Patient empowerment in long-term conditions: development and preliminary testing of a new measure

BACKGROUND: Patient empowerment is viewed by policy makers and health care practitioners as a mechanism to help patients with long-term conditions better manage their health and achieve better outcomes. However, assessing the role of empowerment is dependent on effective measures of empowerment. Although many measures of empowerment exist, no measure has been developed specifically for patients with long-term conditions in the primary care setting. This study presents preliminary data on the development and validation of such a measure. METHODS: We conducted two empirical studies. Study one was an interview study to understand empowerment from the perspective of patients living with long-term conditions. Qualitative analysis identified dimensions of empowerment, and the qualitative data were used to generate items relating to these dimensions. Study two was a cross-sectional postal study involving patients with different types of long-term conditions recruited from general practices. The survey was conducted to test and validate our new measure of empowerment. Factor analysis and regression were performed to test scale structure, internal consistency and construct validity. RESULTS: Sixteen predominately elderly patients with different types of long-term conditions described empowerment in terms of 5 dimensions (identity, knowledge and understanding, personal control, personal decision-making, and enabling other patients). One hundred and ninety seven survey responses were received from mainly older white females, with relatively low levels of formal education, with the majority retired from paid work. Almost half of the sample reported cardiovascular, joint or diabetes long-term conditions. Factor analysis identified a three factor solution (positive attitude and sense of control, knowledge and confidence in decision making and enabling others), although the structure lacked clarity. A total empowerment score across all items showed acceptable levels of internal consistency and relationships with other measures were generally supportive of its construct validity. CONCLUSION: Initial analyses suggest that the new empowerment measure meets basic psychometric criteria. Reasons concerning the failure to confirm the hypothesized factor structure are discussed alongside further developments of the scale

Sanierung kontaminierter Standorte Dokumentation einer Fachtagung

SIGLETIB: RO 2183 (1985)+a-c / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekDEGerman

Results from MEA testing at the CO2 Technology Centre Mongstad. Part II: Verification of baseline results

AbstractIndependent verification protocol (IVP) work has been conducted at the CO2 Technology Centre Mongstad (TCM DA) during treatment of flue gas from a natural gas-fired combined heat and power (CHP) plant. The testing applied an aqueous 30 wt% monoethanolamine (MEA) solvent system treating flue gases with a flow rate of about 47.000 Sm3/hr and a CO2 content of about 3.5%. The CO2 capture rate was about 90% and the thermal steam consumption was about 4.1 GJ/t CO2. Emissions of MEA were very low and MEA-related degradation products were all below detection levels, and all within the emission limits set by the Norwegian environmental authorities. The current work may be considered an independently verified baseline for a non- proprietary post-combustion amine based solvent system carried out at an industrial-scale plant facility.Long-term performance indices, such as material corrosion, MEA solvent degradation, etc., have not been considered in the current IVP work. Additional minor process adaption to the aqueous MEA solvent system, such as increased MEA concentrations, the use of anti-foam solutions, etc., may lead to lower thermal steam consumptions than aforementioned

Top-down and bottom-up narratives of peace and conflict

Based on findings from the Everyday Peace Indicators project, the article considers how top-down and bottom-up narratives and understandings of conflict often differ. The article posits that top-down narratives are often the result of a peculiar framing system that imposes imaginaries on conflicts and those experiencing them. The bottom-up narratives, based on research in South Africa, South Sudan, Uganda and Zimbabwe, show that localised perceptions of peace, safety and security are not only articulated in different ways to top-down narratives but also raise different issues