Table 1
Patients’ main characteristics.
| CHARACTERISCTICS | N (%) (N = 684) |
|---|---|
| Gender | |
| male | 331 (48.4) |
| female | 353 (51.6) |
| Age (min 19, max 96) | |
| ≤54 | 138 (20.2) |
| 55–64 | 206 (30.1) |
| 65+ | 340 (49.7) |
| Marital status | |
| married | 401 (58.6) |
| widow | 151 (22.1) |
| single | 53 (7.8) |
| divorced | 70 (10.2) |
| other | 9 (1.3) |
| Education | |
| primary school or less | 169 (24.7) |
| secondary school/secondary grammar school | 395 (57.8) |
| higher education | 120 (17.5) |
Table 2
Descriptive data on PACIC scale (N = 684).
| MEAN (SD) | FLOOR EFFECTa | CEILING EFFECTa | |
|---|---|---|---|
| N (%) | |||
| Patient activation (1–3 items; no missing data) | 3.32 (0.99) | 9 (1.3) | 50 (7.3) |
| Q1 | 3.17 (1.18) | 64 (9.4) | 98 (14.3) |
| Q2 | 3.08 (1.19) | 75 (11.0) | 87 (12.7) |
| Q3 | 3.71 (1.08) | 21 (3.1) | 185 (27.1) |
| Delivery system design/decision support (4–6 items; no missing data) | 3.53 (0.93) | 2 (0.3) | 65 (9.5) |
| Q4 | 3.05 (1.34) | 118 (17.3) | 116 (17.0) |
| Q5 | 3.85 (1.04) | 11 (1.6) | 225 (32.9) |
| Q6 | 3.68 (1.07) | 21 (3.1) | 169 (24.7) |
| Goal setting/tailoring (7–11 items; 1 missing item in 1 respondent’s questionnaire) | 2.99 (1.02) | 7 (1.02) | 35 (5.12) |
| Q7 | 3.24 (1.22) | 80 (11.7) | 107 (15.6) |
| Q8 | 3.23 (1.19) | 62 (9.06) | 114 (16.67) |
| Q9 | 2.81 (1.53) | 206 (30.2) | 143 (20.9) |
| Q10 | 2.77 (1.37) | 184 (26.9) | 77 (11.3) |
| Q11 | 2.91 (1.29) | 128 (18.7) | 77 (11.3) |
| Problem-solving/contextual counselling (12–15 items; 1 missing item in 1 respondent’s questionnaire) | 3.23 (1.02) | 8 (1.2) | 48 (7.0) |
| Q12 | 3.00 (1.38) | 144 (21.1) | 115 (16.8) |
| Q13 | 3.13 (1.25) | 86 (12.6) | 109 (15.9) |
| Q14 | 3.40 (1.20) | 56 (8.2) | 136 (19.9) |
| Q15 | 3.40 (1.20) | 56 (8.2) | 134 (19.6) |
| Follow-up/coordination (16–20 items; no missing data occured) | 3.29 (1.01) | 5 (0.7) | 69 (10.1) |
| Q16 | 2.94 (1.48) | 180 (26.4) | 136 (19.9) |
| Q17 | 2.82 (1.40) | 183 (26.8) | 92 (13.5) |
| Q18 | 3.48 (1.27) | 72 (10.5) | 169 (24.7) |
| Q19 | 3.52 (1.29) | 63 (9.2) | 199 (29.1) |
| Q20 | 3.70 (1.23) | 48 (7.0) | 230 (33.6) |
| PACIC total score (20 items; 2 missing items alowed) | 3.24 (0.85) | 0 (0) | 5 (0.73) |
[i] a Floor and ceiling effects = percent of respondents attaining minimum or maximum scores (1/5).
Table 3
The numbers of visits of GPs and specialist and mean PACIC scores.
| NUMBER OF GP VISITS IN THE LAST 6 MONTHS | PATIENT ACTIVATION (MEAN (SD)) | DELIVERY SYSTEM DESIGN/DECISION SUPPORT (MEAN (SD)) | GOAL SETTING (MEAN (SD)) | PROBLEM-SOLVING/CONTEXTUAL COUNSELLING (MEAN (SD)) | PROBLEM-SOLVING/CONTEXTUAL COUNSELLING (MEAN (SD)) |
|---|---|---|---|---|---|
| 1x | 3.31 (1.04) | 3.38 (0.99) | 2.80 (1.11) | 3.06 (1.17) | 3.15 (1.03) |
| 2–3x | 3.33 (0.99) | 3.46 (0.89) | 2.92 (0.93) | 3.18 (0.98) | 3.24 (0.92) |
| 4–5x | 3.16 (0.92) | 3.39 (0.94) | 2.92 (0.96) | 3.14 (1.00) | 3.19 (1.00) |
| ≥6 | 3.50 (1.01) | 3.86 (0.90) | 3.28 (1.12) | 3.51 (1.01) | 3.57 (1.11) |
| *p | 0.017 | 0.000 | 0.000 | 0.001 | 0.001 |
| NUMBER OF SPECIALIST VISITS IN THE LAST 6 MONTHS | PATIENT ACTIVATION (MEAN (SD)) | DELIVERY SYSTEM DESIGN/DECISION SUPPORT (MEAN (SD)) | GOAL SETTING (MEAN (SD)) | PROBLEM-SOLVING/CONTEXTUAL COUNSELLING (MEAN (SD)) | PROBLEM-SOLVING/CONTEXTUAL COUNSELLING (MEAN (SD)) |
| 1x | 3.15 (1.03) | 3.43 (0.95) | 2.85 (0.98) | 3.09 (1.00) | 3.19 (0.98) |
| 2–3x | 3.43 (0.94) | 3.51 (0.89) | 3.00 (1.01) | 3.28 (1.00) | 3.26 (1.00) |
| 4–5x | 3.41 (0.92) | 3.69 (1.02) | 3.21 (1.06) | 3.44 (1.07) | 3.35 (1.09) |
| ≥6 | 3.84 (0.72) | 4.02 (0.73) | 3.73 (1.02) | 3.93 (0.91) | 4.00 (1.06) |
| *p | 0.000 | 0.002 | 0.000 | 0.000 | 0.000 |
[i] * ANOVA test.
The highest mean PACIC scores are shown in bold. These mean values are significantly higher than the other group means.
Table 4
Equality between mean PACIC scores and patients’ demographic characteristics (N = 684).
| CHARACTERISTIC | PACIC MEAN (SD) | P-VALUE |
|---|---|---|
| Gender | ||
| male | 3.24 (0.82) | 0.983a |
| female | 3.24 (0.88) | |
| Age | ||
| ≤54 | 3.27 (0.87) | 0.597b |
| 55–64 | 3.28 (0.88) | |
| 65+ | 3.21 (0.83) | |
| Professional education | ||
| upper secondary education or less | 3.24 (0.85) | 0.616a |
| higher education | 3.28 (0.88) | |
| Marital status | ||
| married | 3.23 (0.86) | 0.805b |
| widow | 3.25 (0.87) | |
| single | 3.32 (0.77) | |
| divorced | 3.30 (0.84) | |
[i] a Independent samples t-test.
b ANOVA.
Table 5
Exploratory factor analysis goodness-of-fit results (1–6 factors; N = 684).
| FACTORS | χ2 | DF | P | CFI | TLI | RMSEA |
|---|---|---|---|---|---|---|
| 1 | 1798.8 | 170 | <1.1e–26 | 0.9714 | 0.718 | 0.132 |
| 2 | 922.53 | 151 | <5.7e–11 | 0.9879 | 0.794 | 0.113 |
| 3 | 508.7 | 133 | 2.5e–45 | 0.9952 | 0.832 | 0.102 |
| 4 | 277.82 | 116 | 2.7e–15 | 0.9991 | 0.878 | 0.087 |
| 5 | 176.94 | 100 | 3.3e–06 | – | 0.901 | 0.078 |
| 6 | 98.66 | 85 | <0.15 | – | 0.923 | 0.069 |
[i] Tucker-Lewis index (TLI; >0.95 very good, >0.90 good). Root-Mean-Square Error of Approximation (RMSEA; 0.06> very good; >0.08 good).
Table 6
Factor Analysis: using method = minres; rotation “promax”. Standardized loadings (pattern matrix) based upon correlation matrix.
| PREDETERMINED SUBSCALES AND ITEMS | F1 DETERMINE PURPOSES MR4 | F2 INVOLVEMENT OF SPECIALISTS MR1 | F3 ENCOURAGING PATIENT ACTIVITY MR2 | F4 PERSONALIZATION MR3 |
|---|---|---|---|---|
| Patient activation | ||||
| 1. Asked for my ideas when we made a treatment plan | 0.94 | –0.16 | 0.00 | –0.09 |
| 2. Give choices about treatment to think about. | 0.90 | –0.16 | 0.04 | –0.10 |
| 3. Asked to talk about any problems with my medicines or their effects. | 0.71 | 0.20 | –0.02 | –0.11 |
| 4. Given a written list of things I should do to improve my health. | 0.15 | –0.06 | –0.09 | 0.68 |
| 5. Satisfied that my care was well organized. | 0.54 | 0.36 | –0.23 | 0.03 |
| 6. Shown how what I did to take care of myself influenced my condition. | 0.41 | 0.22 | –0.05 | 0.23 |
| 7. Asked to talk about my goals in caring for my condition. | 0.31 | 0.11 | 0.25 | 0.21 |
| 8. Helped to set specific goals to improve my eating or exercise. | 0.31 | 0.11 | 0.14 | 0.30 |
| 9. Given a copy of my treatment plan. | 0–0.17 | 0.24 | –0.03 | 1.07 |
| 10. Encouraged to go to a specific group or class to help me cope with my chronic condition. | –0.02 | –0.12 | 1.02 | –0.05 |
| 11. Asked questions, either directly or on a survey, about my health habits. | 0.15 | –0.12 | 0.62 | 0.21 |
| 12. Sure that my doctor or nurse thought about my values, beliefs, and traditions when they recommended treatments to me. | –0.02 | –0.03 | 0.22 | 0.49 |
| 13. Helped to make a treatment plan that I could carry out in my daily life. | 0.04 | 0.26 | 0.13 | 0.44 |
| 14. Helped to plan ahead so I could take care of my condition even in hard times. | 0.11 | 0.50 | 0.12 | 0.14 |
| 15. Asked how my chronic condition affects my life. | 0.16 | 0.51 | 0.17 | 0.03 |
| 16. Contacted after a visit to see how things were going. | 0.15 | 0.36 | –0.15 | 0.62 |
| 17. Encouraged to attend program sin the community that could help me. | –0.16 | 0.31 | 0.81 | –0.16 |
| 18. Reffered to a dietitian, health educator, or counselor. | –0.06 | 0.49 | 0.30 | –0.05 |
| 19. Told how my visits with other types of doctors, like an eye doctor or other specialist, helped my treatment. | –0.07 | 0.95 | 0.06 | –0.17 |
| 20. Asked how my visits with other doctors were going. | –0.03 | 0.87 | –0.09 | –0.07 |
Figure 1
Factor Analysis – four-factor model. Standardized loadings (pattern matrix) based upon correlation matrix. The figure also indicates interactions.