A shared journey: evaluating a patient-assessed measure of self-management of chronic conditions in an Australian setting
Phillip Davis A B * , Joanne Bradbury C , Kirstine Shrubsole C D and John Parke BA
B
C
D
Abstract
Patient Assessment of Care in Chronic Conditions (PACIC+), included in some Australian guidelines, has been shown reliable for measuring patient engagement and perception of their care in primary care settings. Various studies have focussed on PACIC+ use in specific conditions. This study aims to expand PACIC+ to measure patient empowerment to self-manage their chronic condition and validate it in the broader Australian primary care population. This study aims to evaluate internal consistency and reliability of PACIC+ and six new supplementary items proposed to assess patient wellbeing and empowerment to self-manage their chronic condition.
A repeated-measures correlation design study assessed the expanded PACIC+ over three time-points. Particpants were patients with at least one chronic disease, referred by consultant physician, or recruited by advertisement posters in hospital clinic areas.
PACIC+ (26-item) had acceptable internal consitency (Cronbach’s alpha 0.96). Test–retest reliability (Time-1 and 2, P < 0.01) was acceptable: Total score r(48) = 0.43; and New supplementary items: Confidence r(48) = 0.54; Understanding r(48) = 0.62; Support r(48) = 0.43; Overall Health r(48) = 0.42; Overall Health Change r(48) = −0.31, P = 0.03; and Acute Episodes of Care in 1-month r(48) = 0.42, P < 0.01. Four factors from the original PACIC+ accounted for 66.5% of the variance.
The expanded PACIC+ is an improved psychometric tool providing for the patient’s voice in a shared health journey. It is a valid, reliable tool to monitor and measure self-management of chronic conditions in Australian population clinic and primary healthcare settings.
Keywords: bootstrapping, chronic care model, chronic illness, PACIC+, patient activation, patient empowerment, self-efficacy, self-management.
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