Patient empowerment. Results of a randomized controlled trial

OBJECTIVE -The purpose of this study was to determine if participation in a patient empowerment program would result in improved psychosocial self-efficacy and attitudes toward diabetes, as well as a reduction in blood glucose levels.

2019

Introduction: Diabetes mellitus is one of the most prevalent diseases caused by metabolic disorders and an important global challenge. Empowerment is a collaborative approach to diabetes care and patient education. In this study, our intention is to systematically review the effects of empowerment interventions in diabetic patients, in order to understand the impact of empowerment on diabetic patients, this study was conducted with the aim of doing this. Materials and Methods: In this systematic review, we used the articles published in the last 30 years regarding the results of empowerment interventions in patients with diabetes. It was conducted in English and Persian by searching articles in search engines, scholarly sites and databases Magiran, Google Scholar, Embase, ResearchGate, Sciencedirect, PubMed, Springer. In the first stage 40 articles were found. Of these, 15 related articles that have been published in the last 30 years have been reviewed. Results: In this study, 15 papers were reviewed the empowerment approach of diabetic patients increases the level of knowledge, Increasing self-efficacy and improving the quality of life of adolescents, Making positive changes in the overall scale of attitude towards the disease and the patient's independent independence scale, Improve self-esteem scores and self-care and reducing the amount of hemoglobin A1C, Improve overall self-care behaviors, Reducing Glycosylated Hemoglobin and Improving Quality of Life, Blood glucose control (decrease in HbA1c), and so on. Conclusion: The review of this review confirms the importance of empowerment-based interventions on increased control and self-care in diabetes patients in diabetic patients. Not paying attention to all dimensions of empowerment, not paying attention to the impact of demographic variables on empowerment, failure to follow up programs Lack of training by specialist staff and so on Can be seen by reviewing the results of the studies. Therefore, considering the broad concept of empowerment and as an effective approach to protecting patients with diabetes, its necessary these restrictions will be considered in future research. Keywords: Empowerment interventions, Diabetic patients, Empowerment approach, Empowerment Program, Diabetes.

The traditional medical treatment model often ignores the emotional, spiritual, social, and cognitive aspects of living with a chronic disease such as diabetes. Empowerment programs address these psychosocial areas by helping individuals develop skills and self-awareness in goal setting, problem solving, stress management, coping, social support, and motivation. Although many diabetes educators have been taught to use an empowerment curriculum to facilitate self-management, there is minimal research concerning the actual process of providing such programs to patients. We evaluated an empowerment curriculum (Empowerment: A Personal Path to Self-Care) with a diverse group of individuals with diabetes to determine the key elements of planning and implementing a successful diabetes patient empowerment program.

BMC public health, 2017

The prevalence of type 2 diabetes mellitus is increasing substantially worldwide, leading to serious economic effects, complications and deaths. This study evaluated the effectiveness of an empowerment program providing support for psychosocial, behavioral, and clinical aspects of diabetes to help Brazilian users of public health services obtain metabolic control of this condition. In this cluster randomized trial, participants aged 30-80 diagnosed with type 2 diabetes were recruited from ten Brazilian public health units in 2014 and 2015. Five units were randomly assigned to receive the empowerment program based on a behavior change protocol, and five continued to receive only conventional treatment. The primary outcome was the biochemical and anthropometric parameters, and the secondary outcomes were self-care, attitude, knowledge and empowerment related to diabetes. The effect of the experiment was defined as the percentage variation between the values at the initial and final pe...

Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy

Patient empowerment is a continuous process in which knowledge, motivation, and capacity to take control of their disease are built within a person. This concept is not always well understood and applied. This review describes the strategies to induce empowerment in patients with diabetes. In addition, the most common scales used to evaluate empowerment in diabetes is described. Furthermore, the effectiveness of the empowermentbased interventions for improving metabolic control and diabetes knowledge are described. Finally, we discuss opportunities for empowerment implementation in clinical practice and current needs on research that can be translated into public policies.

Primary Care Diabetes, 2018

Aims: To identify and evaluate the effectiveness of individual empowerment strategies in patients with diabetes mellitus (DM). Methods: A systematic review was performed in the PubMed, Scopus, Science Direct and BVS. For meta-analysis and evaluation of Cochrane Risk and Bias, Revman V 5.2 software was used. Results: Eleven studies of 1073 publications met the inclusion criteria. The strategies used were individual consultations, phone calls, sessions via a website and use of a booklet. Glycemic Hemoglobin (HbA1c) was used to evaluate the effectiveness of the strategies, and 45.4% of the studies also used the Diabetes Empowerment Scale. Five studies (45.5%) showed significant improvements in HbA1c reduction, improvements in self-efficacy (18.2%), knowledge levels of DM (18.2%), quality of life (18.2%). However, after meta-analysis, no statistically significant improvement was found for HbA1c. Conclusion: This systematic review showed that individual strategies for DM empowerment were not effective in reducing HbA1c, despite contributing to improvements in psychosocial parameters. Therefore, individual strategies need to be reviewed so that they become effective in DM control.

Patient education and counseling, 2010

The purpose of this article is to clarify the concept of empowerment and to correct common misconceptions about its use in diabetes care and education. The patient empowerment approach is well suited to helping patients make self-selected changes related to weight, nutrition, and physical activity. Although the concept of patient empowerment has become an integral part of diabetes education, an accurate understanding and authentic application of empowerment has not occurred as readily. The empowerment approach is clarified and common misconceptions have been corrected. Embracing empowerment means making a paradigm shift that is often difficult because the traditional approach to care is embedded in the training and socialization of most health care professionals (HCPs). Unlike the traditional approach, empowerment is not something one does to patients. Rather, empowerment begins when HCPs acknowledge that patient are in control of their daily diabetes care. Empowerment occurs when t...

Diabetes Spectrum, 2020

BACKGROUND Diabetes is a prevalent chronic condition that poses a major burden for patients and the health care system. Evidence suggests that patient engagement in self-care improves diabetes control and reduces the risk of complications. To provide effective interventions that aim to improve empowerment processes relating to diabetes, a comprehensive and valid measure of empowerment is needed. This article details the development and validation of the McGill Empowerment Assessment–Diabetes (MEA-D). METHODS The development and validation of the MEA-D questionnaire comprised three steps: item generation, qualitative face validation, and factorial content validation. An initial version was created by combining existing items and inductively generated items. Items were mapped to an empowerment framework with four domains: attitude, knowledge, behavior, and relatedness. Semi-structured interviews were conducted with 21 adults living with diabetes to assess face validity. The questionna...

Diabetes Care, 2000

OBJECTIVE -The purpose of this study was to assess the validity, reliability, and utility of the Diabetes Empowerment Scale (DES), which is a measure of diabetes-related psychosocial self-efficacy.

Journal of Pharmaceutical Research International, 2018

Aims: Traditional education fails to effectively treat patients with chronic diseases. Therefore, educating patients through a more comprehensive approach is required to encourage patients to actively participate in the management of the chronic disease. Empowering the patient is considered as a program for self-care and a change in behavior while caring the diabetics. Selfefficacy and self-esteem are the most important components of empowerment. The rise in selfefficacy and self-esteem has been effective in diabetes care improvement. The current study was conducted to determine the effects of empowerment-based education on self-efficacy and selfesteem in diabetic patients referred to diabetes clinic.