1
|
Virtič Potočnik T, Ružić Gorenjec N, Mihevc M, Zavrnik Č, Mori Lukančič M, Poplas Susič A, Klemenc-Ketiš Z. Person-Centred Diabetes Care: Examining Patient Empowerment and Diabetes-Specific Quality of Life in Slovenian Adults with Type 2 Diabetes. Healthcare (Basel) 2024; 12:899. [PMID: 38727456 PMCID: PMC11083539 DOI: 10.3390/healthcare12090899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 04/22/2024] [Accepted: 04/23/2024] [Indexed: 05/13/2024] Open
Abstract
Patient empowerment is crucial for promoting and strengthening health. We aimed to assess patient empowerment and diabetes-specific health-related quality of life (HRQoL) in adults with type 2 diabetes (T2D). A multi-centre, cross-sectional survey was conducted among adults with T2D in urban and rural primary care settings in Slovenia between April and September 2023. The survey utilised convenience sampling and included sociodemographic and clinical data, the Diabetes Empowerment Scale (DES), and the Audit of Diabetes-Dependent QoL (ADDQoL). The study included 289 people with T2D and a mean age of 67.2 years (SD 9.2). The mean overall DES score was 3.9/5 (SD 0.4). In a multivariable linear regression model, higher empowerment was significantly associated with residing in a rural region (p = 0.034), higher education (p = 0.028), and a lack of comorbid AH (p = 0.016). The median overall ADDQoL score was -1.2 (IQR [-2.5, -0.6]). The greatest negative influence of diabetes on HRQoL was observed in the domain 'Freedom to eat', followed by 'Freedom to drink', 'Leisure activities', and 'Holidays'. Despite high empowerment among adults with T2D, the condition still imposes a personal burden. Integrated primary care models should prioritise the importance of implementing targeted interventions to enhance diabetes empowerment, address comorbidities, and improve specific aspects of QoL among individuals with T2D.
Collapse
Affiliation(s)
- Tina Virtič Potočnik
- Primary Healthcare Research and Development Institute, Community Health Centre Ljubljana, Metelkova ulica 9, SI-1000 Ljubljana, Slovenia; (N.R.G.); (M.M.); (Č.Z.); (M.M.L.); (A.P.S.); (Z.K.-K.)
- Department of Family Medicine, Faculty of Medicine, University of Maribor, Taborska ulica 8, SI-2000 Maribor, Slovenia
- Community Health Centre Slovenj Gradec, Partizanska 16, SI-2380 Slovenj Gradec, Slovenia
| | - Nina Ružić Gorenjec
- Primary Healthcare Research and Development Institute, Community Health Centre Ljubljana, Metelkova ulica 9, SI-1000 Ljubljana, Slovenia; (N.R.G.); (M.M.); (Č.Z.); (M.M.L.); (A.P.S.); (Z.K.-K.)
- Institute for Biostatistics and Medical Informatics, Faculty of Medicine, University of Ljubljana, Vrazov trg 2, SI-1000 Ljubljana, Slovenia
| | - Matic Mihevc
- Primary Healthcare Research and Development Institute, Community Health Centre Ljubljana, Metelkova ulica 9, SI-1000 Ljubljana, Slovenia; (N.R.G.); (M.M.); (Č.Z.); (M.M.L.); (A.P.S.); (Z.K.-K.)
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Poljanski nasip 58, SI-1000 Ljubljana, Slovenia
| | - Črt Zavrnik
- Primary Healthcare Research and Development Institute, Community Health Centre Ljubljana, Metelkova ulica 9, SI-1000 Ljubljana, Slovenia; (N.R.G.); (M.M.); (Č.Z.); (M.M.L.); (A.P.S.); (Z.K.-K.)
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Poljanski nasip 58, SI-1000 Ljubljana, Slovenia
| | - Majda Mori Lukančič
- Primary Healthcare Research and Development Institute, Community Health Centre Ljubljana, Metelkova ulica 9, SI-1000 Ljubljana, Slovenia; (N.R.G.); (M.M.); (Č.Z.); (M.M.L.); (A.P.S.); (Z.K.-K.)
| | - Antonija Poplas Susič
- Primary Healthcare Research and Development Institute, Community Health Centre Ljubljana, Metelkova ulica 9, SI-1000 Ljubljana, Slovenia; (N.R.G.); (M.M.); (Č.Z.); (M.M.L.); (A.P.S.); (Z.K.-K.)
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Poljanski nasip 58, SI-1000 Ljubljana, Slovenia
| | - Zalika Klemenc-Ketiš
- Primary Healthcare Research and Development Institute, Community Health Centre Ljubljana, Metelkova ulica 9, SI-1000 Ljubljana, Slovenia; (N.R.G.); (M.M.); (Č.Z.); (M.M.L.); (A.P.S.); (Z.K.-K.)
- Department of Family Medicine, Faculty of Medicine, University of Maribor, Taborska ulica 8, SI-2000 Maribor, Slovenia
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Poljanski nasip 58, SI-1000 Ljubljana, Slovenia
| |
Collapse
|
2
|
Shiu LS, Liu CY, Lin CJ, Chen YC. What are the roles of eHealth literacy and empowerment in self-management in an eHealth care context? A cross-sectional study. J Clin Nurs 2023; 32:8043-8053. [PMID: 37668267 DOI: 10.1111/jocn.16876] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 08/11/2023] [Accepted: 08/21/2023] [Indexed: 09/06/2023]
Abstract
AIMS To examine the relationship among eHealth literacy, empowerment and self-management and the mediating effects of empowerment in diabetic kidney disease (DKD) patients in the eHealthcare context. BACKGROUND Self-management is an essential aspect of healthcare in delaying disease progression for DKD. In the eHealthcare era, health services providing self-management are transforming. The ability and confidence of patients to use eHealth services is a critical issue that impacts the effectiveness of self-management, but little is known about the role of eHealth literacy and empowerment in self-management. DESIGN A cross-sectional study guided by the STROBE. METHODS Overall, 127 Taiwanese patients were enrolled using convenience sampling. Data collection used structured questionnaires and chart reviews. Multiple regression was used to infer self-management predictors, and SPSS PROCESS macro and bootstrapping verified the mediating effects. RESULTS Empowerment and eHealth literacy both showed significant positive correlations with self-management. Empowerment was the main predictor of self-management and had a complete mediating effect between eHealth literacy and self-management. CONCLUSION Increasing patients' eHealth literacy can improve empowerment and prevent health inequality issues. Healthcare providers should consider improving patients' eHealth literacy to enhance their self-management. RELEVANCE TO CLINICAL PRACTICE Healthcare service systems need to create user-friendly eHealthcare environments, and healthcare professionals can provide multifaceted instructions that fit patients' eHealth literacy levels to enhance their motivation and confidence in disease care, thus cultivating positive self-management behaviours. IMPACT The popularity of eHealthcare services aimed at promoting self-management behaviours is increasing. However, the level of eHealth literacy is an essential factor that affects the effectiveness of self-management in the healthcare environment. In addition, empowerment is a major critical influence factor of self-management and a completely mediating variable between self-management and eHealth literacy. Consequently, healthcare providers should consider promoting patients' eHealth literacy to empower people using eHealthcare services for implementing self-management. REPORTING METHOD The Strengthening the Reporting of Observational Studies in cross-sectional studies (STROBE) checklist was used to ensure comprehensive reporting. PATIENT OR PUBLIC CONTRIBUTION Patients were diagnosed with DKD in the study hospital. Physicians and case managers transferred patients to research assistants who screened them for the inclusion criteria and invited them to participate in this study if they met the requirements. After participants signed informed consent, the research nurse encouraged participants to respond to the research questionnaire face to face.
Collapse
Affiliation(s)
- Lian-Shin Shiu
- International Priority Care Center, Taiwan Adventist Hospital, Taipei, Taiwan, ROC
- Department of Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Chieh-Yu Liu
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, ROC
| | - Cheng-Jui Lin
- Division of Nephrology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan, ROC
| | - Yu-Chi Chen
- Institute of Clinical Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| |
Collapse
|
3
|
Al-Mutairi AM, Alshabeeb MA, Abohelaika S, Alomar FA, Bidasee KR. Impact of telemedicine on glycemic control in type 2 diabetes mellitus during the COVID-19 lockdown period. Front Endocrinol (Lausanne) 2023; 14:1068018. [PMID: 36817609 PMCID: PMC9936328 DOI: 10.3389/fendo.2023.1068018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 01/18/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The lockdown at the start of coronavirus disease 2019 (COVID-19) pandemic in Saudi Arabia (March 2020 to June 2020) shifted routine in-person care for patients with type 2 diabetes mellitus (T2DM) to telemedicine. The aim of this study was to investigate the impact telemedicine had during this period on glycemic control (HbA1c) in patients with T2DM. METHODS 4,266 patients with T2DM were screened from five Ministry of National Guard Health Affairs hospitals in the Kingdom of Saudi Arabia. Age, gender, body mass index (BMI), HbA1c (before and after the COVID-19 lockdown), duration of T2DM, comorbidities and antidiabetic medications data were obtained. Mean and standard deviation of differences in HbA1c were calculated to assess the impact of telemedicine intervention. Correlations between clinically significant variances (when change in the level is ≥0.5%) in HbA1c with demographics and clinical characteristic data were determined using chi square test. RESULTS Most of the participants were Saudis (97.7%) with 59.7% female and 56.4% ≥60 years of age. Obesity was 63.8%, dyslipidemia 91%, and hypertension 70%. Mean HbA1c of all patients slightly rose from 8.52% ± 1.5% before lockdown to 8.68% ± 1.6% after lockdown. There were n=1,064 patients (24.9%) whose HbA1c decreased by ≥0.5%, n =1,574 patients whose HbA1c increased by ≥0.5% (36.9%), and n =1,628 patients whose HbA1c changed by <0.5% in either direction (38.2%). More males had significant improvements in glycemia compared to females (28.1% vs 22.8%, p<0.0001), as were individuals below the age of 60 years (28.1% vs 22.5%, p<0.0001). Hypertensive individuals were less likely than non-hypertensive to have glycemic improvement (23.7% vs 27.9%, p=0.015). More patients on sulfonylureas had improvements in HbA1c (42.3% vs 37.9%, p=0.032), whereas patients on insulin had higher HbA1c (62.7% vs 56.2%, p=0.001). HbA1c changes were independent of BMI, duration of disease, hyperlipidemia, heart and kidney diseases. CONCLUSION Telemedicine was helpful in delivering care to T2DM patients during COVID-19 lockdown, with 63.1% of patients maintaining HbA1c and improving glycemia. More males than females showed improvements. However, the HbA1c levels in this cohort of patients pre- and post-lockdown were unsatisfactorily high, and may be due to in part lifestyle, age, education, and hypertension.
Collapse
Affiliation(s)
- Abrar M. Al-Mutairi
- Research Unit, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
- Ministry of National Guard Health Affairs (MNG-HA), Riyadh, Saudi Arabia
- *Correspondence: Abrar M. Al-Mutairi, ; Keshore R. Bidasee,
| | - Mohammad A. Alshabeeb
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
- Ministry of National Guard Health Affairs (MNG-HA), Riyadh, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia
| | - Salah Abohelaika
- Department of Clinical Pharmacology, Qatif Central Hospital, Qatif, Saudi Arabia
| | - Fadhel A. Alomar
- Department of Pharmacology and Toxicology, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Keshore R. Bidasee
- Departments of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, United States
- Department of Environment and Occupational Health, University of Nebraska Medical Center, Omaha, NE, United States
- Nebraska Redox Biology Center, Lincoln, NE, United States
- *Correspondence: Abrar M. Al-Mutairi, ; Keshore R. Bidasee,
| |
Collapse
|
4
|
Rosyida RW, Pertiwi AAP, Pangastuti HS. The effectiveness of a smartphone-based online peer group on type II diabetes mellitus patients self-empowerment in a primary healthcare center in Indonesia. REVISTA CIÊNCIAS EM SAÚDE 2020. [DOI: 10.21876/rcshci.v10i4.1051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Objective: Self-empowerment is an important factor that influences a person's ability to perform effective diabetes management. One effort that can be done to improve self-empowerment is by providing a smartphone-based online peer-group. This research determined the effect of smartphone-based online peer groups on type 2 diabetes mellitus (T2DM) patients self-empowerment in four primary healthcare centers in Indonesia. Methods: This quasi-experimental research was conducted in four healthcare centers in Indonesia. The total sample was 71 divided into two groups (control and intervention). The control group received standard education from the healthcare center, whereas the intervention group underwent an online peer-group. Self-empowerment was measured before and after intervention using the Diabetes Empowerment Scale-Short Form (DES-SF) questionnaire (Indonesian version). General Linear Model was used in statistical analysis. Results: The mean age of respondents was 56.4 ± 8.8 and 56.9 ± 7.1 years old, 59.5%, and 76.5% had good family support, and 70.3% and 50% of respondents had not received diabetes education for the control and intervention groups, respectively. The average pretest self-empowerment score was 27.03 ± 3.73 and 27.59 ± 3.53 (diff. 0.56; 95%CI -1.16; 2.29), and the post-test score was 27.43 ± 4.13 and 32.76 ± 4.38 (diff. 5.33; 95%CI 3.32; 7.35) for the control and intervention groups, respectively. Online peer-group improve self-empowerment significantly in the intervention group. Conclusion: Smartphone-based online peer-group can improve self-empowerment in patients with T2DM.
Collapse
|
5
|
Mansour AA, Alibrahim NTY, Alidrisi HA, Alhamza AH, Almomin AM, Zaboon IA, Kadhim MB, Hussein RN, Nwayyir HA, Mohammed AG, Al-Waeli DKJ, Hussein IH. Prevalence and correlation of glycemic control achievement in patients with type 2 diabetes in Iraq: A retrospective analysis of a tertiary care database over a 9-year period. Diabetes Metab Syndr 2020; 14:265-272. [PMID: 32272433 DOI: 10.1016/j.dsx.2020.03.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 03/18/2020] [Accepted: 03/19/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND This study was designed to assess the achievement of a glycated hemoglobin (HbA1c) target in Iraqi type 2 diabetes mellitus (T2DM) patients via retrospective analysis of a tertiary care database over a 9-year period. METHODS A total of 12,869 patients with T2DM with mean (SEM) age: 51.4(0.1) years, and 54.4% were females registered into Faiha Specialized Diabetes, Endocrine and Metabolism Center(FDEMC) database between August 2008 and July 2017 were included in this retrospective study. Data were recorded for each patient during routine follow-up visits performed at the center every 3-12 months. RESULTS Patients were under oral antidiabetic drugs (OAD; 45.8%) or insulin+ OAD (54.2%) therapy. Hypertension was evident in 42.0% of patients, while dyslipidemia was noted in 70.5%. Glycemic control (HbA1c <7%) was achieved by 13.8% of patients. Multivariate analysis revealed <55 years of age, female gender, >3 years duration of diabetes, HbA1c >10% at the first visit, presence of dyslipidemia, and insulin treatment as significant determinants of an increased risk of poor glycemic control. BMI <25 kg/m2 and presence of hypertension were associated with a decreased risk of poor glycemic control. CONCLUSION Using data from the largest cohort of T2DM patients from Iraq to date, this tertiary care database analysis over a 9-year period indicated poor glycemic control. Younger patient age, female gender, longer disease duration, initially high HbA1c levels, dyslipidemia, insulin treatment, overweight and obesity, and lack of hypertension were associated with an increased risk of poor glycemic control in Iraqi T2DM patients.
Collapse
Affiliation(s)
- Abbas Ali Mansour
- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Basrah Health Directorate, University of Basrah, Basrah, Iraq.
| | - Nassar T Y Alibrahim
- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Basrah Health Directorate, University of Basrah, Basrah, Iraq
| | - Haider A Alidrisi
- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Basrah Health Directorate, University of Basrah, Basrah, Iraq
| | - Ali H Alhamza
- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Basrah Health Directorate, University of Basrah, Basrah, Iraq
| | - Ammar M Almomin
- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Basrah Health Directorate, University of Basrah, Basrah, Iraq
| | - Ibrahim Abbood Zaboon
- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Basrah Health Directorate, University of Basrah, Basrah, Iraq
| | - Muayad Baheer Kadhim
- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Basrah Health Directorate, University of Basrah, Basrah, Iraq
| | - Rudha Naser Hussein
- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Basrah Health Directorate, University of Basrah, Basrah, Iraq
| | - Hussein Ali Nwayyir
- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Basrah Health Directorate, University of Basrah, Basrah, Iraq
| | - Adel Gassab Mohammed
- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Basrah Health Directorate, University of Basrah, Basrah, Iraq
| | - Dheyaa K J Al-Waeli
- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Basrah Health Directorate, University of Basrah, Basrah, Iraq
| | - Ibrahim Hani Hussein
- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Basrah Health Directorate, University of Basrah, Basrah, Iraq
| |
Collapse
|
6
|
Effects of FamilyDoctor Concept and Doctor-Patient Interaction Satisfaction on Glycaemic Control among Type 2 Diabetes Mellitus Patients in the Northeast Region of Peninsular Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051765. [PMID: 32182755 PMCID: PMC7084261 DOI: 10.3390/ijerph17051765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 02/28/2020] [Accepted: 03/06/2020] [Indexed: 11/16/2022]
Abstract
The implementation of Family Doctor Concept (FDC) to restructure the primary healthcare systems in Malaysia were expected to enhance patient’s satisfaction on doctor-patient interaction and subsequently improved glycaemic control among Type 2 Diabetes Mellitus (T2DM) patients. Thus, this study aims to determine the difference in doctor-patient interaction satisfaction between T2DM patients attended FDC-implemented clinic vs non-FDC clinics, and to determine the association between FDC-implemented clinic and doctor-patient interaction satisfaction towards glycaemic control. A cross-sectional study was conducted throughout 10 districts in Kelantan from February until May 2019 using interview-guided Skala Kepuasan Interaksi Perubatan-11 (SKIP-11) and proforma checklist. Data were analyzed using SPSS ver.24. Chi-square statistic used to determine the difference in doctor-patient interaction satisfaction between both clinics type. Multiple logistic regression used to examine the association between FDC-implemented clinic and doctor-patient interaction satisfaction towards glycaemic control. Twenty primary health clinics involved, and 772 T2DM patients recruited. FDC clinics attendees has higher proportion of satisfaction (40.1%) compared to non-FDC attendees (33.7%) (p = 0.070). Multiple logistic regression confirmed the association of FDC-implemented health clinics (Adj. OR 1.63, p = 0.021), and doctor-patients interaction satisfaction (Adj. OR 1.77, p = 0.005) towards glycaemic control. Hence, strengthening of FDC in primary healthcare and improve the doctor-patient interaction satisfaction were essential to escalate good glycaemic control.
Collapse
|
7
|
Zhu TH, Mooi CS, Shamsuddin NH, Mooi CS. Diabetes empowerment scores among type 2 diabetes mellitus patients and its correlated factors: A cross-sectional study in a primary care setting in Malaysia. World J Diabetes 2019; 10:403-413. [PMID: 31363387 PMCID: PMC6656707 DOI: 10.4239/wjd.v10.i7.403] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 05/22/2019] [Accepted: 06/11/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND There are limited studies on diabetes empowerment among type 2 diabetes patients, particularly in the primary care setting.
AIM To assess the diabetes empowerment scores and its correlated factors among type 2 diabetes patients in a primary care clinic in Malaysia.
METHODS This is a cross sectional study involving 322 patients with type 2 diabetes mellitus (DM) followed up in a primary care clinic. Systematic sampling method was used for patient recruitment. The Diabetes Empowerment Scale (DES) questionnaire was used to measure patient empowerment. It consists of three domains: (1) Managing the psychosocial aspect of diabetes (9 items); (2) Assessing dissatisfaction and readiness to change (9 items); and (3) Setting and achieving diabetes goal (10 items). A score was considered high if it ranged from 100 to 140. Data analysis was performed using SPSS version 25 and multiple linear regressions was used to identify the predictors of total diabetes empowerment scores.
RESULTS The median age of the study population was 55 years old. 56% were male and the mean duration of diabetes was 4 years. The total median score of the DES was 110 [interquartile range (IQR) = 10]. The median scores of the three subscales were 40 with (IQR = 4) for “Managing the psychosocial aspect of diabetes”; 36 with (IQR = 3) for “Assessing dissatisfaction and readiness to change”; and 34 with (IQR = 5) for “Setting and achieving diabetes goal”. According to multiple linear regressions, factors that had significant correlation with higher empowerment scores among type 2 diabetes patients included an above secondary education level (P < 0.001), diabetes education exposure (P = 0.003), lack of ischemic heart disease (P = 0.017), and lower glycated hemoglobin (HbA1c) levels (P < 0.001).
CONCLUSION Diabetes empowerment scores were high among type 2 diabetes patients in this study population. Predictors for high empowerment scores included above secondary education level, diabetes education exposure, lack of ischemic heart disease status and lower HbA1c.
Collapse
Affiliation(s)
- Thew Hui Zhu
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia
| | - Ching Siew Mooi
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia
| | - Nurainul Hana Shamsuddin
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia
| | - Ching Siew Mooi
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Serdang 43400, Malaysia, Department of Medical Sciences, School of Healthcare and Medical Sciences, Sunway University, Bandar Sunway, Selangor, Malaysia
| |
Collapse
|
8
|
The Empowerment of Adolescents with Type 1 Diabetes Is Associated with Their Executive Functions. BIOMED RESEARCH INTERNATIONAL 2019; 2019:5184682. [PMID: 31183368 PMCID: PMC6515027 DOI: 10.1155/2019/5184682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 04/16/2019] [Indexed: 12/24/2022]
Abstract
Background Adolescence is a difficult period for young people with type 1 diabetes mellitus (T1DM), both in psychological and clinical terms. Empowerment therapy may support these patients, provided they are ready to change and have adequate executive functions to facilitate this change. Therefore, we hypothesise that the readiness of adolescents with T1DM to change is related to clinical features and/or their executive functions. Methods Using the Diabetes Empowerment Scale and the Behavioural Rating Inventory of Executive Function, we evaluated patients with T1DM duration of more than one year from three Polish diabetes centres of the PolPeDiab study group (N = 146). We related the data to features associated with disease and treatment and compared the results to those of adolescents without diabetes (N = 110). Results We observed that adolescents with T1DM had a higher rate of abnormal results in executive function tests than their peers without diabetes (p > 0.05). Diabetes empowerment in this group of patients decreased with disease duration (r = -0.25, p = 0.006) and increased with deteriorating metabolic control (HbA1c; r = 0.25, p = 0.006). The greater the deficiencies in executive functions among adolescents with T1DM, the greater their readiness to change. The relationship between executive functions and diabetes empowerment is partially gender-differentiated. Conclusions To conclude, we propose individualized diabetes education in this group of patients based on the assessment of readiness to change and executive functions.
Collapse
|
9
|
Alramadan MJ, Magliano DJ, Almigbal TH, Batais MA, Afroz A, Alramadhan HJ, Mahfoud WF, Alragas AM, Billah B. Glycaemic control for people with type 2 diabetes in Saudi Arabia - an urgent need for a review of management plan. BMC Endocr Disord 2018; 18:62. [PMID: 30200959 PMCID: PMC6131885 DOI: 10.1186/s12902-018-0292-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 08/29/2018] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND The aim of this study was to assess inadequate glycaemic control and its associated factors among people with type 2 diabetes in Saudi Arabia. METHODS A cross-sectional study design was used. Adults with type 2 diabetes attending diabetes centres in Riyadh, Hofuf and Jeddah cities were interviewed and their anthropometrics were measured. Their medical records were also reviewed to collect information related to recent lab tests, medications, and documented comorbidities. Multivariable logistic regression were used for data analysis. RESULTS A total of 1111 participants were recruited in the study. Mean age was 57.6 (±11.1) years, 65.2% of the participants were females, and mean HbA1c was 8.5 ± 1.9%. About three-fourths of participants had inadequate glycaemic control (≥ 7%). Multivariable analysis showed that age ≤ 60 years, longer duration of diabetes, living in a remote location, low household income, low intake of fruits and vegetable, low level of physical activity, lack of knowledge about haemoglobin A1c, high waist-hip ratio, low adherence to medication, and using injectable medications were independent risk factors for inadequate glycaemic control. CONCLUSIONS Inadequate glycaemic control is prevalent among people with type 2 diabetes in Saudi Arabia. In order to improve glycaemic control diabetes management plan should aim at controlling the modifiable risk factors which include low intake of fruits and vegetable, low level of physical activity, lack of knowledge about haemoglobin A1c, high waist-hip ratio, and low adherence to medications.
Collapse
Affiliation(s)
- Mohammed J. Alramadan
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Dianna J. Magliano
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Baker Heart and Diabetes Institute, Melbourne, VIC Australia
| | | | | | - Afsana Afroz
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | | | | | | | - Baki Billah
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| |
Collapse
|
10
|
Arda Sürücü H, Büyükkaya Besen D, Erbil EY. Empowerment and Social Support as Predictors of Self-Care Behaviors and Glycemic Control in Individuals With Type 2 Diabetes. Clin Nurs Res 2018; 27:395-413. [DOI: 10.1177/1054773816688940] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
This study investigated empowerment, social support, and diabetes-related characteristics as predictors of self-care behaviors and glycemic control in individuals with type 2 diabetes in Turkey. Descriptive cross-sectional and relational research designs were used in this study. The study was carried out with a cohort of 220 individuals with type 2 diabetes. Linear regression analysis revealed that patient empowerment was a statistically significant predictor of diet (β = .30; p < .001), exercise (β = .19; p = .003), blood glucose monitoring (β = .27; p < .001), foot care (β = .27; p < .001), and A1c (β = −.19; p = .004). Social support was a statistically significant predictor of diet (β = .24; p < .001), exercise (β = .26; p < .001), blood glucose monitoring (β = .16; p = .011), and foot care (β = .19; p = .003). These results indicate that social support and empowerment are important for nurses to consider when planning interventions that increase the self-care behavior of individuals with type 2 diabetes and for improving glycemic control.
Collapse
Affiliation(s)
| | | | - Elif Yeter Erbil
- Diabetes Nursing, Association of Public Hospitals Diyarbakir Education and Research Hospital, Turkey
| |
Collapse
|
11
|
Alramadan MJ, Afroz A, Hussain SM, Batais MA, Almigbal TH, Al-Humrani HA, Albaloshi A, Romero L, Magliano DJ, Billah B. Patient-Related Determinants of Glycaemic Control in People with Type 2 Diabetes in the Gulf Cooperation Council Countries: A Systematic Review. J Diabetes Res 2018; 2018:9389265. [PMID: 29682584 PMCID: PMC5845488 DOI: 10.1155/2018/9389265] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 12/03/2017] [Indexed: 12/02/2022] Open
Abstract
The aim of this systematic review is to assess patient-related factors affecting glycaemic control among people with type 2 diabetes in the Arabian Gulf Council countries. MEDLINE, Embase, PsycINFO, CINAHL, and Cochrane CENTRAL databases were searched from their date of inception to May 2016. Two researchers independently identified eligible studies and assessed the risk of bias. A total of 13 studies met the inclusion criteria. One study was population based, six recruited participants from multiple centres, and the remaining were single centred. The majority of the studies were of low to moderate quality. Factors associated with poor glycaemic control include longer duration of diabetes, low level of education, poor compliance to diet and medication, poor attitude towards the disease, poor self-management behaviour, anxiety, depression, renal impairment, hypertension, and dyslipidaemia. Healthcare providers should be aware of these factors and provide appropriate education and care especially for those who have poor glycaemic control. Innovative educational programs should be implemented in the healthcare systems to improve patient compliance and practices. A variation in the results of the included studies was observed, and some potentially important risk factors such as dietary habits, physical activity, family support, and cognitive function were not adequately addressed. Further research is needed in this area.
Collapse
Affiliation(s)
- Mohammed J. Alramadan
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Afsana Afroz
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Sultana Monira Hussain
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | | | | | | | - Ahmed Albaloshi
- Diabetes Centre, Directorate of Health Affair, Jeddah, Saudi Arabia
| | - Lorena Romero
- The Ian Potter Library, The Alfred, Melbourne, VIC, Australia
| | - Dianna J. Magliano
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Baki Billah
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| |
Collapse
|
12
|
Arda Sürücü H, Büyükkaya Besen D. Predictors of Empowerment in Individuals With Type 2 Diabetes Mellitus. J Transcult Nurs 2017; 29:506-513. [DOI: 10.1177/1043659617750259] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Introduction: Type 2 diabetes is a chronic, progressive disease that has reached pandemic proportions. In Turkey, the frequency of diabetes in individuals aged 20 years or older has been reported to be 13.7% compared with the worldwide prevalence of 8.5%. Empowerment has been correlated with improvement in diabetic self-management capabilities and glycemic control. The purpose of this study was to examine predictors of “empowerment” in individuals with type 2 diabetes from Turkey. Method: This was a secondary analysis with a cross-sectional correlation design using stepwise linear regression to evaluate previously collected data from 220 type 2 diabetic individuals in Turkey from January through July 2014. Demographic and Disease-Related Information Form, Diabetes Empowerment Scale, and Multidimensional Scale of Perceived Social Support were used to collect the research data. Results: Being educated about diabetes (β = .22, p < .001), high school (β = .16, p = .007), university (β = .12, p = .046), age (β = −.18, p = .003), social support (β = .15, p = .027), employment status (β = .13, p = .045), and A1C (β = −.12, p = .046) were statistically significant predictors of empowerment of type 2 diabetic individuals, and these variables explained 30% of the common variance. Discussion: It is important for nurses to assess sources of social support and integrate the results of this assessment to ensure the empowerment of the patient during diabetes education. For the empowerment of diabetic individuals, attempts should be made to increase the diabetes literacy levels of diabetic individuals who have low level of education and who are in the older age group, and patients who can get employed could be directed to work life.
Collapse
|
13
|
Cadier F, Jallow Göransson I, Rosengren K. Nursing Students’ Experiences With Type 2 Diabetes in Jordan: A Qualitative Content Analysis. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2017. [DOI: 10.1177/1084822316682930] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Prevalence of type 2 diabetes has increased worldwide due to lifestyle factors, such as obesity and inactivity, and nurses have an essential role in supporting healthy life situations. The aim was to describe nursing students’ experiences with type 2 diabetes in Jordan with regard to prevention and nursing care. Interviews with eight nursing students were performed. Data were analyzed using content analysis. One category and two subcategories were generated: managing challenges in daily life to prevent type 2 diabetes and promote patient safety, managing risk factors, and dealing with difficulties. Empowerment and person-centered care are tools to increase patients’ self-care to motivate them to live a healthy lifestyle within the whole family to prevent and decrease illness.
Collapse
|
14
|
Łuczyński W, Głowińska-Olszewska B, Bossowski A. Empowerment in the Treatment of Diabetes and Obesity. J Diabetes Res 2016; 2016:5671492. [PMID: 28090541 PMCID: PMC5206444 DOI: 10.1155/2016/5671492] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 11/30/2016] [Indexed: 12/26/2022] Open
Abstract
As the available therapies for diabetes and obesity are not effective enough, diabetologists and educators search for new methods to collaborate with patients in order to support their health behaviors. The aim of this review is to discuss perspectives for the development of new empowerment-type therapies in the treatment of diabetes/obesity. Empowerment is a process whereby patients gain the necessary knowledge to influence their own behavior to improve the quality of their lives. It is carried out in five stages: (1) identify the problem, (2) explain the feelings and meanings, (3) build a plan, (4) act, and (5) experience and assess the execution. Although many years have passed since the advent and popularization of the concept of empowerment, the area remains controversial, mainly with regard to the methodology of therapy. Some previous studies have confirmed the positive effect of empowerment on body weight, metabolic control, and quality of life of patients with type 2 diabetes; however, few studies have been conducted in patients with type 1 diabetes. There is still a need to confirm the effectiveness of empowerment in accordance with Evidence Based Medicine by performing long-term observational studies in a large group of patients. In future, empowerment may become part of the standard of care for patients with diabetes and/or obesity.
Collapse
Affiliation(s)
- Włodzimierz Łuczyński
- Department of Pediatrics, Endocrinology, Diabetology with Cardiology Division, Medical University of Białystok, Waszyngtona 17, 15-274 Białystok, Poland
- *Włodzimierz Łuczyński:
| | - Barbara Głowińska-Olszewska
- Department of Pediatrics, Endocrinology, Diabetology with Cardiology Division, Medical University of Białystok, Waszyngtona 17, 15-274 Białystok, Poland
| | - Artur Bossowski
- Department of Pediatrics, Endocrinology, Diabetology with Cardiology Division, Medical University of Białystok, Waszyngtona 17, 15-274 Białystok, Poland
| |
Collapse
|
15
|
Lavalle-González FJ, Chiquete E. Patients' empowerment, physicians' perceptions, and achievement of therapeutic goals in patients with type 1 and type 2 diabetes mellitus in Mexico. Patient Prefer Adherence 2016; 10:1349-57. [PMID: 27555751 PMCID: PMC4968990 DOI: 10.2147/ppa.s107437] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Physicians' perception may not parallel objective measures of therapeutic targets in patients with diabetes. This is an issue rarely addressed in the medical literature. We aimed to analyze physicians' perception and characteristics of adequate control of patients with diabetes. PATIENTS AND METHODS We studied information on physicians and their patients who participated in the third wave of the International Diabetes Management Practices Study registry in Mexico. This analysis was performed on 2,642 patients, 203 with type 1 diabetes mellitus (T1DM) and 2,439 with type 2 diabetes mellitus (T2DM), treated by 200 physicians. RESULTS The patients perceived at target had lower hemoglobin A1c (HbA1c) and fasting blood glucose than those considered not at target. However, overestimation of the frequency of patients with HbA1c <7% was 41.5% in patients with T1DM and 31.7% in patients with T2DM (underestimation: 2.8% and 8.0%, respectively). The agreement between the physicians' perception and the class of HbA1c was suboptimal (κ: 0.612). Diabetologists and endocrinologists tested HbA1c more frequently than primary care practitioners, internists, or cardiologists; however, no differences were observed in mean HbA1c, for both T1DM (8.4% vs 7.2%, P=0.42) and T2DM (8.03% vs 8.01%, P=0.87) patients. Nevertheless, insulin users perceived at target, who practiced self-monitoring and self-adjustment of insulin, had a lower mean HbA1c than patients without these characteristics (mean HbA1c in T1DM: 6.8% vs 9.6%, respectively; mean HbA1c in T2DM: 7.0% vs 10.1%, respectively). CONCLUSION Although there is a significant physicians' overestimation about the optimal glycemic control, this global impression and characteristics of patients' empowerment, such as self-monitoring and self-adjustment of insulin, are associated with the achievement of targets.
Collapse
Affiliation(s)
| | - Erwin Chiquete
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Correspondence: Erwin Chiquete, Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Tlapan, Ciudad de México, Código Postal 14000, México, Tel +52 54 87 0900 ext 5052, Fax +52 56 55 1076, Email
| |
Collapse
|
16
|
D'Souza MS, Venkatesaperumal R, Ruppert SD, Karkada SN, Jacob D. Health Related Quality of Life among Omani Men and Women with Type 2 Diabetes. J Diabetes Res 2016; 2016:8293579. [PMID: 26682234 PMCID: PMC4670671 DOI: 10.1155/2016/8293579] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Revised: 04/04/2015] [Accepted: 05/06/2015] [Indexed: 12/27/2022] Open
Abstract
The aim of this study was to explore predictors of health related quality of life (HRQoL) among men and women with type 2 diabetes. This cross-sectional descriptive study consisted of a random sample of 300 adults with type 2 diabetes in a selected public hospital. Euro-QoL and Revised Summary of Diabetes Self-Care Activities scales were used to collect data between January and June 2010. Schooling and ability to manage positively were highly significant predictors of quality of life (QoL) among women as compared to men. Age, prevention of activities of daily living and knowledge/management of diabetes were significant predictors of Health state among women as compared to men. Findings demonstrate that 30.6% (versus 35.7%) of the variance in the total QoL and 14% (versus 23%) of the variance in health state could be explained by personal and clinical characteristics among women and men, respectively. The study underlines the importance for nurse educators to assess HRQoL among men and women and to develop effective self-care management strategies based on personal and clinical characteristics.
Collapse
Affiliation(s)
- Melba Sheila D'Souza
- Department of Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, 123 Muscat, Oman
- *Melba Sheila D'Souza:
| | - Ramesh Venkatesaperumal
- Department of Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, 123 Muscat, Oman
| | - Susan D. Ruppert
- The University of Texas Health Science Center at Houston School of Nursing, Houston, TX 77030, USA
| | | | - Devakirubai Jacob
- Department of Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, 123 Muscat, Oman
| |
Collapse
|