title: Patient activation, depression and quality of life.
abstract: OBJECTIVE
  "Patient activation" describes the extent to which individuals manage their own healthcare. This study evaluated the association of patient activation, depressive symptoms and quality of life in a primary care setting.
  
  
  METHODS
  278 patients who visited two primary care clinics were interviewed in the waiting room before their appointment or by telephone. Study participants completed the Patient Activation Measure (PAM), Patient Health Questionnaire-9 (PHQ-9) and Short Form-12 Health Survey (SF-12). Physicians assessed each participant's depression status immediately after the visit.
  
  
  RESULTS
  PAM scores correlated negatively with PHQ-9 (r=-0.35, p<0.0001) and positively with total SF-12 score (r=0.39, p<0.0001). Increased participant involvement by one-level increments on the PAM was predicted by their being in the 55 to 74-year age group and higher total SF-12 quartiles. Almost half of those scoring ≥10 on PHQ-9 were not considered depressed by their physician (false negatives, i.e. "hidden depression").
  
  
  CONCLUSIONS
  In primary care settings, PAM is easily administered and useful for general patients and for those with depressive symptoms.
  
  
  CONCLUSIONS
  Assessing patient activation will enable caregivers to monitor levels of self-care (activation) and potential adherence to health behavior recommendations. PHQ-9 screening could increase awareness of "hidden depression" in the primary care setting.
authors: Department of Management, Bar Ilan University, Ramat Gan, Israel; Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel. Electronic address: magnezir@biu.ac.il.
authors: Racheli
authors: R
authors: Magnezi
authors: Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
authors: Saralee
authors: S
authors: Glasser
authors: Department of Psychiatry, Soroka University Medical Center, Beer Sheva, Israel.
authors: Hadar
authors: H
authors: Shalev
authors: Department of Psychiatry, Soroka University Medical Center, Beer Sheva, Israel.
authors: Asher
authors: A
authors: Sheiber
authors: Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.
authors: Haim
authors: H
authors: Reuveni
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis*; D005260:Female; D006306:Health Surveys; D006801:Humans; D007557:Israel; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010358:Patient Participation; D011320:Primary Health Care; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011788:Quality of Life; D012648:Self Care / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Depression; PHQ-9; Patient Activation Measure (PAM); Primary care; SF-12