Reliability and Validity of the Chinese Version of Patient Empowerment Scale among the Elderly with Chronic Diseases

Objective: To translate the English version of Patient Empowerment Scale (PES) into Chinese, and to test the reliability and validity, and assess the serviceability of the Chinese version of PES among the elderly with chronic diseases. Methods: We adapted the English version of PES following the Brislin's classic model for translation and validation of instruments guidelines for cross-cultural research, including translation, back translation, expert consultation for adjusting the items, then, after a pilot survey using the initial scale, we developed the formal Chinese version of PES. Three hundred elderly patients with chronic diseases who were older than 60 selected by convenient sampling from the First Affiliated Hospital of Zhengzhou University and the Second Affiliated Hospital of Zhengzhou University were surveyed by the Chinese version of PES between April and June 2015. Thirty participants were selected from those who had actively responded to the survey for the test-retest two weeks later. SPSS 17.0 and AMOS 17.0 were used for data analysis. The content validity index (CVI) was used to measure the content validity; exploratory factor analysis was used to measure the construct validity; common factors were extracted with principal component analysis and maximum variance orthogonal rotation, and maximum likelihood method was used for confirmatory factor analysis. The Cronbach's α, split half, and test-retest were used for reliability analysis. Results: A total of 94.7% (284/300) of the participants actively responded to the initial questionnaire survey. The item-total correlation coefficient in the Chinese version of PES ranged from 0.570 to 0.828 (P<0.01). There were significant differences in the scores of 20 items between the high-score group and low-score group (P<0.05). The S-CVI was 0.96. I-CVI ranged from 0.90 to 1.00. The KMO value for the scale by exploratory factor analysis was 0.851, and result of Bartlett's test of sphericity was χ² = 1 099.428 (P<0.01). Four common factors were extracted by exploratory factor analysis, which could explain 73.458% of the total variance. The confirmatory factor analysis revealed a good model fit, P=0.348. The Cronbach's α of the Chinese version of PES was 0.931, split-half reliability was 0.814, test-retest reliability was 0.820 (P<0.01). Conclusion: The Chinese version of PES is reliable and valid, so it can be used to assess the empowerment of elderly patients with chronic diseases.