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The internal consistency and construct validity of the partners in health scale: validation of a patient rated chronic condition self-management measure

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The purpose of this study was to test the internal consistency and construct validity of the revised 12-item self-rated Partners in Health (PIH) scale used to assess patients’ chronic condition self-management knowledge and behaviours.


Baseline PIH data were collected for a total of 294 patients with a range of co-morbid chronic conditions including diabetes, cardiovascular disease and arthritis. Scale data for the initial sample of 176 patients were analysed for internal consistency and construct validity using Reliability Analysis and Factor Analysis. Construct validity was tested in a separate sample of 118 patients using confirmatory factor analysis and a structural equation model.


Good internal consistency was indicated with a Cronbach’s alpha coefficient of 0.82 in the initial sample. Factor analysis for this sample revealed four key factors (knowledge, coping, management of condition and adherence to treatment) across the twelve items of the scale. These four key factors were then confirmed by applying the exploratory structural equation model to the separate sample.


The PIH scale exhibits construct validity and internal consistency. It therefore is both a generic self-rated clinical tool for assessing self-management in a range of chronic conditions as well as an outcome measure to compare populations and change in patient self-management knowledge and behaviour over time. The four domains of self-management provide a valid measure of patient competency in relation to the self-management of their chronic condition(s).

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Correspondence to Peter Harvey.

Appendix 1: The PIH 12 items

Appendix 1: The PIH 12 items

  • Item 1: Knowledge of illness.

  • Item 2: Knowledge of treatment of illness.

  • Item 3: Taking medication as prescribed.

  • Item 4: Sharing in decisions.

  • Item 5: Arranging and attending appointments.

  • Item 6: Understanding of need to check and record symptoms.

  • Item 7: Checking and writing down symptoms.

  • Item 8: Knowledge of what to do when symptoms get worse.

  • Item 9: Doing the right things when symptoms get worse.

  • Item 10: Dealing with effects of illness on physical activities.

  • Item 11: Dealing with effects of illness on social life.

  • Item 12: Progressing toward leading a healthy life.

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Petkov, J., Harvey, P. & Battersby, M. The internal consistency and construct validity of the partners in health scale: validation of a patient rated chronic condition self-management measure. Qual Life Res 19, 1079–1085 (2010).

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