Patient activation supporting cardiac rehabilitation

Han's story: Feeling overwhelmed after a heart attack

After his heart attack, Hans felt lost. He was overwhelmed, unsure what to do next, and had started to lose hope. Everyday decisions about his health felt too big to manage alone.

That’s when he met Amanda, a Cardiac Rehabilitation Nurse Specialist. She introduced Hans to the Patient Activation Measure (PAM), a simple but powerful way of understanding how confident and equipped a person feels to look after their own health.

What is Activation?

Activation, or Patient Activation, is about a person’s knowledge, skills, and confidence to manage their own health and wellbeing.

People with higher activation levels tend to feel more in control, make informed decisions, and take actions that support their recovery and long-term wellbeing.

The Patient Activation Measure (PAM) provides a clear score from Level 1 to Level 4.

• Level 1: Feeling overwhelmed and struggling to manage

• Level 4: Feeling confident, informed, and ready to take the lead

By knowing someone’s starting point, healthcare professionals can tailor support so it feels manageable - not too much, not too little. This approach helps people build independence, self-belief, and resilience over time.

Listening first: Building trust and understanding

Using PAM gave Amanda a natural way to start an open conversation with Hans.

Hans:  “The process was tailored to me because Amanda sat and listened to what my lifestyle was. She asked what I needed. It didn’t feel like a standard response to ‘someone who’s had a heart attack’. We took the time to work out who I was, and then she offered support based on my needs.”

Amanda: “Talking about how overwhelmed Hans felt didn’t take long, but it gave us a foundation to build from. Without the Activation Measure, I wouldn’t have known where his knowledge, skills, or confidence were. PAM gave me a level to guide how I worked with him.”

Together, they broke information into small, manageable sessions, always at Hans’ pace - another key part of building confidence and autonomy.

Growing independence and resilience

As the weeks went on, Hans gradually shifted from feeling unsure to feeling capable. Each small success strengthened his confidence.

Amanda: “As we approached the end of Hans’ programme, we repeated the Patient Activation Measure. He had absolutely zoomed through to Level 4 - back in charge, and moving forward with his own health requirements.”

Hans: “The changes I made gave me positivity, especially when other things still felt negative. Amanda gave me hope in what I had to look forward to.” 

By understanding his activation level and working with it, Hans built the resilience and independence he needed to manage his health long after the programme ended.

How Hans and Amanda used the Our Shared Agreement Five Foundations to guide their work together

Foundation 1: Being prepared to do things differently

Amanda used a different approach - the Patient Activation Measure - to establish, and then measure the change, in Hans' ability to manage his own wellbeing, tailoring support to Hans rather than relying on a standard pathway.

Foundation 2: Understanding what matters to ourselves and each other

Amanda took the time to discover what Hans valued, what he worried about, and what mattered most to him in daily life.

Foundation 3: Working together for the wellbeing of everyone

Hans and Amanda combined their strengths - his personal experience and her professional knowledge - to create a plan that worked.

Foundation 4: Conversations with and not about people

Amanda involved Hans in every decision, giving him space to think, speak, and lead his own journey.

Foundation 5: Making the most of what we have available to us

By uncovering Hans’ existing strengths and motivation, Amanda helped him build confidence, resilience, and long-term self-management skills.

Conclusion 

Hans’ story shows how personalised care, supported by the Patient Activation Measure, can rebuild confidence and strengthen independence.

By listening deeply, tailoring support, and focusing on what matters to each person, healthcare professionals can help people move from feeling overwhelmed to feeling capable and in control.

This is personalised care in action, empowering people to take the lead in their health, one step at a time.

Watch Hans' story

The broader benefits of the PAM approach

Here's a more detailed look at the benefits of the PAM approach:

Improved Health Outcomes:

• The PAM approach can help improve patient outcomes by fostering self-management behaviors and healthier lifestyle choices, reducing unnecessary emergency department visits, hospital admissions, and readmissions.  

Reduced healthcare costs:

• As activated people / patients are more likely to effectively self-manage long-term conditions, and have reduced need for interventions and visits, this naturally leads to a reduction in healthcare costs. 

Enhanced patient experience:

• PAM helps tailor healthcare support to a person's individual needs, making them feel more engaged and heard. 
• A more collaborative person-provider relationship can improve both the person's and the provider's overall satisfaction with the care delivered. 

Other benefits:

• PAM can be used to evaluate the effectiveness of interventions designed to improve patient activation and self-management. 
• It can also help identify areas where patients may need additional support and resources. 
• By making patient activation central to healthcare delivery, systems can focus on building healthier communities.