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      How health literacy and patient activation play their own unique role in self-management of chronic obstructive pulmonary disease (COPD)?

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          Abstract

          Current evidence indicates that although they are correlated, health literacy (HL) and patient activation (PA) are distinct. This article describes how HL, PA and their determinants intersect and diverge and how these concepts might inform the development of self-management interventions. The concepts of HL and PA contribute to self-management interventions in different ways. HL includes the skills and confidence required for self-management while PA focuses more on motivation and ability to take action. In this light, communication of concepts on HL and PA needs to be more widely understood by academics, researchers and policy experts as each of them plays a unique role in promoting self-management for long-term conditions such as chronic obstructive pulmonary disease.

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

          Judith Hibbard, Eldon R. Mahoney, Jean Stockard … (2005)
          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.
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            Self management for patients with chronic obstructive pulmonary disease.

            Marlies Zwerink, Marjolein Brusse-Keizer, Paul van der Valk … (2014)
            Self management interventions help patients with chronic obstructive pulmonary disease (COPD) acquire and practise the skills they need to carry out disease-specific medical regimens, guide changes in health behaviour and provide emotional support to enable patients to control their disease. Since the first update of this review in 2007, several studies have been published. The results of the second update are reported here.
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              Patient and Disease Characteristics Associated with Activation for Self-Management in Patients with Diabetes, Chronic Obstructive Pulmonary Disease, Chronic Heart Failure and Chronic Renal Disease: A Cross-Sectional Survey Study

              Irene Bos-Touwen, Marieke Schuurmans, Evelyn Monninkhof … (2015)
              A substantial proportion of chronic disease patients do not respond to self-management interventions, which suggests that one size interventions do not fit all, demanding more tailored interventions. To compose more individualized strategies, we aim to increase our understanding of characteristics associated with patient activation for self-management and to evaluate whether these are disease-transcending. A cross-sectional survey study was conducted in primary and secondary care in patients with type-2 Diabetes Mellitus (DM-II), Chronic Obstructive Pulmonary Disease (COPD), Chronic Heart Failure (CHF) and Chronic Renal Disease (CRD). Using multiple linear regression analysis, we analyzed associations between self-management activation (13-item Patient Activation Measure; PAM-13) and a wide range of socio-demographic, clinical, and psychosocial determinants. Furthermore, we assessed whether the associations between the determinants and the PAM were disease-transcending by testing whether disease was an effect modifier. In addition, we identified determinants associated with low activation for self-management using logistic regression analysis. We included 1154 patients (53% response rate); 422 DM-II patients, 290 COPD patients, 223 HF patients and 219 CRD patients. Mean age was 69.6±10.9. Multiple linear regression analysis revealed 9 explanatory determinants of activation for self-management: age, BMI, educational level, financial distress, physical health status, depression, illness perception, social support and underlying disease, explaining a variance of 16.3%. All associations, except for social support, were disease transcending. This study explored factors associated with varying levels of activation for self-management. These results are a first step in supporting clinicians and researchers to identify subpopulations of chronic disease patients less likely to be engaged in self-management. Increased scientific efforts are needed to explain the greater part of the factors that contribute to the complex nature of patient activation for self-management.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Chron Respir Dis
                Journal ID (iso-abbrev): Chron Respir Dis
                Journal ID (publisher-id): CRD
                Journal ID (hwp): spcrd
                Title: Chronic Respiratory Disease
                Publisher: SAGE Publications (Sage UK: London, England )
                ISSN (Print): 1479-9723
                ISSN (Electronic): 1479-9731
                Publication date (Electronic): 26 December 2018
                Publication date Collection: Jan-Dec 2019
                Volume: 16
                Electronic Location Identifier: 1479973118816418
                Affiliations
                [1 ]Centre for Primary Health Care and Equity, UNSW, Sydney, Australia
                [2 ]School of Public Health and Community Medicine, UNSW, Sydney, Australia
                Author notes
                [*]Uday Narayan Yadav, Centre for Primary Health Care and Equity, School of Public Health and Community Medicine, UNSW, Sydney, Australia. Email: u.yadav@ 123456unsw.edu.au
                Author information
                https://orcid.org/0000-0002-6626-1604
                Article
                Publisher ID: 10.1177_1479973118816418
                DOI: 10.1177/1479973118816418
                PMC ID: 6318723
                PubMed ID: 30789021
                SO-VID: c1b4e843-d84f-494b-803a-863d0612b29b
                Copyright © © The Author(s) 2018
                License:

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                Date received : 28 June 2018
                Date accepted : 31 October 2018
                Categories
                Subject: Hot Topic
                Custom metadata
                cover-date January-December 2019

                ScienceOpen disciplines: Respiratory medicine
                Keywords: behaviour,chronic obstructive pulmonary disease,health literacy,patient activation,self-management
                Data availability:
                ScienceOpen disciplines: Respiratory medicine
                Keywords: behaviour, chronic obstructive pulmonary disease, health literacy, patient activation, self-management

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