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Background: The increasing burden of chronic illness highlights the importance of self-care and shifts from hierarchical and patriarchal models to partnerships. Primary care providers (PCPs) play an important role in supporting patients in self-management, enabling activation and supporting chronic care. We explored the extent to which PCPs' beliefs about the importance of the patients' role relate to the frequency in which they report engaging in collaborative and partnership-building behaviors with patients.Methods: PCPs' beliefs were measured using the Clinician Support for Patient Activation Measure (CS-PAM). We also assessed whether PCPs' CS-PAM scores were positively associated with changes in their patients' Patient Activation Measure (PAM) scores. Participants included 181 PCPs from a single accountable care organization in Minnesota who completed an online survey. We conducted bivariate analyses and multivariate regression models to examine relationships between CS-PAM and PCP self-management support behaviors and changes in level of patient activation.Results: PCPs with high CS-PAM scores were much more likely to engage in supportive self-management and patient behavior change approaches, such as involving the patient in agenda-setting, problem-solving, and collaboratively setting behavioral goals, than were PCPs with low CS-PAM scores. More positive PCPs' belief in the patients' role in self-management was positively correlated with improvements in their patients' level of patient activation.Conclusions: More positive PCP beliefs about the patients' role in self-management was strongly related to PCP behaviors geared towards increasing patient activation. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to test the Dutch version of the Clinician Support for Patient Activation Measure (CS-PAM), to explore the beliefs of Dutch clinicians about patients' self-management, and to establish whether there are differences in this respect between general practitioners and other primary care providers. Methods: The CS-PAM was translated in Dutch and data were collected in a sample of 489 general practitioners and other primary care providers. Statistical analyses (RASCH, Cronbach's α) were performed to establish the psychometric properties of the instrument. Results: The psychometric scores of the Dutch CS-PAM were acceptable to good, and the difficulty level and structure was comparable to that of the original instrument. The average score of Dutch clinicians on the CS-PAM was 65.1 (SD 10.7), somewhat lower compared to their colleagues in the US (69; SD 12.1) and the UK (69, SD 12.8). Dutch general practitioners scored significantly lower on the CS-PAM compared to other primary care providers. Conclusions: The Dutch CS-PAM is a reliable instrument to measure beliefs of clinicians regarding patient self-management. Further validation studies are necessary to establish the distribution of scores in specific provider populations and to assess the clinical relevance of the instrument for different outcomes. [ABSTRACT FROM AUTHOR]

Background: Nowadays, patients are expected to be involved in their health care, well-informed and able to adjust their behavior to maintain a good health. Investigating patient activation and its relationships with patient characteristics and health-related outcomes will provide further insight into the gains to be expected if patients are more involved in their healthcare. Methods: Based on claims data, 5,346 people were selected who received diabetes care in the last 12 months. They received a questionnaire including the Patient Activation Measure (PAM) and questions on patient characteristics, life style and self-management behaviors, knowledge about diabetes, healthcare utilization and own clinical values. We used bivariate analyses and regression analyses to investigate the relationships between patient characteristics, patient activation level, and health-related outcomes. Results: Data of 1,845 (35%) people were used in the analyses. Patient activation differed depending upon several patient characteristics. Patient activation level was positively related to getting the recommended feet and eye examinations after controlling for several patient characteristics; no association was found for life-style and self-management behaviors and the other healthcare utilization measures. Those with a low patient activation level less often reported to have knowledge about diabetes and of their values on clinical indicators. Conclusions: Among people with diabetes, patient activation level was especially related to disease-specific knowledge and less with health-related behavior and outcomes. The PAM might therefore especially be an useful instrument for clinical practice to identify patients most in need for diabetes education. [ABSTRACT FROM AUTHOR]