BACKGROUND: Health promotion has become an integral part of primary healthcare for patients with chronic illness. A practical instrument to identify patient needs in health promotion will support patient-centered health counseling. OBJECTIVE: The objective of the study was to develop and pilot test the 'Health Promotion Diabetes' (HEPRODIA) instrument, which aims to identify the needs of patients with diabetes mellitus for health-promoting activities with regard to their preferred lifestyle behavior change. METHODS: Scale development of the instrument was guided by existing insights and expert opinion. Questionnaire data were collected in a sample of patients (n = 221) from eight primary care practices in the southern part of the Netherlands. The resulting instrument comprised a fixed set of 14 items to elicit patients' preferred lifestyle change, plus a variable set of 4-20 items concerning specific barriers and support needs regarding the chosen change. The instrument provides a starting point for discussion with a practice nurse about healthy lifestyle changes. Internal consistency (Cronbach's α) and feasibility of the instrument, as well as experiences of the practice nurses using the instrument, were evaluated. RESULTS: Cronbach's α of the different scales ranged from 0.46 to 0.74. The practice nurses perceived the instrument as useful in daily practice and that it may be improved by further adjustment of patient segments. CONCLUSION: The HEPRODIA instrument is an aid to assess patient needs concerning health-promoting activities and to facilitate health counseling. Patients and practice nurses can benefit from using the instrument for patient-orientated health-promotion counseling. The psychometric properties of the instrument can be further improved.
BACKGROUND: Health promotion has become an integral part of primary healthcare for patients with chronic illness. A practical instrument to identify patient needs in health promotion will support patient-centered health counseling. OBJECTIVE: The objective of the study was to develop and pilot test the 'Health Promotion Diabetes' (HEPRODIA) instrument, which aims to identify the needs of patients with diabetes mellitus for health-promoting activities with regard to their preferred lifestyle behavior change. METHODS: Scale development of the instrument was guided by existing insights and expert opinion. Questionnaire data were collected in a sample of patients (n = 221) from eight primary care practices in the southern part of the Netherlands. The resulting instrument comprised a fixed set of 14 items to elicit patients' preferred lifestyle change, plus a variable set of 4-20 items concerning specific barriers and support needs regarding the chosen change. The instrument provides a starting point for discussion with a practice nurse about healthy lifestyle changes. Internal consistency (Cronbach's α) and feasibility of the instrument, as well as experiences of the practice nurses using the instrument, were evaluated. RESULTS: Cronbach's α of the different scales ranged from 0.46 to 0.74. The practice nurses perceived the instrument as useful in daily practice and that it may be improved by further adjustment of patient segments. CONCLUSION: The HEPRODIA instrument is an aid to assess patient needs concerning health-promoting activities and to facilitate health counseling. Patients and practice nurses can benefit from using the instrument for patient-orientated health-promotion counseling. The psychometric properties of the instrument can be further improved.
Authors: Andrea S Wallace; Hilary K Seligman; Terry C Davis; Dean Schillinger; Connie L Arnold; Betsy Bryant-Shilliday; Janet K Freburger; Darren A DeWalt Journal: Patient Educ Couns Date: 2009-01-23