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Empowerment Scale

Policy concerning the management of long-term conditions gives high priority to active patient participation in the delivery of health care and to the importance of self-management. Improvements in patient participation and self-management can be achieved through ‘empowerment’ – an enabling process or outcome arising from communication with the health care professional and a mutual sharing of resources over information relating to illness, which enhances the patient’s feelings of control, self-efficacy, coping abilities and ability to achieve change over their condition.

Whilst a few PROMs have been developed to measure empowerment in patients with specific long-term conditions, those that exist have been developed for particular long-term conditions, such as diabetes, cancer and in specific contexts, such as rehabilitation and self-help settings.

The Empowerment Scale is the first PROM to have been developed specifically for patients with long-term conditions in the primary care setting.

The scale was developed following qualitative work with practitioners and predominately older (average age: 66 years), multimorbid patients. The Empowerment Scale was preliminarily tested in a population of patients with long-term conditions, of whom 60% were aged 68+, and a third had multimorbidity. It has acceptable levels of internal consistency (Cronbach alpha > 0.8), and scores have been found to be highly reproducible over time (intraclass correlation coefficient of 0.90). The Empowerment Scale has good construct validity. Higher empowerment is significantly associated with higher self-efficacy (β 1.76, p<0.01) enablement (β 2.09, p<0.01), quality of care (β 0.65, p<0.01), and interpersonal care (β 0.91, p<0.01).

The Empowerment Scale in its current form (47 items) is being back translated and/or validated in a total of eight countries with different long-term condition populations:

Spain: elderly patients with heart failure
Portugal: elderly patients with long-term conditions
Canada (Quebec): elderly patients with myotonic dystrophy
United States: obese, African adolescents and parents in underserved populations
Belgium, Sweden and Denmark: adolescents with congenital heart disease
China: elderly patients with long-term conditions

We request that where you use the Empowerment Scale, you share your research findings with the author, Dr. Nicola Small. For any enquiries please contact Nicola by email; Nicola.Small@manchester.ac.uk 

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Empowerment Scale (PROM)

Patient Reported Outcome Measure (PROM) for the measurement of empowerment in patients with long-term conditions in primary care

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