| ObjectivesTo investigate the ability of empowerment in patients with type2diabetes mellitus (T2DM) and its influence factors; To explore the relationship among the level of empowerment, the style of medical coping, the activity of self-care and quality of life in patients with T2DM; To explore the effects of empowerment-based education in patients with T2DM.MethodsAn experiment design was used in this study. From May2012to July2013, the patients who suffered from T2DM and received treatment in Tianjin Medical University Metabolic Diseases Hospital were invited to be as subjects. They were randomly divided into the experimental group and the control group by random number table. All of the participants were requested to finish the baseline questionnaire before the intervention. The experimental group received empowerment-based education, while the control group received routine education. The duration time of health education was two weeks. In addition, we conducted follow-up at three months and six months after the intervention respectively. At3months and6months after intervention, Diabetes Empowerment Scale-Short Form (DES-SF), Medical Coping Modes Questionnaire (MCMQ), Diabetes Self-Care Scale (DSCS) and Short Form36Health Survey (SF-36) were applied between two groups again, and collected the results of relevant clinical test. T-test, Chi-square test, correlations analysis, multiple linear regression analysis and repeated measure ANOVA were used to analyze the data with SPSS16.0.Results1The results of investigation and analysis1.1According to the inclusion and exclusion criteria, a total of86patients with type2diabetes mellitus were included in this study. They were randomly divided into the experimental group (n=43) and the control group (n=43) by random number table. At6months after intervention, both groups were shedding11patients. The experiment group was38patients successfully follow-up, and the control group was 37patients.75patients were analyzed eventually for this research.1.2In the study, the average score of empowerment in patients with T2DM was3.61±0.60. Among them,69.3%was in the middle level about the ability of empowerment. Multtiple stepwise regression analysis showed that confrontation, role physical and role emotional entered into regression equation.1.3In the study, the average score of confrontation, obviatation and submission in patients with T2DM were18.57±4.07,14.56±2.79and9.73±2.91respectively. Compared with the normal people model of China (the normal people model was701patients with a clear diagnosis of chronic diseases), T2DM patients have a higher score of confrontation and a lower score of submission (P<0.05). Correlation analysis showed that the level of empowerment was positively correlated with confrontation (r=0.56, P<0.01), and negatively correlated with submission (r=-0.35, P<0.01).1.4In the study, the average score of diabetes self-care activity in patients with T2DM was30.73±10.34. The score of general diet, specific diet, exercise, Self-monitoring of blood glucose and foot care were4.05±1.30,4.10±1.70,2.89±1.98,1.54±1.21and2.79±2.46. Correlation analysis showed that the level of empowerment was positively correlated with the score of self-care activity and specific diet (r=0.23, P<0.05).1.5In the study, the average score of quality of life in patients with T2DM was59.08±17.74. The average score of Physical Function (PF), Role Physical (RP), Bodily pain (BP), General Health (GH), Vitality (VT), Social Function (SF), Role Emotional (RE) and Mental Health (MH) were73.87±20.43,34.00±36.68,55.44±23.16,51.03±21.31,64.07±17.78,78.33±21.59,50.67±45.64and65.28±18.01respectively. Compared with the normal people model of China (the normal people model was2249cases of urban and rural residents aged over16in Sichuan Province), the score of all SF-36subscales, including PF, RP, BP, GH, VT, SF, RE, MH and SF, were significantly lower in T2DM patients than in control group (P<0.05). Correlation analysis showed that the level of empowerment was positively correlated with the score of RP, BP, GH, VT, SF, RE, MH and SF (r=0.42,0.34,0.29,0.49,0.29,0.35,0.36,0.48), but not with PF (P>0.05).2The results of intervention 2.1The study found no significant difference in the demography, relevant clinical manifestation and the scores of DES-SF, MCMQ, DSCS and SF-36assessment scales (P>0.05).2.2The patients in the intervention group had a better improve of the ability of empowerment, the style of medical coping, self-care behaviors and indicators of glucose metabolism at3months and6months after intervention (P<0.05). And the experimental group were significantly better than the control group, the differences were statistically significant (P<0.05); While there were no significant differences at each time point in quality of life (.P>0.05).Conclusion1The level of empowerment in patients with T2DM was generally low. It was influenced by confrontation, role physical and role emotional.2T2DM patients’ empowerment was significantly associated with the style of medical coping, self-care behavior and quality of life. Hence, the nursing staff should take all relevant factors into account to design and implement some intervention measures, so as to enhance T2DM patients’ empowerment, in order to improve their heath status.3The empowerment-based health education played an important role in the improvement of empowerment, the style of medical coping, self-management skills as well as glycemic control. It has played an active role in helping individuals to manage one’s disease and control glycemic in patients with T2DM. The empowerment-based education could be an effective intervention for patients with T2DM. |
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