title: Clinicians' beliefs and attitudes toward patient self-management in the Netherlands; translation and testing of the American Clinician Support for Patient Activation Measure (CS-PAM).
abstract: BACKGROUND
  The aim of this study was to test the Dutch version of the Clinician Support for Patient Activation Measure (CS-PAM), to explore the beliefs of Dutch clinicians about patients' self-management, and to establish whether there are differences in this respect between general practitioners and other primary care providers.
  
  
  METHODS
  The CS-PAM was translated in Dutch and data were collected in a sample of 489 general practitioners and other primary care providers. Statistical analyses (RASCH, Cronbach's α) were performed to establish the psychometric properties of the instrument.
  
  
  RESULTS
  The psychometric scores of the Dutch CS-PAM were acceptable to good, and the difficulty level and structure was comparable to that of the original instrument. The average score of Dutch clinicians on the CS-PAM was 65.1 (SD 10.7), somewhat lower compared to their colleagues in the US (69; SD 12.1) and the UK (69, SD 12.8). Dutch general practitioners scored significantly lower on the CS-PAM compared to other primary care providers.
  
  
  CONCLUSIONS
  The Dutch CS-PAM is a reliable instrument to measure beliefs of clinicians regarding patient self-management. Further validation studies are necessary to establish the distribution of scores in specific provider populations and to assess the clinical relevance of the instrument for different outcomes.
authors.affiliation: NIVEL - Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN, Utrecht, The Netherlands. j.rademakers@nivel.nl.
authors.forename: Jany
authors.initials: J
authors.lastname: Rademakers
authors.affiliation: NIVEL - Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN, Utrecht, The Netherlands. d.jansen@nivel.nl.
authors.forename: Daphne
authors.initials: D
authors.lastname: Jansen
authors.affiliation: NIVEL - Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN, Utrecht, The Netherlands. l.vanderhoek@nivel.nl.
authors.forename: Lucas
authors.initials: L
authors.lastname: van der Hoek
authors.affiliation: NIVEL - Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN, Utrecht, The Netherlands. m.heijmans@nivel.nl.
authors.forename: Monique
authors.initials: M
authors.lastname: Heijmans
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D005006:Ethnicity / Q000523:psychology*; D005260:Female; D058005:General Practitioners / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010358:Patient Participation / Q000523:psychology*; D058007:Physicians, Primary Care / Q000523:psychology*; D015397:Program Evaluation; D011594:Psychometrics; D012648:Self Care / Q000523:psychology*; D011795:Surveys and Questionnaires; D014175:Translating; D014177:Translations; D014481:United States