[Evaluation and validation of quality care indicators relative to empowerment in complex chronic disease]

The purpose of the study was to identify, validate and rank, through multi-attribute hierarchical analysis, indicators of quality of care related to the empowerment of patients having a chronic complex illness, or their natural care givers. This methodological study was carried within case management and was theoretically based on the quality model of Donabedian (1980) and the empowerment theory of Zimmerman (1995), while also drawing from values underlying nursing practise described by the health promotion model of Allen (1977). Two groups of professional and one group of non professional were considered. Using the DELPHI technique and interviews, the study has 1) provided an evaluation model for quality of care comprising 239 elements (12 main attributes, 75 secondary attributes and 152 indicators), 2) allowed its validation, and 3) its ranking by experts. The discussion encompasses theoretical, empirical and methodological considerations.