Measuring Empowerment Counselling in Routine Primary Health Care: Psychometric Properties of a Portuguese Adaptation of the Empowering Speech Practices Scale

Abstract

PurposeEmpowerment is a widely accepted approach to health promotion in which primary care nurses play an important role. Despite its clinical importance, empirical knowledge is low, mainly due to the lack of instruments to measure this construct. The Empowering Speech Practices Scale (ESPS) is a Finnish measure used to assess the empowerment process in counselling sessions. We designed this study to assess the psychometric properties of a Portuguese adaptation of the ESPS for families of 5-year-old children and nurses in well-child visits. Design and methodsWe used a cross-sectional survey design. The ESPS was translated and adapted to the context of children and family health promotion. We administered a sociodemographic questionnaire and the Portuguese ESPS to a sample of 82 families attending a 5-year-old well-child visit and 25 primary care nurses in Portugal. We evaluated the Portuguese ESPS for construct validity and internal consistency. ResultsExploratory factor analysis supported a 44-item scale, two-component model, which is similar to the original version, explaining 73.79% of the total variance. Each subscale presented excellent internal consistency and distinguished consultations conducted by nurses with academic training in empowerment patient education. Conclusions and implicationsThe Portuguese ESPS is a valid and reliable instrument for assessing empowerment in health counselling with families in well-child visits. It looks at the process from two perspectives: the nurses' and the families' perspectives. It can be useful to evaluate quality of care, to identify areas of improvement, and to delve deeper into relationships between empowerment and health outcomes.