Association between patient activation and patient-assessed quality of care in type 2 diabetes: results of a longitudinal study

作者：Aung Eindra^*; Donald Maria; Coll Joseph R; Williams Gail M; Doi Suhail A R

来源：Health Expectations, 2016, 19(2): 356-366.

DOI：10.1111/hex.12359

• chronic illness care
• patient activation
• Patient Assessment of Chronic Illness Care
• patient experiences
• quality assessment

BackgroundPrevious research using cross-sectional data has shown a positive relationship between patient activation and quality of care. The quantitative relationships in the same patients over time, however, remain undefined.
ObjectiveTo examine the relationship between changes in activation over time and patient-assessed quality of chronic illness care.
DesignProspective cohort study.
ParticipantsThe study used data reported annually from 2008 (N=3761) to 2010 (N=3040), using self-report survey questionnaires, completed by patients with type 2 diabetes in a population-based cohort in Queensland, Australia.
Main MeasuresPrincipal measures were the 13-item Patient Activation Measure (PAM), and the 20-item Patient Assessment of Chronic Illness Care (PACIC) instrument.
MethodsNonparametric anova was used to determine the association between patient activation and patient-assessed quality of care in low and high patient activation groups at baseline (2008), and in 2009 and 2010, when patients had changed group membership. The Wilcoxon signed ranks test was used to compare the PACIC scores between baseline and each follow-up survey for the same patient activation level.
ResultsPatient activation was positively associated with the median PACIC score within each survey year and within each of the groups defined at baseline (high- and low-activation groups; P<0.001).
ConclusionsPatient activation and the PACIC change in the same direction and should be considered together in the interpretation of patient care assessment. This can be carried out by interpreting PACIC scores within strata of PAM.

• 出版日期2016-4