Health-related Empowerment Research Articles

Indicators for evaluating cancer organizations' support services: performance and associations with empowerment.

Community-based cancer organizations provide services to support patients. An anticipated benefit of these services is patient empowerment. However, this outcome has not been evaluated because of the lack of validated health-related empowerment questionnaires in the cancer context. In this validation study, the authors assessed the extent to which 16 indicators used by the Canadian Cancer Society (CCS) and the Cancer Council Victoria, Australia (CCV) to evaluate their services were associated with health-related empowerment. Cancer patients/survivors who were diagnosed < 3 years earlier and who used CCS programs completed a questionnaire that included the 16 CCS-CCV indicators and 5 scales from the Health Education Impact Questionnaire (heiQ) measuring key dimensions of empowerment. To determine whether the CCS-CCV indicators captured empowerment, differences in heiQ scores were compared between 2 groups: those with higher levels of agreement (agreeing or agreeing strongly) with an indicator and those with lower levels of agreement (agreeing slightly or disagreeing to any degree). Participation was 72% (207 of 289 eligible CCS users). Compared with participants who had lower levels of agreement on CCS-CCV indicators, those who had higher levels of agreement were more likely to report higher levels of empowerment on the different heiQ scales. For 15 of 16 indicators, these differences were significant (Wilcoxon rank-sum test; P < .10) on ≥ 1 of 5 heiQ scales and for 10 of 16 indicators on ≥ 3 of 5 heiQ scales. Two indicators were associated significantly with all 5 heiQ scales (cope better and feel more in control). Using CCS-CCV indicators to evaluate community-based cancer organizations' services will help determine whether these services are reaching one of their important goals: namely empowering patients.

Gender Differences and Predictors of Self-Rated Health Development Among Swedish Adolescents

The purpose of the study was to evaluate the development of self-rated health among boys and girls during adolescence. Longitudinal cohort study, involving 1,046 Swedish adolescents from the seventh (12-13 years old) to the ninth grade. Self-rated health (well-being) and health-related empowerment were measured using a questionnaire. In the seventh as well as in the ninth grade, the proportion of adolescents reporting a good health was lower in girls than in boys. In general, girls showed lower health-related empowerment as compared with boys and this difference remained between both the grades. In boys and girls belonging to both grades, a high empowerment score was related to a high self-rated health. For both boys and girls, self-rated health declined between the seventh and ninth grade. In girls, the proportion rating their health as "very good" declined from 47 % to 30%, and in boys the same proportion declined from 56% to 46%, indicating an increasing gender difference. Only a minor proportion of adolescents (16% of the boys and 13% of the girls) reported an improvement. A high self-rated health in grade nine was, in girls, predicted by positive school experiences in seventh grade and, in boys, by a good mood in the family. During adolescence, girls reported lower self-rated health than boys and this gender difference increased over the years. High empowerment is related to high self-rated health, and positive school experiences and a good mood in the family seem to be important predictors of a positive development of self-rated health.

A Systematic Review of Questionnaires Measuring Health-Related Empowerment

The objective of this systematic review was to identify questionnaires that measure health-related empowerment in adults or families and demonstrated the best evidence of reliability and validity. A search of nine data bases identified 8,269 abstracts that referred to empowerment. Full article review was completed for abstracts that met the inclusion criteria or that could not be excluded with certainty (n = 124). Fifty distinct, modified, or translated questionnaires measuring empowerment were identified in 74 articles. Each was rated in terms of reliability and validity. One questionnaire had good evidence of reliability and validity, four had moderate evidence, and 45 had limited or no evidence. Limited or no evidence for reliability and validity for many questionnaires could relate in part to lack of consensus on the theoretical definition of, and indicators for measuring empowerment. We recommend that researchers use the questionnaire rated as having good evidence and that data on reliability and validity continue to be reported for other questionnaires.