Diabetes Empowerment, Medication Adherence and Self-Care Behaviors in Adults with Type 2 Diabetes

Abstract

Background: Evidence suggests that empowerment is an important factor to address everyday aspects of dealing with a chronic disease. This study evaluated the effect of diabetes empowerment on medication adherence and self-care behaviors in adults with type 2 diabetes. Subjects and Methods: Data on 378 subjects with type 2 diabetes recruited from two primary care clinics in the southeastern United States were examined. Previously validated scales were used to measure diabetes empowerment, medication adherence, diabetes knowledge, and diabetes self-care behaviors (including diet, physical activity, blood sugar testing, and foot care). Multiple linear regression was used to assess the independent effect of diabetes empowerment on medication adherence and self-care behaviors controlling for relevant covariates. Results: Eighty-three percent were non-Hispanic blacks, 69% were women, 22% were 65 years or older, 68% were not married, 26% had less than high school education, 60% were unemployed, 39% were uninsured, and 47% had a yearly income < $10,000. Empowerment had significant correlations with medication adherence (r = 0.17, P < 0.003), diabetes knowledge (r = 0.16, P = 0.007), diet (r = 0.24, P < 0.001), exercise (r = 0.25, P < 0.001), blood sugar testing (r = 0.12, P = 0.043), and foot care (r = 0.18, P = 0.002). In the regression model, diabetes empowerment was significantly associated with medication adherence (b = -0.04, P = 0.001), diabetes knowledge (b = 0.09, P = 0.012), diet (b = 0.09, P < 0.001), exercise (b = 0.10, P < 0.001), blood sugar testing (b = 0.07, P = 0.016), and foot care (b = 0.08, P = 0.001). Conclusions: In this sample, diabetes empowerment was related to better diabetes knowledge, medication adherence and improved self-care behaviors. Emphasis on empowerment and self-efficacy is relevant to improve outcomes in the management of diabetes.

Effect of Activities of Daily Living on Self-Care Agency in Individuals with Type 2 Diabetes

“…Similar to the result of our study, another study also found that self-care affected glycemic control [34]. It was found in a different study that there was a significant correlation between self-care behaviors such as following a diet and having blood sugar measured/monitored, and compliance with medication [45]. Another study made with diabetic patients found that from the diabetic self-care activities, the patients performed mostly foot care and blood sugar measurement in the last one week and the least they performed was physical activity [47].…”

“…A study found that 28.2% of the patients with type 2 diabetes experienced problems with self-care [51]. Effective self-care behaviors, increased knowledge and improved compliance with medication have been shown to be associated with improved diabetes [45]. A significant positive correlation was found in this study between activities of daily living and self-care agency.…”

Does Patient Empowerment Predict Self-Care Behavior and Glycosylated Hemoglobin in Chinese Patients with Type 2 Diabetes?

“…24 Higher scores in patient empowerment were related to better selfcare behavior and better glycemic control. This is understandable given that higher empowerment scores indicate that patients have an enhanced capacity to accept responsibility for their daily self-management, 12 leading to improved self-care and health outcomes.…”

The Effect of Self-Care on Glycated Hemoglobin and Fasting Blood Sugar Levels on Adolescents with Diabetes

“…Regarding the increasing prevalence of diabetes and the many complications of the disease that require longterm treatment and daily blood glucose control, lifestyle modification and acquisition of knowledge about special self-care behaviors are essential throughout life (8). Selfcare is one of the most important methods to treat and control complications of diabetes, resulting in improved quality of life (9).…”