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The Patient Activation Measure: a validation study in a neurological population

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Abstract

Purpose

To assess the validity of the Patient Activation Measure (PAM13) of patient activation in persons with neurological conditions.

Methods

“The Everyday Experience of Living with and Managing a Neurological Condition” (The LINC study) surveyed 948 adults with neurological conditions residing in Canada in 2011 and 2012. Using data for 722 respondents who met coding requirements for the PAM-13, we examined the properties of the measure using principle components analysis, inter-item correlations and Cronbach’s alpha to assess unidimensionality and internal consistency. Rasch modeling was used to assess item performance and scaling. Construct validity was assessed by calculating associations between the PAM and known correlates.

Results

PAM-13 provides a suitably reliable and valid instrument for research in patients with neurological conditions, but scaling problems may yield measurement error and biases for those with low levels of activation. This is of particular importance when used in clinical settings or for individual client care. Our study also suggests that measurement of activation may benefit from tailoring items and scaling to specific diagnostic groups such as people with neurological conditions, thus allowing the PAM-13 to recognize unique attributes and management challenges in those conditions.

Conclusions

The PAM-13 is an internally reliable and valid tool for research purposes. The use of categorical activation “level” in clinical settings should be done with caution.

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Acknowledgments

This study was part of the National Population Health Study of Neurological Conditions. We wish to acknowledge the membership of Neurological Health Charities Canada and the Public Health Agency of Canada for their contribution to the success of this initiative. Funding for the study was provided by the Public Health Agency of Canada. The opinions expressed in this publication are those of the authors/researchers and do not necessarily reflect the official views of the Public Health Agency of Canada. The authors wish to thank the many participants in the LINC study as well as the large research team who made the study possible.

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Authors and Affiliations

  1. School of Occupational Therapy, Dalhousie University, Forrest Building, Rm 161, 5869 University Av., P.O. Box 15000, Halifax, NS, B3H 4R2, Canada

    Tanya L. Packer, Åsa Audulv, Joan Versnel & Grace Warner

  2. Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada

    George Kephart

  3. School of Rehabilitation Therapy, Queen’s University, Kingston, ON, Canada

    Setareh Ghahari

  4. Department of Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

    Setareh Ghahari

  5. Department of Nursing, Mid Sweden University, Sundsvall, Sweden

    Åsa Audulv

Authors
  1. Tanya L. Packer
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  2. George Kephart
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  3. Setareh Ghahari
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  4. Åsa Audulv
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  5. Joan Versnel
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  6. Grace Warner
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Correspondence to Tanya L. Packer.

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Packer, T.L., Kephart, G., Ghahari, S. et al. The Patient Activation Measure: a validation study in a neurological population. Qual Life Res 24, 1587–1596 (2015). https://doi.org/10.1007/s11136-014-0908-0

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