PDF(Pubmed)
Abstract：
Patient activation, broadly defined as the ability of individuals to manage their health and navigate the healthcare system effectively, is crucial for achieving positive health outcomes. The Patient Activation Measure (PAM), a popularly used tool, was developed to assess this vital component of health care. This review is the first to systematically examine the validity of the PAM, as well as study its reliability, factor structure, and validity across various populations. Following the PRISMA and COSMIN guidelines, a search was conducted in MEDLINE, EMBASE, and Cochrane Library, from inception to 1 October 2023, using combinations of keywords related to patient activation and the PAM. The inclusion criteria were original quantitative or mixed methods studies focusing on PAM-13 or its translated versions and containing data on psychometric properties. Out of 3007 abstracts retrieved, 39 studies were included in the final review. The PAM has been extensively studied across diverse populations and geographical regions, including the United States, Europe, Asia, and Australia. Most studies looked at populations with chronic conditions. Only two studies applied the PAM to community-dwelling individuals and found support for its use. Studies predominantly showed a high internal consistency (Cronbach\'s alpha > 0.80) for the PAM. Most studies supported a unidimensional construct of patient activation, although cultural differences influenced the factor structure in some cases. Construct validity was established through correlations with health behaviors and outcomes. Despite its strengths, there is a need for further research, particularly in exploring content validity and differential item functioning. Expanding the PAM\'s application to more diverse demographic groups and community-dwelling individuals could enhance our understanding of patient activation and its impact on health outcomes.
摘要：
患者激活,广义上定义为个人有效管理健康和驾驭医疗系统的能力，对于实现积极的健康结果至关重要。患者激活测量（PAM）一种普遍使用的工具，是为了评估医疗保健的这一重要组成部分而开发的。这篇综述是第一个系统检验PAM有效性的综述，以及研究其可靠性，要素结构，以及不同人群的有效性。按照PRISMA和COSMIN准则,在MEDLINE进行了搜索，EMBASE,和Cochrane图书馆,从开始到2023年10月1日，使用与患者激活和PAM相关的关键词的组合。纳入标准是原始的定量或混合方法研究，重点是PAM-13或其翻译版本，并包含有关心理测量特性的数据。在检索到的3007份摘要中，39项研究纳入最终审查。PAM已在不同的人群和地理区域进行了广泛的研究，包括美国,欧洲,亚洲,和澳大利亚。大多数研究着眼于患有慢性病的人群。只有两项研究将PAM应用于社区居民，并找到了对其使用的支持。研究主要显示PAM的内部一致性很高(Cronbach'sα>0.80)。大多数研究支持患者激活的一维结构，尽管文化差异在某些情况下影响了因素结构。通过与健康行为和结果的相关性来建立结构效度。尽管它的优势，需要进一步研究，特别是在探索内容有效性和差异项目功能方面。将PAM的应用扩展到更多样化的人口群体和社区居民可以增强我们对患者激活及其对健康结果的影响的理解。
