Patients proceed through these levels as they make improvements in self-management. The four PAM activation levels are marker points on a continuum. Patients have adopted many behaviours to support their health, but may be unable to maintain them when faced with adversity or life stressors. Patients are beginning to take action, but may lack the confidence and skill to support and sustain these behaviours. Patients may lack the knowledge and confidence to self-manage their health. They may be unprepared to take an active role in their own health. Patients may be passive and feel overwhelmed about managing their health.
2 3 The PAM includes a scale from 0 to 100, which can be divided into four developmental levels: 1 Patient activation can be measured using the Patient Activation Measure (PAM), which aims to assess ‘patient self-reported knowledge, skill and confidence for self-management of one’s health or chronic condition’. 1 Patient activation incorporates elements of self-efficacy and readiness to change, and is moderately correlated with health literacy. Patient activation has been described as a behavioural concept, and relates to the degree to which patients understand their role in their healthcare, and how competent they feel to fulfil that role.
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