Reliability and validity of the patient activation measure in hospitalized patients

Abstract

Objective: The purposes of this paper are to describe the internal consistency reliability and construct validity of the PAM-13 for hospitalized cardiology and oncology patients and to examine the predictors of low patient activation in the same population.

Methods: We evaluated the internal consistency reliability of the PAM-13 in the inpatient setting. Construct validity of the PAM-13 was then assessed using two approaches: expected known-groups differences between patients with planned and unplanned admissions PAM-13 levels and convergence of PAM-13 levels with other measures.

Results: The PAM demonstrated adequate internal consistency overall (Cronbach α=0.81). Patients with unplanned admissions were more likely to have low activation than patients with planned admissions (adjusted OR=5.7, p=0.008). The PAM-13 was modestly correlated (p<0.001) with each of the PROMIS Global Health components used in this study (global, physical and mental health).

Conclusion: This study demonstrates the PAM-13 is a reliable and valid measure for use in the inpatient hospital setting and that type of admission (planned versus unplanned) is an important predictor of patient activation.

Practice implications: By measuring patient activation with the PAM-13, clinicians and researchers can provide tailored communication and care strategies to meet patient's needs.

Keywords: Clinical informatics; Inpatient; Known-group analysis; Patient activation; Patient engagement; Validation.