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Open AccessArticle

PEN-13: A New Generic 13-Item Questionnaire for Measuring Patient Enablement (German Version)

Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, Wilhelmstraße 27, 72074 Tübingen, Germany
PMV forschungsgruppe, University of Cologne, Herderstraße 52, 50391 Cologne, Germany
OptiMedis AG, Burchardstraße 17, 20095 Hamburg, Germany
London School of Hygiene and Tropical Medicine, University of London, London WC1E 7HT, UK
Division of General Practice, University Medical Center Freiburg, 79910 Freiburg, Germany
Institute for Clinical Epidemiology and Applied Biometry, University Hospital Tübingen, Silcherstr. 5, 72076 Tübingen, Germany
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(23), 4867;
Received: 13 November 2019 / Accepted: 28 November 2019 / Published: 3 December 2019
Background: The purpose of our study was to develop and psychometrically test a German-language survey instrument that measures patient enablement generically and in greater detail than previous instruments. Methods: A multidisciplinary team developed 13 items to capture individual aspects of patient enablement (PEN-13). A pre-test with 26 subjects was followed by a random sample survey of N = 1168 subjects. An exploratory factor analysis was conducted in a random split-half sample of the data to explore PEN-13’s factor structure; a confirmatory factor analysis was conducted in the validation sample. The internal consistency of the factors was evaluated using Cronbach’s alpha, PEN-13’s construct validity was checked by means of additional hypothesis testing. Results: The two factors self-management and patient-practitioner interaction, detected in the exploratory analysis, were confirmed with a few modifications in the confirmatory factor analysis, with the comparative fit index (CFI) amounting to 0.903. The Cronbach’s alpha values of those two factors amounted to α = 0.90 and α = 0.82, respectively. The correlations of the PEN-13 score with the ’general self-efficacy’ and ’health literacy’ (HLS-EU-Q16) scores further confirmed its construct validity; the respective correlation coefficients amounted to 0.57 and 0.60. Conclusion: The German version of the survey instrument Patient Enablement Scale—13 items (PEN-13) shows acceptable psychometric properties. Practical implications: PEN-13 seems particularly suitable for health services research purposes. We recommend checking the results in another sample as well as evaluating its responsiveness to enablement-enhancing interventions. View Full-Text
Keywords: standardized questionnaire; validation; patient enablement; patient empowerment; patient activation standardized questionnaire; validation; patient enablement; patient empowerment; patient activation
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Siegel, A.; Ehmann, A.T.; Meyer, I.; Gröne, O.; Niebling, W.; Martus, P.; Rieger, M.A. PEN-13: A New Generic 13-Item Questionnaire for Measuring Patient Enablement (German Version). Int. J. Environ. Res. Public Health 2019, 16, 4867.

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