title: Patient empowerment: a systematic review of questionnaires measuring empowerment in cancer patients.
abstract: BACKGROUND
  There is an increased attention to and demand for patient empowerment in cancer treatment and follow-up programs. Patient empowerment has been defined as feeling in control of or having mastery in relation to cancer and cancer care. This calls for properly developed questionnaires assessing empowerment from the user perspective. The aim of this review was to identify questionnaires and subscales measuring empowerment and manifestations of empowerment among cancer patients.
  
  
  METHODS
  We conducted a systematic search of the PubMed, PsycINFO and CINAHL databases. Empowerment and multiple search terms associated with empowerment were included. We included peer-reviewed articles published in English, which described questionnaires measuring empowerment or manifestations of empowerment in a cancer setting. In addition, the questionnaire had to be a patient-reported outcome measure for adult cancer patients.
  
  
  RESULTS
  Database searches identified 831 records. Title and abstract screening resulted in 482 records being excluded. The remaining 349 full text articles were retrieved and assessed for eligibility. This led to the inclusion of 33 individual instruments measuring empowerment and manifestations of empowerment. Of these, only four were specifically developed to measure empowerment, and two were originally developed for the cancer setting, whereas the remaining two were developed elsewhere, but adapted to the cancer setting. The other 29 questionnaires were not intended to measure the concept of empowerment, but focused on patient-centered care, patient competence, self-efficacy, etc. However, they were included because part of the instrument (at least five items) was considered to measure empowerment or manifestations of empowerment.
  
  
  CONCLUSIONS
  Our study provides an overview of the available questionnaires, which can be used by researchers and practitioners who wish to measure the concept of empowerment among cancer patients. Very few questionnaires were explicitly developed to explore empowerment, and the review brings to light a significant lack of questionnaires that measure patient empowerment comprehensively.
authors.affiliation: a Department of Psychology , University of Southern Denmark , Odense , Denmark.
authors.forename: Nanna Bjerg
authors.initials: NB
authors.lastname: Eskildsen
authors.affiliation: b Warwick Medical School, University of Warwick , Coventry , UK.
authors.forename: Clara Ruebner
authors.initials: CR
authors.lastname: Joergensen
authors.affiliation: c Zealand University Hospital , Roskilde , Denmark.|d Department of Regional Health Research , University of Southern Denmark , Odense , Denmark.
authors.forename: Thora Grothe
authors.initials: TG
authors.lastname: Thomsen
authors.affiliation: e Department of Palliative Medicine , Bispebjerg Hospital , Copenhagen , Denmark.
authors.forename: Lone
authors.initials: L
authors.lastname: Ross
authors.affiliation: f Patient representative.
authors.forename: Susanne Malchau
authors.initials: SM
authors.lastname: Dietz
authors.affiliation: e Department of Palliative Medicine , Bispebjerg Hospital , Copenhagen , Denmark.|g Department of Public Health , University of Copenhagen , Copenhagen , Denmark.
authors.forename: Mogens
authors.initials: M
authors.lastname: Groenvold
authors.affiliation: a Department of Psychology , University of Southern Denmark , Odense , Denmark.|e Department of Palliative Medicine , Bispebjerg Hospital , Copenhagen , Denmark.
authors.forename: Anna Thit
authors.initials: AT
authors.lastname: Johnsen
mesh_terms: D006801:Humans; D009369:Neoplasms / Q000523:psychology*; D010358:Patient Participation; D018802:Patient-Centered Care; D011209:Power, Psychological; D011594:Psychometrics; D011795:Surveys and Questionnaires