ArticleBMC geriatrics2018
Low patient activation levels in frail older adults: a cross-sectional study.
Article in BMC geriatrics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
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Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Self-care needs in an aged population living with a chronic condition or multimorbidity: a systematic review.BMC geriatrics · 2026Pooled it
- Meta-analysis and GRADE profiles of exercise interventions for falls prevention in long-term care facilities.Journal of advanced nursing · 2020Pooled it
- Home-based exercise for people living with frailty and chronic kidney disease: A mixed-methods pilot randomised controlled trial.PloS one · 2021Trial
- The Mediation Role of Relatedness and Competence for Patient Activation: A Longitudinal Study of Older Adults with Chronic Illness.Healthcare (Basel, Switzerland) · 2026Article
- Patient activation among patients with Parkinsonism and informal caregivers: results from the PRIME-UK cross-sectional study.European geriatric medicine · 2026Article
- Patient Activation Impacts Exercise in Older Adults With Kidney Disease.Kidney international reports · 2025Article
- Effect of medication adherence on quality of life, activation measures, and health imagine in the elderly people: a cross-sectional study.BMC geriatrics · 2024Article
- The impact of patient activation on the effectiveness of digital health remote post-discharge follow-up and same-day-discharge after elective colorectal surgery.Surgical endoscopy · 2024Article
- A codesigned integrated kidney and diabetes model of care improves patient activation among patients from culturally and linguistically diverse backgrounds.Health expectations : an international journal of public participation in health care and health policy · 2023Article
- Status and factors associated with patient activation and its relationship with HIV clinic outcomes among Yi minority people living with HIV in Liangshan, China: a cross-sectional study.Frontiers in public health · 2023Article
- Nursing staff's experiences of how weighted blankets influence resident's in nursing homes expressions of health.International journal of qualitative studies on health and well-being · 2022Article
- Engagement in Primary Prevention Program among Rural Veterans With Osteoporosis Risk.JBMR plus · 2022Article
- Article
- Patient activation for self-management among adult patients with multimorbidity in primary healthcare settings.Health science reports · 2022Article
- Improving Patient Activation among Older Veterans: Results from a Social Worker-Led Care Transitions Intervention.Journal of gerontological social work · 2022Article
- Self-management perspectives of elderly patients with multimorbidity and practitioners - status, challenges and further support needed?BMC family practice · 2021Article
- Factors of Anti-Vascular Endothelial Growth Factor Therapy Withdrawal in Patients with Neovascular Age-Related Macular Degeneration: Implications for Improving Patient Adherence.Journal of clinical medicine · 2021Article
- Value-based chronic care model approach for vulnerable older patients with multiple chronic conditions.Journal of gastrointestinal oncology · 2021Review
- Outcomes of a 12-month patient-centred medical home model in improving patient activation and self-management behaviours among primary care patients presenting with chronic diseases in Sydney, Australia: a before-and-after study.BMC family practice · 2020Article
- High Patient Activation Is Associated With Remission in Patients With Inflammatory Bowel Disease.Inflammatory bowel diseases · 2019Article
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Authors and funding
7 authors.
Funding
Abstract
backgroundFrail older adults are increasingly expected to self-manage their health and healthcare. We assessed the extent to which this group is able to take up this responsibility by measuring their level of activation as patients (i.e. their knowledge, skills and confidence to self-manage their health and healthcare). Further, we studied which characteristics of older adults were associated with patient activation.
methodsIn this cross-sectional study 200 frail, competent adults (median age 87 years) participated. Participants were community-dwelling adults who received home care and residents of care homes. Data were collected via personal interviews in participants' homes. The main outcome measure was patient activation assessed by the short version of the Patient Activation Measure (PAM-13; range: 0-100). The PAM distinguishes four levels of increasing activation with level 1 indicating poor patient activation and level 4 adequate patient activation. Other studied variables were: multimorbidity, type of residency, frailty (Tilburg Frailty Index), mental competence (Mini Mental State Examination), health-related quality of life (SF-12), satisfaction with healthcare (subscale Patient Satisfaction Questionnaire) and personal characteristics (age, gender, marital status, educational level). Regression analyses were performed to investigate which variables were associated with patient activation.
resultsParticipants had a median PAM score of 51. Thirty-nine percent had level 1 activation, 31% level 2, 26% level 3 and 5% level 4. Fifty-nine percent of community dwelling adults had level 1 or 2 activation versus 81% of care home residents (p = 0.007). Mental competence (Effect: 0.52, CI: 0.03-1.01, p = 0.04) and health-related quality of life (Effect: 0.15, CI: 0.01-0.30, p = 0.04 for physical health; Effect: 0.20, CI: 0.07-0.34, p = 0.003 for mental health) were positively associated with patient activation. Frailty (Effect: -1.06, CI: -1.75 - -0.36, p = 0.003) was negatively associated with patient activation.
conclusionsThe majority of this frail and very old study population, especially those with a lower health-related quality of life, may be unable to self-manage their health and healthcare to the level expected from them. The increasing population of frail older adults may need help in managing their health and healthcare.
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