title: What are the highly important and desirable patient engagement actions for self-care as perceived by individuals living in the southern United States?
abstract: OBJECTIVE
  This exploratory survey study aimed to identify patient engagement actions that are the most frequently named as being highly important (top 30 by importance) or ones that they want to do (top 30 by desire) for community-dwelling adult patients living in the southern United States. Items not making the list of the top 30 by ability were also identified.
  
  
  BACKGROUND
  Patient engagement is still an ambiguous term among population health and health care professionals in the United States as we lack a clear understanding of what it entails.
  
  
  METHODS
  This 2015-2016 study used convenience sampling to recruit subjects in a university's student health service department and in eight senior centers. Two hundred and fifty adult patients older than 18 years in the Upper Cumberland region of Tennessee participated in the study (82% response rate). A 57-item inventory, "The Patient Action Inventory for Self-Care," was developed and used to ascertain patients' self-designated preferences and capabilities in order to understand their needs for education and support.
  
  
  RESULTS
  Respondents included 159 (63.6%) women, 62 (24.8%) men, and 29 (11.6%) who did not indicate their gender. Combining the list of the top 30 importance items and the list of the top 30 desired items yielded a list of 35 items; noteworthy is the fact that the list of the top 30 ability actions contained nine items that were not found in a previously mentioned list of 35 high-ranking importance and desired items. This study validated the necessity of analyzing patient engagement actions by importance, desirability, and ability to accomplish it. These three levels are distinct from each other.
  
  
  CONCLUSIONS
  Nurses may use future versions of the inventory to assist patients in identifying self-care actions to engage in. Use of the inventory will demonstrate respect for patients' preferences and may thus improve engagement.
authors.affiliation: Whitson-Hester School of Nursing, Tennessee Technological University, Cookeville, TN.
authors.forename: Huey-Ming
authors.initials: HM
authors.lastname: Tzeng
authors.affiliation: Cambridge Management Group, Belmont, MA, USA.
authors.forename: James Marcus
authors.initials: JM
authors.lastname: Pierson
keywords: nurse; nursing; patient engagement; patient involvement; patient participation; self-care