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词条 Patient Activation Measure
释义

  1. Development and science

  2. Research

  3. Use through Insignia Health

  4. References

The Patient Activation Measure (PAM) is a commercial product which assesses an individual's knowledge, skill, and confidence for managing one's health and healthcare. Individuals who measure high on this assessment typically understand the importance of taking a pro-active role in managing their health and have the skills and confidence to do so.

The PAM survey measures patients on a 0–100 scale and can segment patients into one of four activation levels along an empirically derived continuum. Each activation level reveals insight into an array of health-related characteristics, including attitudes, motivators, behaviors, and outcomes.

Development and science

PAM was developed using qualitative methods, Rasch analysis, and classical test theory psychometric methods. Developed by Judith Hibbard and colleagues at the University of Oregon, the resulting 13-item measure is a uni-dimensional, interval level, Guttman-like scale.[1][2] The PAM has strong psychometric properties, and has been translated into 22 different languages.[3] The measure is currently used to assess patient activation or engagement by researchers and clinicians around the world.[4][5][6][7] PAM is offered to healthcare organizations exclusively by Insignia Health, a company based in Portland, Oregon.

Research

Multiple studies show that PAM scores are predictive of most health behaviors, including preventive behaviors (e.g. obtaining screenings and immunizations); healthy behaviors (e.g. healthy diet and regular exercise); self-management behaviors (e.g. monitoring and medication management); and health information seeking.[8][9][10][11][12][13][14][15][16][17][18] Higher activated individuals also have better health outcomes and lower rates of costly utilization, such as emergency department use and hospitalizations.[8][16][17][18][19]

Further there is evidence that with support and appropriate interventions it is possible to increase activation levels in patients.[20][21][22][23][24]

The Patient Activation Measure is being used in a number of ways to improve the delivery of health care, including:

  • a metric to assess the degree to which patients are prepared and able to self-manage
  • to tailor support and education to help patients increase in activation
  • to track the impact of interventions and tailored support on increasing patient activation levels
  • to segment an enrolled patient population, and direct more resources to low activated patients (a more efficient use of resources )
  • to use in population health management
  • to use in predictive modeling, by using both PAM scores and clinical data, it is possible to identify future high risk/high cost patients more accurately than just using clinical data[25]

Use through Insignia Health

Insignia Health holds the worldwide exclusive rights to PAM per a technology transfer from University of Oregon. Insignia licenses PAM and other related products to organizations in the U.S. and abroad. PAM is being used in 16 countries today.

References

1. ^{{cite journal|last1=Hibbard|first1=Judith |last2=Stockard|first2=J |last3=Mahoney|first3=ER |last4=Tusler|first4=M |title=Development of the Patient Activation Measure (PAM): Conceptualizing and measuring activation in patients and consumers|journal=Health Services Research|date=August 2004|volume=39|issue=4|pages=1005–10026|doi=10.1111/j.1475-6773.2004.00269.x|pmid=15230939|pmc=1361049}}
2. ^{{cite journal|last1=Hibbard|first1=Judith |last2=Mahoney|first2=Eldon R. |last3=Stockard|first3=Jean |last4=Tusler|first4=Martin |title=Development and testing of a short form of the patient activation measure|journal=Health Services Research|date=December 2005|volume=40|issue=6|pages=1918–1930|doi=10.1111/j.1475-6773.2005.00438.x|pmid=16336556|pmc=1361231}}
3. ^{{cite web |last1=Hibbard |first1=Judith |editor-last1=deBronkart |editor1-first=e-Patient Dave |date=27 July 2014 |title=[Comment on] The Patient Activation Measure (PAM): a framework for developing patient engagement |website=e-patients.net |publisher=Society for Participatory Medicine |url=http://e-patients.net/archives/2011/10/the-patient-activation-measure-pam-a-framework-for-developing-patient-engagement.html#comment-263236 }}
4. ^{{cite journal |last1=Rademakers |first1=Jany |last2=Nijman |first2=Jessica |last3=van der Hoek |first3=Lucas |last4=Heijmans |first4=Monique |last5=Rijken |first5=Mieke |title=Measuring patient activation in the Netherlands: translation and validation of the American short form Patient Activation Measure (PAM13) |journal=BMC Public Health |date=31 July 2012 |volume=12 |page=577 |doi=10.1186/1471-2458-12-577 |pmid=22849664 |pmc=3490810 }}
5. ^{{cite journal |last1=Brenk-Franz|first1=K |last2=Hibbard|first2=JH |last3=Herrmann|first3=WJ |last4=Freund|first4=T |last5=Szecsenyi|first5=J |last6=Djalali|first6=S |last7=Steurer-Stey|first7=C |last8=Sönnichsen|first8=A |last9=Tiesler|first9=F |last10=Storch|first10=M |last11=Schneider|first11=N |last12=Gensichen|first12=J |date=30 September 2013 |title=Validation of the German version of the patient activation measure 13 (PAM13-D) in an international multicentre study of primary care patients |journal=PLoS One |volume=8 |issue=9 |page=e74786 |doi=10.1371/journal.pone.0074786 |pmid=24098669 |pmc=3787015 }}
6. ^{{cite journal |last1=Fujita|first1=Emi |last2=Kuno|first2=Eri |last3=Kato|first3=Daiji |last4=Kokochi|first4=Mariko |last5=Uehara|first5=Kumi |last6=Hirayasu|first6=Yoshio |title=精神の健康管理への積極性評価尺度(Patient Activation Measure 13 for Mental Health；PAM13-MH)日本語版の開発 |trans-title=Development and Validation of the Japanese Version of the Patient Activation Measure 13 for Mental Health |language=Japanese |journal=Seishin Igaku (Clinical Psychiatry) |date=15 August 2010 |volume=52 |pages=765–772 |doi=10.11477/mf.1405101678 }}
7. ^{{cite journal |last1=Steinsbekk |first1=A |title=Måling av effekt av pasientopplæring |trans-title=Patient Activation Measure |language=Norwegian |journal=Tidsskrift for den Norske Lægeforening |date=23 October 2008 |volume=128 |issue=20 |pages=2316–2318 |pmid=19096487 |url=http://tidsskriftet.no/article/1748238 }}
8. ^1 {{cite journal |last1=Greene |first1=Jessica |last2=Hibbard |first2=Judith H. |title=Why Does Patient Activation Matter? An Examination of the Relationship Between Patient Activation and Health-Related Outcomes |journal=Journal of General Internal Medicine |date=May 2012 |volume=27 |issue=5 |pages=520–6 |doi=10.1007/s11606-011-1931-2 |pmid=22127797 |pmc=3326094 }}
9. ^{{cite journal|last1=Hibbard|first1=Judith |last2=Mahoney|first2=ER |last3=Stock|first3=R |last4=Tusler|first4=M |title=Do increases in patient activation result in improved self-management behaviors?|journal=Health Services Research|date=August 2007|volume=42|issue=4|pages=1443–1463|doi=10.1111/j.1475-6773.2006.00669.x|pmid=17610432|pmc=1955271}}
10. ^{{cite journal|last1=Fowles|first1=Jinnet Briggs |last2=Terry|first2=Paul |last3=Xi|first3=Min |last4=Hibbard|first4=Judith |last5=Bloom|first5=Christine Taddy |last6=Harvey|first6=Lisa |title=Measuring self-management of patients' and employees' health: further validation of the Patient Activation Measure (PAM) based on its relation to employee characteristics|journal=Patient Education and Counseling|date=October 2009|volume=77|issue=1|pages=116–122|doi=10.1016/j.pec.2009.02.018 |pmid=19356881}}
11. ^{{cite journal |last1=Mosen|first1=David M. |last2=Schmittdiel|first2=Julie |last3=Hibbard|first3=Judith |last4=Sobel|first4=David |last5=Remmers|first5=Carol |last6=Bellows|first6=Jim |title=Is patient activation associated with outcomes of care for adults with chronic conditions?|journal=Journal of Ambulatory Care Management|date=January–March 2007|volume=30|issue=1|pages=21–29|doi=10.1097/00004479-200701000-00005 |pmid=17170635 }}
12. ^{{cite journal |last1=Becker |first1=Edmund R. |last2=Roblin |first2=Douglas W. |title=Translating primary care practice climate into patient activation: the role of patient trust in physician |journal=Medical Care |date=August 2008 |volume=46 |issue=8 |pages=795–805 |doi=10.1097/mlr.0b013e31817919c0 |pmid=18665059 }}
13. ^{{cite journal |last1=Hibbard |first1=Judith |last2=Cunningham |first2=PJ |title=How engaged are consumers in their health and health care, and why does it matter? |journal=Research Brief |date=October 2008 |volume=8 |issue=8 |pages=1–9 |pmid=18946947 }}
14. ^{{cite journal |last1=Tabrizi |first1=Jafar S. |last2=Wilson |first2=Andrew J. |last3=O'Rourke |first3=Peter K. |title=Customer Quality and Type 2 Diabetes from the Patients' Perspective: A Cross-Sectional Study |journal=Journal of Research in Health Sciences |date=18 December 2010 |volume=10 |issue=2 |pages=69–76 |url=http://jrhs.umsha.ac.ir/index.php/JRHS/article/view/207/html |pmid=22911927 }}
15. ^{{cite journal|last1=Rask|first1=Kimberly J. |last2=Ziemer|first2=David C. |last3=Kohler|first3=Susan A. |last4=Hawley|first4=Jonathan N. |last5=Arinde|first5=Folakemi J. |last6=Barnes|first6=Catherine S. |title=Patient activation is associated with healthy behaviors and ease in managing diabetes in an indigent populations|journal=Diabetes Education|date=July–August 2009|volume=35|issue=4|pages=622–630|doi=10.1177/0145721709335004 |pmid=19419972 }}
16. ^1 {{cite journal |last1=Rogvi|first1=S |last2=Tapager|first2=I |last3=Almdal|first3=TP |last4=Schiøtz|first4=ML |last5=Willaing|first5=I |date=October 2012 |title=Patient factors and glycaemic control: associations and explanatory power |journal=Diabetic Medicine |volume=29 |issue=10 |pages=e382–9 |doi=10.1111/j.1464-5491.2012.03703.x |pmid=22540962 }}
17. ^1 {{cite journal|last1=Salyers|first1=Michelle P. |last2=Matthias|first2=Marianne S. |last3=Spann|first3=Crystal L. |last4=Lydick|first4=Jennifer M. |last5=Rollins|first5=Angela L. |last6=Frankel|first6=Richard M. |title=The role of patient activation in psychiatric visits |journal=Psychiatric Services |date=November 2009 |volume=60 |issue=11 |pages=1535–1539 |doi=10.1176/appi.ps.60.11.1535 |pmid=19880475 |pmc=2777630 }}
18. ^1 {{cite journal |last1=Remmers|first1=Carol |last2=Hibbard|first2=Judith |last3=Mosen|first3=David M. |last4=Wagenfield|first4=Morton |last5=Hoy|first5=Robert E. |last6=Jones |first6=Ches |title=Is patient activation associated with future health outcomes and healthcare utilization among patients with diabetes? |journal=Journal of Ambulatory Care Management |date=October–December 2009 |volume=32 |issue=4 |pages=320–327 |doi=10.1097/jac.0b013e3181ba6e77 |pmid=19888008 }}
19. ^{{cite journal |last1=Begum|first1=Nelufa |last2=Donald|first2=Maria |last3=Ozolins|first3=Ieva Z. |last4=Dower|first4=Jo |title=Hospital admissions, emergency department utilisation and patient activation for self-management among people with diabetes |journal=Diabetes Research and Clinical Practice |date=August 2011 |volume=93 |issue=2 |pages=260–267 |doi=10.1016/j.diabres.2011.05.031 |pmid=21684030 }}
20. ^{{cite journal|last1=Lorig|first1=K |last2=Ritter|first2=PL |last3=Laurent|first3=DD |last4=Plant|first4=K |last5=Green|first5=M |last6=Jernigan|first6=VB |last7=Case|first7=S |title=Online Diabetes Self-Management Program: A randomized study|journal=Diabetes Care|date=June 2010|volume=33|issue=6|pages=1275–1281|doi=10.2337/dc09-2153|pmid=20299481|pmc=2875437}}
21. ^{{cite journal |last1=Druss|first1=Benjamin G. |last2=Zhao|first2=Liping |last3=von Esenwein|first3=Silke A. |last4=Bona|first4=Joseph R. |last5=Fricks|first5=Larry |last6=Jenkins-Tucker|first6=Sherry |last7=Sterling|first7=Evelina |last8=DiClemente|first8=Ralph |last9=Lorig|first9=Kate |title=The Health and Recovery Peer (HARP) Program: a peer-led intervention to improve medical self-management for persons with serious mental illness |journal=Schizophrenia Research |date=May 2010 |volume=118 |issue=1–3 |pages=264–270 |doi=10.1016/j.schres.2010.01.026 |pmid=20185272 |pmc=2856811 }}
22. ^{{cite journal |last1=Terry|first1=Paul E. |last2=Fowles|first2=Jinnet Briggs |last3=Xi|first3=Min |last4=Harvey|first4=Lisa |title=The ACTIVATE study: results from a group-randomized controlled trial comparing a traditional worksite health promotion program with an activated consumer program |journal=American Journal of Health Promotion |date=November–December 2011 |volume=26 |issue=2 |pages=e64–73 |doi=10.4278/ajhp.091029-quan-348 |pmid=22040398 }}
23. ^{{cite journal |last1=Shively|first1=MJ |last2=Gardetto|first2=NJ |last3=Kodiath|first3=MF |last4=Kelly|first4=A |last5=Smith|first5=TL |last6=Stepnowsky|first6=C |last7=Maynard|first7=C |last8=Larson|first8=CB |date=January–February 2013 |title=Effect of Patient Activation on Self-Management in Patients with Heart Failure |journal=Journal of Cardiovascular Nursing |volume=28 |issue=1 |pages=20–34 |doi=10.1097/JCN.0b013e318239f9f9 |pmid=22343209 }}
24. ^{{cite journal |last1=Hibbard |first1=Judith H. |last2=Greene |first2=Jessica |last3=Tusler |first3=Martin |title=Improving the outcomes of disease management by tailoring care to the patient's level of activation |journal=American Journal of Managed Care |date=15 June 2009 |volume=15 |issue=6 |pages=353–360 |url=http://www.ajmc.com/journals/issue/2009/2009-06-vol15-n6/AJMC_09Jun_Hibbard_353to360/ |pmid=19514801 }}
25. ^{{cite journal|last1=Hibbard|first1=Judith|title=Adding A Measure Of Patient Self-Management Capability To Risk Assessment Can Improve Prediction Of High Costs|journal=Health Affairs|date=March 2016|volume=35|issue=3|pages=489–494|doi=10.1377/hlthaff.2015.1031|pmid=26953304}}

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