What Are The Crucial Components of Patient Activation Interventions?
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2017, Vol 1, Issue 2
Abstract
Objective: With evidence that patient activation is alterable and can be increased in adults with chronic conditions [1], interventions targeting activation it is growing. However, little is known about what constitutes a patient activation intervention (PAI). Therefore, this integrative review aims to explore the components of PAI in existing literature. Methods: An integrative review based on updated methodology proposed by Whittemore and Knafl [2], was used to examine the components of PAIs. A literature search was conducted using CINAHL, PubMed, PsycINFO, and PsycARTICLES. Results: A total of 10 peer-reviewed articles were identified. All articles originated from USA, with seven based in community health services. There are two main types of PAI found in this review. Half of the studies focused specifically on physician-patient relationships, with a narrower definition of activation. The others focused on self-management, facilitating behaviour changes and tailoring interventions according to activation levels. Conclusion: There are various format and contents in the ten studies, with interventions focusing on physician-patient communication being the most widely replicated format. Practice Implications: While there are some promising results, more studies are needed to examine components of PAI that works and the long-term effectiveness. The burden of chronic diseases is escalating rapidly worldwide. According to the World Health Organization [3], 68% of global deaths in 2012 were due to chronic diseases, contributing significantly to the leading causes of burden of disease. The Chronic Care Model (CCM) [4] is a widely adopted approach to inform chronic diseases practices. Although evidence suggests that such practices generally improve quality of care and outcomes for patients with chronic diseases [5], it has been argued that the lack of effective patient activation strategies has limited the full implementation of this model [6]. Patient activation defined as one having knowledge to manage their condition and maintain functioning and prevent health declines; skills and behavioral repertoire to manage their condition, abilities to collaborate with their health providers, maintain their health functioning, and access appropriate and high-quality care [7], can significantly improve health outcomes in chronic diseases care [1,8,9]. Hibbard and colleagues [7] developed the Patient Activation Measure (PAM) to assess knowledge, skills and confidence in managing health [7,10]. Research demonstrated that higher PAM scores are associated with more satisfaction with services [9], more engagement in care and self-management behaviours [7,9], and improved health outcomes [9,11]. With evidence that patient activation is alterable and can be increased in adults with chronic conditions [1], interventions targeting activation it is growing. However, little is known about what constitutes a patient activation intervention (PAI). Therefore, this integrative review aims to explore the components of PAI in existing literature. The specific objectives are to examine i. The intervention format ii. Intervention contents iii. Training for providers/facilitators An integrative review based on updated methodology proposed by Whittemore and Knafl [2], was used to examine the components of PAIs. A literature search was conducted using CINAHL, PubMed, PsycINFO, and Psyc ARTICLES. The specific search terms used were: “patient activation” AND interven(*) or treat(*) in PubMed, (patient N3 activat*) AND interven(*) or treat(*) in the other 3 databases. The search resulted in 581 references. Of these 139 were duplicates, reducing the total to 442 articles. Given the research aims to be examined in this integrative review, specific inclusion criteria were used to ensure the inclusion and review of all relevant intervention studies.
Authors and Affiliations
Bi Xia Ngooi, Tanya Packer
Keywords
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- EP ID EP567594
- DOI 10.26717/BJSTR.2017.01.000215
- Views 166
- Downloads 0
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