes. In this review, we aimed at identifying and comparing instruments that assess enablement in the health care context. METHOD We conducted a systematic literature review using Medline, Embase, Cochrane, Cinahl and PsycINFO databases, 1980 through March 2009, with specific search strategy for each database. Citations were included if they reported: (1) development and/or validation of an instrument; (2) evaluation of enablement in a health care context; and (3) quantitative results following administration of the instrument. The quality of each main retained citation was assessed using a modified version of the Standards for Reporting of Diagnostic Accuracy. RESULTS Of 3135 citations identified, 53 were retrieved for detailed evaluation. Four articles were included. Two instruments were found: the Patient Empowerment Scale (PES) and the Empowering Speech Practices Scale (ESPS). Both instruments assessed enablement in hospital setting, one from the inpatient's perspective (PES) and the other from both perspectives (ESPS). CONCLUSION Two instruments assess enablement in hospital setting. No instrument is currently available to assess enablement in an ambulatory care context.
Collapse
Affiliation(s)
- Catherine Hudon
- Department of Family Medicine, Université de Sherbrooke, Sherbrooke, Québec, Canada.
| | | | | | | | | | | |
Collapse
|