Background: Chronic disease accounts for 75% of total Australian health expenditure. Self-management is important for healthcare quality and cost containment but is challenging to assess. Reliable and valid assessment tools, like the Patient Assessment of Care in Chronic Conditions (PACIC+), are required. International studies found the PACIC+ reliable but question its subscale structure. Objectives: The internal consistency, reliability, and subscale structure of the PACIC+ were evaluated in an Australian setting. New supplementary scales estimating patient empowerment, health status, and health service utilisation were also examined. Design: Cross-sectional and repeated-measures correlational designs assessed the PACIC+ with supplemental patient empowerment and health status scales.Participants: Participants were 18 years or older, with one or more chronic diseases, and attending a metropolitan hospital. Sample size at time-1 was 100, and 27 participants, using the same survey data collection method, completed surveys at times-2 and 3. Exclusion criteria were cognitive impairment, pregnancy, or non-fluent English. Main Measures: The PACIC+ scores, age, gender, comorbidities, number of acute care episodes, and new patient empowerment ratings of health status, support, self-care confidence and understanding (new patient empowerment items) were recorded 3 times, 1 month apart. Key Results: Time-1 PACIC+ total and subscale scores did not vary significantly by age, gender, or comorbidities. There was a negative correlation between acute care episodes in the past 1-month period and ratings of confidence (rs (99) = (-0.25), p < 0.01) and understanding (rs (99) = (-0.30), p < 0.01). Supplementary scales were reliable across all time points. The PACIC+ (total score) test-retest correlation at 4 weeks (r (26) = 0.69, p < 0.01), and internal consistency (Cronbach α = 0.96; Original Subscales 0.68 - 0.82) were acceptable. Given high inter-correlation of some PACIC+ items, a revised 20-item version was derived and shown to have acceptable test-retest (total score) (r (26) = 0.71, p < 0.01) and internal consistency (Cronbach α = 0.94; Revised Subscales 0.81 – 0.87). Factor analysis found that four components accounted for 66.5% of the variance in the 26-item PACIC+ and 67.9% of the variance in the revised 20-item survey.Conclusions: The PACIC+ was reliable, linked to some health-related thinking and behaviour, and internally consistent when assessing self-care reported by Australian patients with chronic illnesses. The current factor structure differed from previous reports. The removal of items that covaried significantly, and inclusion of the four revised subscales, showed the new 20-item survey had acceptable internal consistency and test-retest reliability. Supplementary scales to evaluate patient empowerment, overall health status and health service demand over time were reliable
