Sains Malaysiana 49(10)(2020): 2487-2497

http://dx.doi.org/10.17576/jsm-2020-4910-14

The Malay Version of Patient Activation Measure: An Instrument for Measuring Patient Engagement in Healthcare

(Ukuran Pengaktifan Pesakit Versi Melayu: Alat untuk Mengukur Penglibatan Pesakit dalam Penjagaan Kesihatan)

SYAHNAZ MOHD HASHIM^1,2, IDAYU BADILLA IDRIS¹*, SHALISAH SHARIP³, RAFIDAH BAHARI⁴ & NASRIN JAHAN⁵

¹Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre, 56000 Kuala Lumpur, Federal Territory, Malaysia

²Department of Family Medicine, Universiti Kebangsaan Malaysia Medical Centre, 56000 Kuala Lumpur, Federal Territory, Malaysia

³Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, 56000 Kuala Lumpur, Federal Territory, Malaysia

⁴Department of Psychiatry, Cyberjaya University College of Medical Sciences, 63000 Cyberjaya, Selangor Darul Ehsan, Malaysia

⁵Freelance Public Health Physician, Dhaka, Bangladesh

Received: 30 April 2019/Accepted: 18 April 2020

ABSTRACT

Effective diabetes management depends on both pharmacological treatment and patients’ engagement in their own care. PAM is an instrument that measures patients’ ability to self-manage their chronic illnesses and determines patients’ level of activation. The purpose of this study was to develop a translated Malay version of the PAM instrument and subsequently, to conduct a reliability and validity assessment. A cross-sectional study among patients with type 2 diabetes was performed in a teaching public primary care clinic. Forward and backward translation was conducted, followed by pre-testing and cognitive interviewing.  Data from 130 patients were analysed using SPSS software to assess the internal consistency and the psychometric properties of the Malay version of PAM instrument. Cronbach’s alpha for all items was 0.87, indicating good internal consistency. Exploratory Factor Analysis (EFA) showed a possibility of a three-factor model, which were labelled as a) confidence in performing preventive behaviors b) feel responsible and in charge of own health, and c) knowledge, ability to communicate and adherence to treatment. All items have a factor loading of higher than 0.4. The Cronbach’s alpha value was 0.85, 0.7 and 0.58 for the first, second and third subscales, respectively. The Malay version of PAM instrument showed a good reliability index and might have multiple subscales. Assessing these subscales are useful for the healthcare team in the evaluation of ‘patient activation’ among patients with diabetes. Efforts will thus be easier when responding to the patients’ needs and facilitating them to become active health managers.

Keywords: Malay; patient activation; patient engagement; reliability; validation

ABSTRAK

Pengurusan diabetes yang berkesan bergantung kepada kedua-dua rawatan farmakologi dan penglibatan pesakit dalam penjagaan kesihatan mereka. Ukuran Pengaktifan Pesakit (PAM) adalah satu instrumen yang mengukur keupayaan pesakit untuk mengurus kendiri penyakit kronik dan menentukan tahap pengaktifan pesakit. Tujuan kajian ini adalah untuk menghasilkan versi Bahasa Melayu bagi instrumen PAM dan untuk menjalankan penilaian kebolehpercayaan dan kesahihan. Kajian keratan rentas dalam kalangan pesakit diabetes telah dijalankan di sebuah klinik pengajaran awam penjagaan primer. Penterjemahan ke dalam Bahasa Melayu dan semula ke dalam Bahasa Inggeris telah dilakukan, diikuti dengan pra-ujian dan wawancara kognitif. Data daripada 130 pesakit dianalisis dengan perisian SPSS untuk menilai ketekalan dalaman dan ciri psikometrik bagi instrumen PAM versi Bahasa Melayu. Nilai Cronbach alpha untuk semua item adalah 0.87, menunjukkan konsistensi dalaman yang baik. Analisis faktor eksplorasi menunjukkan kemungkinan wujudnya tiga faktor model yang dilabelkan sebagai: a) keyakinan dalam melakukan amalan pencegahan b) berasa bertanggungjawab dan menjaga kesihatan diri dan c) pengetahuan, berkeupayaan untuk berkomunikasi dan pematuhan langkah rawatan. Semua item mempunyai faktor pemuatan melebihi 0.4. Nilai Cronbach alpha adalah 0.85, 0.7 dan 0.58 untuk subskala pertama, kedua dan ketiga. Instrumen PAM versi Bahasa Melayu telah menunjukkan indeks kebolehpercayaan yang baik dan berkemungkinan mempunyai tiga subskala. Pengukuran subskala ini memanfaatkan pasukan penjagaan kesihatan untuk membuat penilaian aktivasi dalam kalangan pesakit diabetes. Usaha akan menjadi lebih mudah dalam menanggapi keperluan pesakit dan membantu mereka menjadi pengurus kesihatan yang aktif.

Kata kunci: Aktivasi pesakit; kebolehpercayaan; Melayu; pengesahan; penglibatan pesakit

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*Corresponding author; email: idayubadilla.idris@gmail.com