Background: Decision-making and problem-solving processes are powerful activities occurring daily across all healthcare settings. Their empowering potential is seldom fully exploited, and they may even be perceived as disempowering. We developed the EMPOWER-UP questionnaire to enable assessment of healthcare users' perception of empowerment across health conditions, healthcare settings, and healthcare providers' professional backgrounds. This article reports the initial development of EMPOWER-UP, including face and content validation.
Methods: Four grounded theories explaining barriers and enablers to empowerment in relational decision-making and problem-solving were reviewed to generate a preliminary item pool, which was subsequently reduced using constant comparison. Preliminary items were evaluated for face and content validity using an expert panel of seven researchers and cognitive interviews in Danish and English with 29 adults diagnosed with diabetes, cancer, or schizophrenia.
Results: A preliminary pool of 139 items was reduced to 46. Independent feedback from expert panel members resulted in further item reduction and modifications supporting content validity and strengthening the potential for generic use. Forty-one preliminary items were evaluated through 29 cognitive interviews, resulting in a 36-item draft questionnaire deemed to have good face and content validity and generic potential.
Conclusions: Face and content validation using an expert panel and cognitive interviews resulted in a 36-item draft questionnaire with a potential for evaluating empowerment in user-provider interactions regardless of health conditions, healthcare settings, and healthcare providers' professional backgrounds.
Keywords: Decision making; Empowerment; Patient-reported outcome measure; Problem solving; Questionnaire design; User-provider relationships.
Users of healthcare services living with long-term health conditions may need empowerment-based support from healthcare providers to discover and develop their inherent capacity to be responsible for their own life. This ensures that healthcare users develop the skills needed to manage the many decisions and problems they face. Yet many healthcare users still experience lack of involvement and support in decision-making and problem-solving. Therefore, we developed the EMPOWER-UP questionnaire to allow healthcare users to evaluate the empowering qualities of their interactions with healthcare providers regardless of their diagnosis, where the interactions take place, and with whom. The aim of this article was to describe the development of EMPOWER-UP and to present the results of early evaluations of its content.The questionnaire was developed in Danish based on thorough qualitative research explaining distinct, complex patterns in user-provider interactions and translated to English during the evaluation process. We used individual feedback from a panel of expert researchers and interviews conducted with healthcare users diagnosed with diabetes, cancer, or schizophrenia to evaluate EMPOWER-UP’s content. Interviews were conducted while the participants answered preliminary versions of the questionnaire.As a result of these evaluations, several items in the questionnaire were adjusted, some were deleted, and some new items were developed. We believe that EMPOWER-UP can be an important tool to help evaluate the effectiveness of interventions aimed at ensuring empowering support from healthcare providers. Thus, EMPOWER-UP may help to identify the most effective interventions for specific healthcare contexts.
© 2024. The Author(s).