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Document Type

Dissertation - University Access Only

Award Date


Degree Name

Doctor of Philosophy (PhD)


Graduate Nursing

First Advisor

Thomas E. Stenvig


Patients who actively participate in their health care have better health and lower healthcare costs. Patient activation is the patient’s level of knowledge, skill, and confidence to provide self-care. It is a construct predictive of patients’ health outcomes. The purpose of this study was to analyze the degree to which a sample of RNs support patient activation and the extent to which the nurses’ activation intentions, their practice climate, and selected demographic characteristics predict their support for patient activation. Data were collected using the Clinician Support – Patient Activation Measure (CS-PAM) (Insignia Health, LLC, 2010), Practice Climate Scale (Becker & Roblin, 2008), activation intention statements, and demographic characteristics questions. Nurses were randomly sampled from the Iowa State Board of Nursing list of RNs and mailed a survey following Dillman, Smyth, and Christian’s (2009) total design method. SPSS v. 22 analyzed respondents’ CS-PAM scores and responses to activation intention and practice climate statements, and demographic questions. Respondents’ (N = 442) mean CS-PAM score was 74.58 (SD = 15.05). Most nurses agreed patients are able to function as members of the healthcare team. The nurses’ age and patient activation support scores were positively correlated (p = .000). Nurses dissatisfied with their practice climate had significantly lower CS-PAM scores than those more satisfied (p = .002). Satisfaction with delegation of tasks was found to be the strongest predictor of CS-PAM scores (p =.022). Activation intentions and the CS-PAM scores were positively correlated (p = .000). Amount of time for following up with patients, the stability of the nurse-patient relationship, ability to provide continuity of care, and the nurses’ degree of responsibility were positively correlated with the nurses’ activation intentions. This study initiated the exploration of patient activation support among RNs. Study findings provide a basis for nurse educators to formulate curriculum to foster nursing student support for patient activation. Nurse administrators may consider modifying the practice climate to facilitate strengthening the nurse-patient relationship, the continuity of care provided by, and the degree of responsibility given to nurses in order to achieve greater support for patient activation among RNs.

Library of Congress Subject Headings

Self-care, Health
Nurse and patient
Nurses -- Attitude


Includes bibliographical references (pages 210-218)



Number of Pages



South Dakota State University


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