Abstract
The Patient Health Engagement Scale (PHE-s) was designed to assess the emotional and psychological attitudes of patients' engagement along their healthcare management journey. The aim of this study was to validate a culturally adapted Chinese version of the PHE-s (CPHE-s). Three hundred and seventy-seven participants were recruited from eight community health centers in a sample of patients with chronic disease in Hunan Province, China. The original Italian PHE-s was translated into Mandarin Chinese using a standardized forward–backward translation. The Rasch model was utilized and presented uni-dimensionality and good items fitness of the PHE-s. The internal consistency was 0.89 and the weighted Kappa coefficients of the items (test–retest reliability) ranged from 0.52 to 0.79. Both principal component analysis and confirmatory factor analysis supported a single-factor structure of the PHE-s. In testing the external validity, the PHE-s showed a significant moderate correlation with patient activation but not with medicine adherence behavior, which requires further exploration. The result suggested that the PHE-s is a reliable and valid instrument to assess the level of patient engagement in his or her own health management among chronic patients in China. Further analysis of reliability and validity should be assessed among other patient cohorts in China, and future directions for testing changes after patient engagement interventions should be developed by exploring some clinical relevance.
Highlights
Chronic diseases are the leading health concerns of the twenty-first century
An expert panel including three clinicians experienced in chronic care or psychology from university teaching hospitals and two faculty members from university was asked to rate each item of the Chinese version of the Patient Health Engagement Scale (PHEs)-s (CPHE-s)
The I-content validity index (CVI) was between 0.80 and 1.00, and the S-CVI/Ave was 0.92 in the final version of the CPHE-s. These results indicate acceptable content validity for the CPHE-s
Summary
Chronic diseases are the leading health concerns of the twenty-first century. Deaths from chronic diseases rose by just under 8 million between 1990 and 2010, accounting for two-thirds of global deaths, half of all disabilities, and rapidly growing costs (Lozano et al, 2012). The low- and middle-income countries are projected to experience the greatest challenge resulting from chronic disease, which makes up 80% of the causes of death among the world’s population (Bloom et al, 2011) and bears. 533 out of every 100,000 Chinese residents died from chronic disease in 2012, resulting in 86.6% of all deaths with cardio-cerebrovascular disease, cancer, and chronic respiratory disease as the top causes (Yang et al, 2013)
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