ArticleBMC public health2025
Measuring empowerment to address chronic diseases in mexico: validation of the american short form patient activation measure (PAM13).
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe empowerment of persons facing chronic conditions in Mexico can support health care in the context of vertical and fragmented institutions. The American short form Patient Activation Measure (PAM) is a 13-item instrument designed to assess patient knowledge, skills and confidence for self-management. PAM-13 was translated into Mexican Spanish, its psychometric properties were established for both sick and healthy persons, and its external validity assessed against health service utilization.
methodsThe translation was carried out according to WHO guidelines. The PAM 13-Mexico was applied in a nationally representative household survey to healthy persons and to persons living with diabetes and hypertension, equally divided within a sample of 2,400 persons. The instrument was also applied to an opportunistic sample of 136 women living with breast cancer in two large cities. Internal consistency and cross-validation against care variables were computed. Results were compared to similar data for other high and upper middle-income countries.
resultsThe psychometric properties of the PAM 13-Mexico were generally good. The level of internal consistency is high (α = 0.88; McDonald's omega coefficient = 0.88) and item-rest correlations are moderate to strong. The Mexican mean PAM score (77.1) is greater than the American (61.9) and the Danish (64.2). The association with health service utilization and quality was weak to strong.
conclusionsThe PAM-13 Mexico is a reliable instrument to measure empowerment of persons to address chronic diseases. The validity of PAM-13 needs to be researched against a wider set of health care variables and with diverse populations.
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