Assessment of patient empowerment in type 2 diabetic patients

Aim: Empowering patients means providing them with the opportunities and the environment to develop the skills, confidence and knowledge to move from being a passive recipient of care to an active partner in their health care. Patient empowerment is gaining greater international importance in healthcare but uncertainty remains about the best way to define and measure it. The purpose of the study was to assess the factors influencing patient empowerment in patients with type 2 diabetes. Material and Method: The participants of the study were 125 diabetic patients in Çukurova University Hospital Endocrinology Outpatient Clinic. A sociodemographic questionnaire and the Diabetes Empowerment Scale (DES) were used. Adherence to medications, diet, and exercise and the numbers of diabetes consultations were asked. Statistical analysis was used to determine any relationship with the above mentioned variables to the DES ratings. Results: The mean age was 55,1±9,7 years (range=25-77). Of the patients, 24,8% were male, 81,6% were married, and 93,6% had education level of diploma and higher. The mean duration of diabetes was 9,56±7,98 years. Diabetes Empowerment Scale has three conceptual domains of 'Managing the psychosocial aspect of diabetes', 'Assessing dissatisfaction and readiness to change' and 'Setting and achieving diabetes goal'. The mean score of each domain was 23,6±3,8, 24,4±3,7, and 34,4±6,1, respectively. It was found that age, gender, marital, educational, work, and socioeconomic status, dietary status, state of being educated about the illness, psychological support received, level of knowledge about the illness, and length of time after diagnosis have influence on the illness perception in diabetes. Partial correlation analyses failed to show any statistically significant relationship between patient empowerment and glycemic control or other diabetes management variables (HbA1c, p=0,229; HDL, p=0,492; LDL, p=0,977; TC, p=0,873; triglycerides, p=0,893). Logistic regression analysis confirmed that patient empowerment score was not a significant predictor of glycemic control. The mean total empowerment score was 82,4 (SD=11,4) indicating a moderate-to-high level of self-management in diabetes. Conclusion: Combining family medicine-based approaches with culturally competent diabetes care may improve knowledge, attitudes, perceptions and self-care practices of and collaborative care for people with diabetes. Empowering the patients encourages interaction of communities, health care professionals, policy makers and all other civil society actors with respect to health and well-being of individuals. Patient empowerment programs have been shown to improve mental health, doctor-patient communication, healthy eating, and patient self-efficacy, although the capacity of existing outcome measures to capture the patient benefits of these programs has been questioned. Key Words: Patient empowerment, type 2 diabetes, primary care, family medicine