22
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      The role of Patient Health Engagement Model (PHE-model) in affecting patient activation and medication adherence: A structural equation model

      research-article
      1 , * , 1 , 2
      PLoS ONE
      Public Library of Science

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Increasing bodies of scientific research today examines the factors and interventions affecting patients’ ability to self-manage and adhere to treatment. Patient activation is considered the most reliable indicator of patients’ ability to manage health autonomously. Only a few studies have tried to assess the role of psychosocial factors in promoting patient activation. A more systematic modeling of the psychosocial factors explaining the variance of patient activation is needed.

          Objective

          To test the hypothesized effect of patient activation on medication adherence; to test the the hypothesized effects of positive emotions and of the quality of the patient/doctor relationship on patient activation; and to test the hypothesized mediating effect of Patient Health Engagement (PHE-model) in this pathway.

          Material and methods

          This cross-sectional study involved 352 Italian-speaking adult chronic patients. The survey included measures of i) patient activation ( Patient Activation Measure 13 –short form); ii) Patient Health Engagement model ( Patient Health Engagement Scale); iii) patient adherence ( 4 item-Morinsky Medication Adherence Scale); iv) the quality of the patients’ emotional feelings ( Manikin Self Assessment Scale); v) the quality of the patient/doctor relationship ( Health Care Climate Questionnaire). Structural equation modeling was used to test the hypotheses proposed.

          Results

          According to the theoretical model we hypothesized, research results confirmed that patients’ activation significantly affects their reported medication adherence. Moreover, psychosocial factors, such as the patients’ quality of the emotional feelings and the quality of the patient/doctor relationship were demonstrated to be factors affecting the level of patient activation. Finally, the mediation effect of the Patient Health Engagement model was confirmed by the analysis.

          Conclusions

          Consistently with the results of previous studies, these findings demonstrate that the Patient Health Engagement Model is a critical factor in enhancing the quality of care. The Patient Health Engagement Model might acts as a mechanism to increase patient activation and adherence.

          Related collections

          Most cited references60

          • Record: found
          • Abstract: found
          • Article: not found

          Measuring emotion: the Self-Assessment Manikin and the Semantic Differential.

          The Self-Assessment Manikin (SAM) is a non-verbal pictorial assessment technique that directly measures the pleasure, arousal, and dominance associated with a person's affective reaction to a wide variety of stimuli. In this experiment, we compare reports of affective experience obtained using SAM, which requires only three simple judgments, to the Semantic Differential scale devised by Mehrabian and Russell (An approach to environmental psychology, 1974) which requires 18 different ratings. Subjective reports were measured to a series of pictures that varied in both affective valence and intensity. Correlations across the two rating methods were high both for reports of experienced pleasure and felt arousal. Differences obtained in the dominance dimension of the two instruments suggest that SAM may better track the personal response to an affective stimulus. SAM is an inexpensive, easy method for quickly assessing reports of affective response in many contexts.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Development and testing of a short form of the patient activation measure.

            The Patient Activation Measure (PAM) is a 22-item measure that assesses patient knowledge, skill, and confidence for self-management. The measure was developed using Rasch analyses and is an interval level, unidimensional, Guttman-like measure. The current analysis is aimed at reducing the number of items in the measure while maintaining adequate precision. We relied on an iterative use of Rasch analysis to identify items that could be eliminated without loss of significant precision and reliability. With each item deletion, the item scale locations were recalibrated and the person reliability evaluated to check if and how much of a decline in precision of measurement resulted from the deletion of the item. The data used in the analysis were the same data used in the development of the original 22-item measure. These data were collected in 2003 via a telephone survey of 1,515 randomly selected adults. Principal Findings. The analysis yielded a 13-item measure that has psychometric properties similar to the original 22-item version. The scores for the 13-item measure range in value from 38.6 to 53.0 (on a theoretical 0-100 point scale). The range of values is essentially unchanged from the original 22-item version. Subgroup analysis suggests that there is a slight loss of precision with some subgroups. The results of the analysis indicate that the shortened 13-item version is both reliable and valid.
              Bookmark
              • Record: found
              • Abstract: not found
              • Article: not found

              Self-efficacy: Toward a unifying theory of behavioral change

                Bookmark

                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                27 June 2017
                2017
                : 12
                : 6
                : e0179865
                Affiliations
                [1 ]Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
                [2 ]Department of Statistical Sciences, Università Cattolica del Sacro Cuore, Milan, Italy
                IRCCS Istituto Auxologico Italiano, ITALY
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                • Conceptualization: GG SB.

                • Data curation: AB.

                • Formal analysis: AB.

                • Investigation: GG SB.

                • Methodology: GG SB.

                • Project administration: GG.

                • Resources: GG SB.

                • Software: AB.

                • Supervision: GG.

                • Validation: GG SB.

                • Writing – original draft: GG SB.

                • Writing – review & editing: GG SB AB.

                Author information
                http://orcid.org/0000-0002-8514-2563
                Article
                PONE-D-16-46639
                10.1371/journal.pone.0179865
                5487073
                28654686
                057e02b1-35e5-4257-bf3a-7aa7073f1010
                © 2017 Graffigna et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 24 November 2016
                : 6 June 2017
                Page count
                Figures: 2, Tables: 5, Pages: 19
                Funding
                The authors received no specific funding for this work.
                Categories
                Research Article
                Medicine and Health Sciences
                Health Care
                Patients
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Biology and Life Sciences
                Psychology
                Psychometrics
                Social Sciences
                Psychology
                Psychometrics
                Biology and Life Sciences
                Psychology
                Emotions
                Social Sciences
                Psychology
                Emotions
                Social Sciences
                Sociology
                Education
                Schools
                People and Places
                Population Groupings
                Ethnicities
                Italian People
                Research and Analysis Methods
                Research Design
                Survey Research
                Surveys
                Research and Analysis Methods
                Research Design
                Survey Research
                Questionnaires
                Custom metadata
                All relevant data are within the paper.

                Uncategorized
                Uncategorized

                Comments

                Comment on this article