Development and validation of the healthcare providers patient-activation scale.

Abstract

It has become increasingly important to assess healthcare providers' role in chronic disease self-management (CDSM) and patient activation (PA). The present study extends previous work relating to patients' behaviours by assessing healthcare providers' own behaviours in supporting PA. 50 items were generated: half assessed a PA approach; half reflected a non-patient-activation approach. 105 healthcare providers working in cardiac rehabilitation who were participants in a CDSM online training program completed the items pre- and post-training. Factor analysis determined the presence of higher order factors. Item responses pre- and post-training were compared to assess sensitivity to change. Results indicated the presence of two factors: 'patient-activation approach' and 'non-patient-activation approach'. While both demonstrated good internal consistency, the' non-PA approach' had superior discriminatory validity and sensitivity to change. Healthcare providers' beliefs about the importance of patient-activation behaviours can be measured by 40-item Healthcare Provider-Patient Activation Scale (HP-PAS). The scale could be easily converted to measure healthcare providers' actual PA behaviours. The HP-PAS could be used to assess the effectiveness of clinician training for healthcare providers working in cardiac rehabilitation and other areas of CDSM. Further reliability and validity testing within other healthcare provider samples is warranted.