Tohoku J. Exp. Med., 2012, 227(2)

Two Principal Components, Coping and Independence, Comprise Patient Enablement in Japan: Cross Sectional Study in Tohoku Area

SATOKO KUROSAWA,¹ MASATO MATSUSHIMA,¹ YASUKI FUJINUMA,² DAICHI HAYASHI,³ IKUKO NORO,⁴ TOHRU KANAYA,⁵ TAKAMASA WATANABE,¹ TOMOKAZU TOMINAGA,¹ TAKUYA NAGATA,¹ AYAKO KAWASAKI,¹ TAKUMI HOSOYA⁶ and HIROYUKI YANAGISAWA⁷

¹Division of Clinical Epidemiology, Research Center for Medical Science, Jikei University School of Medicine, Tokyo, Japan
²Centre for Family Medicine Development, Japanese Health and Welfare Co-operative Federation, Tokyo, Japan
³Department of Radiology, Jikei University School of Medicine, Tokyo, Japan
⁴Department of Human Science, Japanese Language, Jikei University School of Medicine, Tokyo, Japan
⁵Department of Cardiovascular Medicine, Tohoku Central Hospital of Japan Mutual Aid Association of Public School Teachers, Yamagata, Japan
⁶Division of General Medicine, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
⁷Department of Public Health and Environmental Medicine, Jikei University School of Medicine, Tokyo, Japan

The concept of “patient enablement” involves patients' perceptions of ability to understand and cope with illness. Improving enablement is an important goal of medical consultations for patients with chronic illness. To measure “enablement,” a post-medical-consultation patient-reported questionnaire was developed and named “Patient Enablement Instrument (PEI)” in the United Kingdom. Unfortunately, there has been no tool to evaluate patient enablement in Japan. Therefore, this study aimed to develop PEI Japanese version, to examine its validity and reliability, and to clarify the constitution of concept about patient enablement among Japanese patients. The translation process included forward translation, expert panel back-translation, following the standard WHO process. Participants were 256 individuals (157 men and 99 women; mean age 62.9 ± 11.8 years) receiving a regular outpatient treatment due to chronic illness at the Department of Cardiology, Respiratory, or Endocrinology and Metabolism in a regional hospital. To assess validity, we compared PEI with Medical Interview Satisfaction Scale (MISS) by correlation coefficient, which was 0.55 (P < 0.01). Furthermore, factor analysis indicated that PEI had two principal factors labeled “coping with illness and health maintenance” and “confidence in oneself and independence”. For an evaluation of reliability, internal consistency was calculated (Cronbach's alpha = 0.875). In conclusion, two principal factors comprise patient enablement measured by PEI with satisfactory validity and reliability. PEI Japanese version will be a useful tool to evaluate and improve medical consultations in Japan.

keywords —— enablement; medical consultations; patient satisfaction; physician-patient relations; questionnaires

© 2012 Tohoku University Medical Press

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Tohoku J. Exp. Med., 2012, 227, 97-104

Correspondence: Masato Matsushima, Division of Clinical Epidemiology, Research Center for Medical Science, Jikei University School of Medicine, 3-25-8, Nishishimbashi, Minato-ku, Tokyo 105-8461, Japan.

e-mail: masato@jikei.ac.jp