Mariela Acuña Mora1,2, Koen Raymaekers3,4, Liesbet Van Bulck4,5, Eva Goossens5,6, Koen Luyckx3,7, Adrienne H Kovacs8, Brith Andresen9, Ju Ryoung Moon10, Alexander Van De Bruaene11,12, Jessica Rassart3,4, Philip Moons13,14,15. 1. Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden. 2. Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden. 3. School Psychology and Development in Context, Leuven, KU, Belgium. 4. Research Foundation Flanders (FWO), Brussels, Belgium. 5. Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35, B-3000, Leuven, Box 7001, Belgium. 6. Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care, Division of Nursing and Midwifery, University of Antwerp, Antwerp, Belgium. 7. UNIBS, University of the Free State, Bloemfontein, South Africa. 8. Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, USA. 9. Department of Cardiothoracic Surgery, Department of Cardiology, Oslo University Hospital, Oslo, Norway. 10. Department of Nursing, Samsung Medical Center, Seoul, South Korea. 11. Congenital and Structural Cardiology, University Hospitals Leuven, Leuven, Belgium. 12. Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium. 13. Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden. philip.moons@kuleuven.be. 14. Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35, B-3000, Leuven, Box 7001, Belgium. philip.moons@kuleuven.be. 15. Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa. philip.moons@kuleuven.be.
Abstract
BACKGROUND: Patient empowerment is associated with improvements in different patient-reported and clinical outcomes. However, despite being widely researched, high quality and theoretically substantiated disease-generic measures of patient empowerment are lacking. The few good instruments that are available have not reported important psychometric properties, including measurement invariance. The aim of this study was to assess the psychometric properties of the 15-item Gothenburg Empowerment Scale (GES), with a particular focus on measurement invariance of the GES across individuals from three countries. METHODS: Adults with congenital heart disease from Belgium, Norway and South Korea completed the GES and other patient-reported outcomes as part of an international, cross-sectional, descriptive study called APPROACH-IS II. The scale's content (missing data) and factorial validity (confirmatory factor analyses), measurement invariance (multi-group confirmatory factor analyses), responsiveness (floor and ceiling effects) and reliability (internal consistency) were assessed. RESULTS: Content validity, responsiveness and reliability were confirmed. Nonetheless, metric but not scalar measurement invariance was supported when including the three countries, possibly because the scale performed differently in the sample from South Korea. A second set of analyses supported partial scalar invariance for a sample that was limited to Norway and Belgium. CONCLUSION: Our study offers preliminary evidence that GES is a valid and reliable measure of patient empowerment in adults with congenital heart disease. However, cross-country comparisons must be made with caution, given the scale did not perform equivalently across the three countries.
BACKGROUND: Patient empowerment is associated with improvements in different patient-reported and clinical outcomes. However, despite being widely researched, high quality and theoretically substantiated disease-generic measures of patient empowerment are lacking. The few good instruments that are available have not reported important psychometric properties, including measurement invariance. The aim of this study was to assess the psychometric properties of the 15-item Gothenburg Empowerment Scale (GES), with a particular focus on measurement invariance of the GES across individuals from three countries. METHODS: Adults with congenital heart disease from Belgium, Norway and South Korea completed the GES and other patient-reported outcomes as part of an international, cross-sectional, descriptive study called APPROACH-IS II. The scale's content (missing data) and factorial validity (confirmatory factor analyses), measurement invariance (multi-group confirmatory factor analyses), responsiveness (floor and ceiling effects) and reliability (internal consistency) were assessed. RESULTS: Content validity, responsiveness and reliability were confirmed. Nonetheless, metric but not scalar measurement invariance was supported when including the three countries, possibly because the scale performed differently in the sample from South Korea. A second set of analyses supported partial scalar invariance for a sample that was limited to Norway and Belgium. CONCLUSION: Our study offers preliminary evidence that GES is a valid and reliable measure of patient empowerment in adults with congenital heart disease. However, cross-country comparisons must be made with caution, given the scale did not perform equivalently across the three countries.
Authors: Paulina Bravo; Adrian Edwards; Paul James Barr; Isabelle Scholl; Glyn Elwyn; Marion McAllister Journal: BMC Health Serv Res Date: 2015-07-01 Impact factor: 2.655