Validation of the Patient Activation Measure (PAM-13) among individuals with chronic spinal cord injury in mainland China

Context/objective:The 13-item Patient Activation Measure (PAM-13) is the most widely used generic patient activation measure, but spinal cord injury (SCI) related psychometric evaluation of PAM-13 has not been explored globally. This study aimed to assess the validity of the Chinese version of the PAM-13 (PAM-13-C) for individuals with chronic spinal cord injury (CSCI).Design:Cross-sectional study.Setting:Shanghai Sunshine Rehabilitation Center, and some participants were recruited in a WeChat group (the most commonly used social media platform in China).Participants:284 individuals with spinal cord injury who had lived with the injury for >= 0.5 year.Interventions:NA.Outcome measures:The PAM-13-C, global QoL, seven-item generalized anxiety disorder scale (GAD-7) and nine-item patient health questionnaire (PHQ-9), and General Self-Efficacy Scale (GSES) were used.Results:The mean (SD) PAM-13-C score was 57.4 (16.5). The highest percentage of NA could be observed in item 9 (12.0%). Floor and ceiling effects of the total scores of PAM-13-C were small (0.7% and 6.7%), but a ceiling effect could be observed among all items. Exploratory Factor Analysis supported a one-factor model of the PAM-13-C (CFI = 0.97; RMSEA = 0.07). Construct validity was established through correlation analysis among the PAM-13-C, GAD-7/PHQ-9, global QoL, and GSES. The PAM-13-C demonstrated excellent internal consistency (Cronbach's alpha = 0.95) and acceptable test-retest reliability.Conclusion:The PAM-13-C is a reliable and valid measure of patient activation for individuals with CSCI in China.