title: Validation of the patient activation measure in a multiple sclerosis clinic sample and implications for care.
abstract: OBJECTIVE
  Patient engagement in multiple sclerosis (MS) care can be challenging at times given the unpredictable disease course, wide range of symptoms, variable therapeutic response to treatment and high rates of patient depression. Patient activation, a model for conceptualising patients' involvement in their health care, has been found useful for discerning patient differences in chronic illness management. The purpose of this study was to validate the patient activation measure (PAM-13) in an MS clinic sample.
  
  
  METHODS
  This was a survey study of 199 MS clinic patients. Participants completed the PAM-13 along with measures of MS medication adherence, self-efficacy, depression and quality of life.
  
  
  RESULTS
  Results from Rasch and correlation analyses indicate that the PAM-13 is reliable and valid for the MS population. Activation was associated with MS self-efficacy, depression and quality of life but not with self-reported medication adherence. Also, participants with relapse-remitting MS, current employment, or high levels of education were more activated than other subgroups.
  
  
  CONCLUSIONS
  The PAM-13 is a useful tool for understanding health behaviours in MS. The findings of this study support further clinical consideration and investigation into developing interventions to increase patient activation and improve health outcomes in MS.
authors.affiliation: Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta, GA 30912, USA. lsteplem@mcg.edu
authors.forename: Lara
authors.initials: L
authors.lastname: Stepleman
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Rutter
authors.forename: Judith
authors.initials: J
authors.lastname: Hibbard
authors.forename: Lisa
authors.initials: L
authors.lastname: Johns
authors.forename: Dustin
authors.initials: D
authors.lastname: Wright
authors.forename: Mary
authors.initials: M
authors.lastname: Hughes
mesh_terms: D000704:Analysis of Variance; D003863:Depression / Q000453:epidemiology; D004522:Educational Status; D004651:Employment; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000453:epidemiology*; D010358:Patient Participation; D011788:Quality of Life; D020377:Self Efficacy; D011795:Surveys and Questionnaires