Introduction
The Health Care Empowerment Questionnaire (HCEQ) is a 10-item questionnaire that measures how empowered people are in their own health care and services. It covers their ability to exercise control, take part in interactions with health professionals and share in health care decisions. Maxime Gagnon and colleagues published it in 2006.
The HCEQ was developed in Canada within the PRISMA research program on services for maintaining autonomy, and it has received more than 100 citations. This guide explains its subscales, scoring, languages and evidence.
Key Features of the Health Care Empowerment Questionnaire (HCEQ)
Purpose and Use
The HCEQ measures individual empowerment in relation to personal health care and services. It was developed in the Program of Research to Integrate Services for the Maintenance of Autonomy (PRISMA).
Target Population
The HCEQ was first validated in older adults aged 75 and over. Later studies have validated it in other adult populations.
Structure
The HCEQ has 10 items in three areas:
Degree of control over the health care and services receivedInvolvement in interactions with health professionalsInvolvement in health care decisionsItems cover asking for explanations, asking questions and advice, communicating with professionals, having choices respected, getting information and help, and taking part with loved ones in decisions about the need for, type and amount of health care and services.
Scoring Method
Each item uses two 4-point scales in turn:
Perceived control: 1 (not at all) to 4 (extremely)Motivation or importance: 1 (not important at all) to 4 (extremely important)The item score is the product of the two answers, from 1 to 16. An overall summed score therefore ranges from 10 to 160. No cut-off scores are reported.
Administration Format
The HCEQ is a questionnaire completed by the person receiving health care.
Applications of the Health Care Empowerment Questionnaire (HCEQ)
The HCEQ supports several uses:
Research on older adults: measuring empowerment in health care among people at risk of losing autonomy.Patient empowerment research: studying involvement in care in other adult groups, such as people with arthritis and rheumatic conditions.Health services evaluation: assessing control and participation in health care and services.Languages and availability
The HCEQ has been used and validated in several languages:
French: the original validation was in French-speaking older adults, and it has been used in a registered clinical trialPersian: psychometrics among Iranian women of reproductive ageKorean: reliability and validity of the K-HCEQThe original article is available from the American Journal of Health Promotion.
Reliability and Validity
The original study showed good internal consistency, temporal stability and support for a three-factor structure.
Validation studies:
Development and validation of an instrument measuring individual empowerment in relation to personal health care: the HCEQ (2006): study linkPsychometric characteristics of the HCEQ in patients with arthritis and rheumatic conditions (2021): study linkTesting psychometrics of the HCEQ among Iranian women of reproductive age (2018): study linkLimitations and Considerations
Keep these points in mind:
Original sample: validation was conducted mainly in elderly French-speaking participants at risk of loss of autonomy, so use in other populations should be supported by further validation.No cut-offs: no cut-off scores are reported.Two answers per item: each item needs both a control and an importance rating to be scored.Other Versions And Related Questionnaires
A related questionnaire is the Perceived Efficacy in Patient-Physician Interactions (PEPPI) scale.
Additional Resources
The original article: linkThe HCEQ in the EULAR Outcome Measures Library: linkFor inquiries, contact Maxime Gagnon, Research Center on Aging, Sherbrooke Geriatric University Institute, Sherbrooke, Canada, at maxine.gagnon@usherbrooke.ca.Browse more public health questionnaires in the ResRef database.Frequently Asked Questions (FAQ)
What does the Health Care Empowerment Questionnaire measure?The HCEQ measures how empowered people are in their own health care: their degree of control, their involvement in interactions with health professionals and their involvement in health care decisions.
How is the HCEQ scored?Each item is rated twice on 4-point scales, once for perceived control and once for importance. The two answers are multiplied for an item score of 1 to 16, and an overall summed score ranges from 10 to 160.
Who was the HCEQ developed for?The HCEQ was first validated in older adults aged 75 and over, mainly French-speaking people at risk of losing autonomy. Later studies have validated it in other adult populations.
In which languages is the HCEQ available?The HCEQ was validated in French-speaking older adults, and Persian and Korean versions have been tested for reliability and validity in later studies.
A Word from ResRef About the Health Care Empowerment Questionnaire (HCEQ)
The HCEQ is a 10-item instrument designed to assess individual empowerment in relation to personal health care and services, particularly among older adults. The original study demonstrated good internal consistency, temporal stability and support for a three-factor structure. Validation was conducted primarily in elderly French-speaking participants at risk of loss of autonomy, so use in other populations should be supported by further validation.
References
Gagnon, M., Hébert, R., Dubé, M., & Dubois, M. F. (2006). Development and validation of an instrument measuring individual empowerment in relation to personal health care: the Health Care Empowerment Questionnaire (HCEQ). American Journal of Health Promotion: AJHP, 20(6), 429–35. https://doi.org/10.4278/0890-1171-20.6.429Knight, E., Carluzzo, K., Schifferdecker, K. E., Creek, E., Butcher, R. L., & Eakin, G. S. (2021). Psychometric characteristics of the health care empowerment questionnaire in a sample of patients with arthritis and rheumatic conditions. Health Expectations, 24(2), 537–547. https://doi.org/10.1111/hex.13196Mohebbi, B., Tol, A., Shakibazadeh, E., Yaseri, M., Sabouri, M., & Agide, F. D. (2018). Testing Psychometrics of Healthcare Empowerment Questionnaires (HCEQ) among Iranian Reproductive Age Women: Persian Version. Ethiopian Journal of Health Sciences, 28(3), 341. https://doi.org/10.4314/ejhs.v28i3.12Lim, S., & Lee, K. (2022). Reliability and Validity of the Korean Version of the Health Care Empowerment Questionnaire (K-HCEQ). Journal of Korean Academy of Fundamentals of Nursing, 29(2), 131–140. https://doi.org/10.7739/jkafn.2022.29.2.131