Validity and reliability of the Turkish version of patient health engagement scale

This research was carried out to test the validity and reliability of the Turkish version of "Patient Health Engagement Scale". All patients that had any type of chronic disease and hospitalized in the clinics of Internal Diseases/received outpatient treatment in Ege University Medical Faculty hospital between March 2017 and February 2018 constituted the population of this methodological study. Volunteer patients with chronic diseases (260) selected through non-probability sampling comprised the sampling of the research. The data were collected using "Socio Demographic Information Form", "Patient Health Engagement Scale (PHE)" and "Patient Activation Measure (PAM)". Scale's language validity was ensured through "translation-back translation method". For the content validity of the original "Patient Health Engagement Scale" (PHE) developed by Graffigna et al. (2015) expert opinion was obtained and the "Content Validity Index" (CVI) was found as 0.88. Kendall's coefficient of concordance was obtained as W= 0.199 (p< 0.05). In order to determine scale's structural validity the "principal components analysis" and "confirmatory factor analysis" were made and consequently one factor with eigenvalue (4.2) was yielded and Scree Plot graphic also determined that the scale was in one factor structure consistent with the conceptual structure of the unique form of the scale. CFA showed reasonable multiple goodness-of-fit indexes and these results gave evidence of concordance between the model formed and unique scale model (x2/df=2.12, RMSEA=0.066, CFI=0.99, NFI=0.99, NNFI=0.99, SRMR=0.06, GFI=0.98). For concurrent validity of the PHE scale validity the "Patient Activation Measure (PAM)" was used and a strong, positive and very significant correlation was found between two scales. For the internal consistency reliability, Cronbach alpha value of the Turkish version of the "Patient Health Engagement Scale (PHE)" was found as 0.95. Item by item correlation coefficients varied between 0.68 and 0.87 and correlation coefficients of the item-total scores varied between 0.86 and 0.95. In the scope of item analysis, the difference between item scores of the groups with 27 % top, 27 % bottom, was tested through Independent sample t-test and a significant difference at p< 0.05 level was detected at all test items between group averages. In order to determine the stability of Patient Health Engagement Scale (PHE), scale was applied to 30 patients with two-week interval and a very strong, positive and significant relationship was found between two measurements (r=0.99, p<0.01). "Patient Health Engagement Scale (PHE)" was found to be a valid and reliable measurement tool to be used to determine health engagement levels of individuals with chronic diseases. Scale can be utilized to identify patients lacking self-management skills before they fall into higher health risk groups, to apply early interventions and to develop care plans that will enable more effective use of both time and resources for patients and health system. Keywords: Patient health engagement, chronic disease, validity, reliability