Ask, Understand, Remember: A Brief Measure of Patient Communication Self-Efficacy Within Clinical Encounters
Open accessAbstract
Patients' ability to effectively communicate with their health care providers is an essential aspect of proper self-care, especially for those with chronic conditions. We wanted to develop and validate a brief, reliable measure of patient communication self-efficacy within clinical encounters. Consecutively recruited patients (n = 330) with diagnosed hypertension from seven primary care clinics in Chicago, Illinois, Grand Rapids, Michigan, and Shreveport, Louisiana completed an in-person interview including chronic disease self-efficacy, hypertension knowledge, health literacy assessments, and items modified from the Communication and Attitudinal Self-Efficacy (CASE) - Cancer scale. Six items from the CASE were candidates for a new scale due to their focus on the patient-provider relationship. Using principal components analysis with varimax rotation, four items strongly loaded onto one factor (Eigenvalue = 2.33; proportion of variance explained = 58%) with a Cronbach's α coefficient of 0.75. The measure, referred to as the Ask, Understand, Remember Assessment, (AURA) was moderately correlated with the total score from an existing chronic disease management self-efficacy scale (r = 0.31) and disease knowledge (beta coefficient = 0.2, 95% Confidence Interval 0.04 - 0.3, p = .03). Patients with low health literacy had lower scores on the AURA than those with marginal or adequate health literacy (p < .05). The AURA demonstrated high internal consistency and was correlated with both hypertension knowledge and a chronic disease self-efficacy scale. The AURA is brief, valid, has low reading demands, and is an appropriate tool for use among patients with chronic illness. It may also be useful in identifying and assisting patients who are at risk for errors or non-adherence with self-care behaviors.
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Patients who lack confidence in communicating with providers are indirectly at risk of nonadherence because they may misunderstand instructions or not report side effects.
“Patients lacking confidence in their ability to effectively communicate with their providers (e.g., factor 1) are indirectly at risk for nonadherence to treatment regimens, as they may misunderstand treatment instructions or fail to report adverse side effects (58).”
From Reliability and validity of a self‐efficacy instrument for hepatitis C antiviral treatment regimens (2012) · cites this paper as [58]
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- Authors
- Clayman, M. L., Pandit, A. U., Bergeron, A. R., Cameron, K. A., Ross, E., & Wolf, M. S.
- Affiliations
- Northwestern University (US)
- Corresponding author
- Clayman, Marla L.
- Venue
- Journal of Health Communication
- Publisher
- Informa UK Limited
- Published
- 2010-08-31
- Volume
- 15
- Issue
- sup2
- Pages
- 72-79
- ISSN
- 1081-0730 (ISSN-L)
- 1087-0415
- PMC
- PMC3184840
- OpenAlex
- W1969728816
- Cited by
- 63
- References
- 36
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 1 · 2023: 6 · 2022: 4 · 2021: 4 · 2020: 5 · 2019: 4 · 2018: 4 · 2017: 2 · 2016: 3 · 2015: 5 · 2014: 4 · 2013: 6 · 2012: 5
- FWCI
- 9.68
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Health Communication (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Pfizer
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (K12HD055884)
- Topics
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
- Social Sciences › Education › Health Education and Validation
- Keywords
- patient-provider communication, hypertension, chronic disease self-efficacy, health literacy, scale development, self-care adherence, disease knowledge
- MeSH terms
- Chicago, Chronic Disease, Communication, Female, Humans, Hypertension, Health Knowledge, Attitudes, Practice, Louisiana, Male, Memory, Michigan, Middle Aged, Physician-Patient Relations, Self Care, Reproducibility of Results, Self Efficacy, Comprehension, Qualitative Research, Health Literacy
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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