• Internal medicine journal · Dec 2021

    Psychometric validation of the Partners in Health scale as a self-management tool in patients with liver cirrhosis.

    • Jeyamani Ramachandran, David Smith, Richard Woodman, Kate Muller, Rachel Wundke, Rosemary McCormick, Billingsley Kaambwa, and Alan Wigg.
    • Hepatology and Liver Transplant Unit, Flinders Medical Centre, Adelaide, South Australia, Australia.
    • Intern Med J. 2021 Dec 1; 51 (12): 2104-2110.

    Background And AimLiver cirrhosis is a chronic disease complicated by recurrent hospital admissions. Self-management skills could facilitate optimal disease management. At present there is no validated instrument for measuring self-management in these patients. Hence, we evaluated the internal reliability and construct validity of the Partners in Health (PIH) scale, a chronic condition self-management tool in cirrhotic patients.MethodsIn this prospective cohort study, the PIH scale was administered to 133 consenting patients within a Chronic Liver Failure Program of a tertiary hospital from February 2017 to May 2018. A Bayesian confirmatory factor analysis was used to evaluate a priori four-factor structure. Omega coefficients and 95% credible intervals (CrI) were used to assess internal reliability. Known-group validity was assessed in patients receiving active case management (n = 60) versus those without (n = 73).ResultsThe mean (± standard deviation (SD)) age of the participants was 62 (±11) years. Model fit for the hypothesised model was adequate (posterior predictive P-value = 0.073) and all hypothesised factor loadings were substantial (>0.6) and significant (P < 0.001). Omega coefficients (95% CrI) for the PIH subscales of Knowledge, Partnership, Management and Coping were 0.88 (0.82-0.91), 0.68 (0.57-0.76), 0.92 (0.89-0.94) and 0.89 (0.85-0.92) respectively. The mean (±SD) overall PIH score was higher in patients receiving case management compared to those without case management (81 ± 12 vs 73 ± 17, P < 0.001).ConclusionThe dimensionality, known-group validity and reliability of the PIH scale for measuring self-management in patients with liver cirrhosis were confirmed. Its clinical predictive value requires further assessment.© 2020 Royal Australasian College of Physicians.

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