Factors associated with patient empowerment in Spanish adults with type 2 diabetes: A cross‐sectional analysis

Abstract

Objective The aim of the present study is to identify factors associated with patient empowerment in people living with type 2 diabetes mellitus (T2DM) in the Canary Islands (Spain). Methods Secondary cross‐sectional analysis was carried out of data obtained in the INDICA study: A 24‐month cluster randomized‐controlled trial evaluating the effectiveness of educational interventions supported by new technology decision tools for T2DM patients. Sociodemographic variables, clinical data (years since diagnosis, glycated haemoglobin level, creatine, triglycerides, waist hip index, body mass index and number of comorbidities), diabetes knowledge (DIATEK), affective outcomes (Beck Depression Inventory‐II, the State subscale of the State‐Trait Anxiety Inventory and The Diabetes Distress Scale) and diabetes‐related quality of life (The Audit of Diabetes‐Dependent Quality of life) were assessed as potential correlates of patient empowerment, assessed using the Diabetes Empowerment Scale‐Short Form. Multilevel mixed linear regression models on patient empowerment were developed. Results The analysis included the baseline data of 2334 patients. Results showed that age (B = −0.14; p < .001), diabetes knowledge (B = 0.61; p < .001) and state‐anxiety (B = −0.09; p < .001) are significantly associated with patient empowerment. Sex, education level, living alone, employment status, country of birth, time since diagnosis, number of comorbidities, glycated haemoglobin level, depression and distress were not independently associated with patient empowerment in the multivariate analyses. Conclusion Younger age, lower state‐anxiety and greater diabetes‐specific knowledge are important correlates of patient empowerment. In line with the results of the INDICA study, interventions based on patient‐centred care might be effective in improving patient empowerment in adults with T2DM. Understanding the factors associated with empowerment may help clinicians and policymakers to identify high‐risk groups, prioritize resources and target evidence‐based interventions to better support people with T2DM to be actively involved in their own care. Patient or Public Contribution Patients with T2DM were actively involved in the design of the INDICA study. Two patient associations were included as part of the research team and actively participated in designing the interventions and selecting outcome measures.

Person-Centred Diabetes Care: Examining Patient Empowerment and Diabetes-Specific Quality of Life in Slovenian Adults with Type 2 Diabetes

“…Surprisingly, our study did not reveal any correlation between DES and ADDQoL scores, indicating that these two questionnaires likely capture different concepts related to T2D, which aligns with findings from a study in Spain [19]. Changes in how empowered a person feels about managing their diabetes might not correlate directly with changes in their reported diabetes-specific HRQoL.…”

“…In our study, there was no significant correlation between diabetes empowerment and the age of participants. Previous studies have shown an inverse association between age and empowerment [15,17,19,21,26], which could be explained by lower levels of health literacy observed in older persons with T2D. On the contrary, research by Simonsen et al showed that adults with T2D, aged 27-57 years, had a lower level of empowerment, lower emotional well-being, more psychosocial distress, and less diabetes-related social support than older participants [4].…”

“…Higher levels of education are often associated with increased health literacy. This connection could contribute to a better understanding of diabetes-related processes and an increased awareness of the importance of self-care in disease management to prevent or delay severe complications [19].…”

“…The positive impact of patient empowerment on clinical and psychosocial outcomes is well established [10][11][12][13][14]. Past research indicates that factors such as higher education [15][16][17], diabetes-specific knowledge [15,18,19], improved glycaemic control [4,16,[20][21][22], and community support [4] are linked to higher levels of empowerment in individuals with T2D. Conversely, anxiety [23,24], depression [25], and older age [15,17,19,21,26] show negative associations with self-efficacy and patient empowerment.…”

Peran Perawat dalam Mengatasi Diabetes Distress

“…Intervensi berdasarkan kepada perawatan yang berpusat pada pasien akan efektif dalam meningkatkan pemberdayaan pada pasien dengan diabetes melitus (Duarte-Díaz et al, 2022). Selain itu, penggunaan Cognitive Behavior Therapy (CBT) dinilai efektif dalam membantu mengurangi rasa cemas dan depresi pada pasien dengan diabetes distress (Zhang et al, 2021;Abbas et al, 2023).…”