• Open Access

The development and testing of a measure assessing clinician beliefs about patient self-management


Judith H. Hibbard
Senior Researcher and Professor
Institute for Policy Research and Innovation
University of Oregon 5293
Eugene OR 97403-5293
E-mail: jhibbard@uoregon.edu


Background  Clinicians have been slow to embrace support for patient self-management.

Objective  To explore clinicians’ beliefs about patient self-management and specifically assess which patient competencies clinicians believe are most important for their patients.

Methods  Using items adapted from the Patient Activation Measure (PAM) as a basis, a new measure that assesses clinicians’ beliefs about patient self-management was created using Rasch analysis. The development and testing of the new measure Clinician Support for Patient Activation Measure (CS-PAM) is described here. Primary care clinicians from the UK and the USA were recruited to participate in the survey (= 175).

Findings  The CS-PAM reliably measures clinician attitudes about the patient role in the care process. Clinicians strongly endorse that patients should follow medical advice but are less likely to endorse that patients should be able to make independent judgements or take independent actions. Endorsed to a lesser degree was the idea that patients should be able to function as a member of the care team. Least endorsed was the notion that patients should be independent information seekers.

Discussion  Clinicians’ views appear to be out of step with current policy directions and professional codes. Clinicians need support to transition to understand the need to support patients as independent actors.