Ask, understand, remember: A brief measure of patient communication self-efficacy within the clinical encounter

BACKGROUND: Our objective was to develop and validate a reliable, brief measure of patientsx self-reported ability and confidence to obtain, understand, and recall information from their physicians.

METHODS: Consecutive patients (n=330) with diagnosed hypertension and scheduled appointments were recruited from primary care clinics in three cities. Patients completed structured interviews with items modified from a previously validated communication and attitudinal self efficacy scale. Six items were identified by the research team as most appropriate for potential inclusion in the Ask, Understand, Remember Assessment given the narrow context to be addressed. We conducted a principal components analysis with varimax rotation to assess the construct validity and used Cronbach's α to examine reliability of the scale. It was postulated that higher AURA scores would correspond with greater disease and treatment knowledge.

RESULTS: Four items strongly loaded onto one factor (Eigenvalue=2.39; proportion of variance explained=59%) with a Cronbach's α coefficient of 0.81. The AURA score was strongly correlated with the total score from an existing chronic disease management self-efficacy scale (r=0.53) and disease knowledge (beta coefficient=0.2, 95% CI 0.04 - 0.3, p=0.03).

CONCLUSION: The Ask, Understand, Remember Assessment (AURA) has high internal consistency and was strongly correlated with both hypertension knowledge and a previously validated chronic disease self-efficacy scale. However, the AURA is brief and appropriate for patients with and without chronic illness. The AURA may be useful for testing the effect of interventions designed to improve patient participation and enhance the patient-provider relationship.