1 Jiangsu Province Hospital on Integration of Chinese and Western Medicine affiliated with Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China .
Diabetes Technol Ther. 2015 May;17(5):343-8. doi: 10.1089/dia.2014.0345. Epub 2015 Feb 5.
Patient empowerment is playing an increasingly important role in diabetes and related disorders. This study evaluated the correlations among patient empowerment, self-care behavior, and glycemic control among patients with type 2 diabetes in mainland China.
We conducted a multicenter cross-sectional study. Eight hundred eighty-five patients who sought care at hospitals in Nanjing, Changsha, Yunnan, and Chongqing, China, were enrolled. Structured questionnaires and medical records provided the data. The instruments included a demographic and clinical questionnaire, the Diabetes Empowerment Scale-Short Form, and the Chinese version of the Summary of Diabetes Self-Care Activities Scale. Glycosylated hemoglobin (HbA1c) was used as a measure of glycemic control. The data analyses are presented as proportions, means (±SD), β, and 95% confidence intervals (CIs). Multilinear regressions were used to examine the correlations among the scores of patient empowerment, self-care behavior, and HbA1c values.
Linear regression revealed that patient empowerment was a statistically significant predictor of patients' self-care behavior even after controlling for age, gender, marital status, educational level, and diabetes duration. Diet (β=0.449; 95% CI, 0.370, 0.528), exercise (β=0.222; 95% CI, 0.164, 0.279), blood glucose testing (β=0.152; 95% CI, 0.106, 0.199), medication taking (β=0.062; 95% CI, 0.030, 0.095), and foot care (β=0.279; 95% CI, 0.217, 0.342). Additionally, patient empowerment was a statistically significant predictor of HbA1c (β=-0.094; 95% CI, -0.123, -0.065).
Our study indicated that perceived diabetes empowerment is a predictor of self-care behavior and HbA1c in Chinese patients with type 2 diabetes. Therefore, interventions to enhance and promote patient empowerment should be essential components of diabetes education programs to improve self-care behavior and glycemic control.
患者赋权在糖尿病及相关疾病中发挥着越来越重要的作用。本研究评估了中国大陆 2 型糖尿病患者的患者赋权、自我护理行为和血糖控制之间的相关性。
我们进行了一项多中心横断面研究。共纳入了 885 名在南京、长沙、云南和重庆的医院就诊的患者。结构化问卷和病历提供了数据。研究工具包括人口统计学和临床问卷、糖尿病赋权量表-短表和中文版糖尿病自我护理活动量表。糖化血红蛋白（HbA1c）被用作血糖控制的衡量标准。数据分析以比例、平均值（±SD）、β 和 95%置信区间（CI）呈现。多元线性回归用于检验患者赋权、自我护理行为和 HbA1c 值之间的相关性。
线性回归显示，即使在控制了年龄、性别、婚姻状况、教育程度和糖尿病病程后，患者赋权仍然是患者自我护理行为的统计学显著预测因素。饮食（β=0.449；95%CI，0.370，0.528）、运动（β=0.222；95%CI，0.164，0.279）、血糖检测（β=0.152；95%CI，0.106，0.199）、药物服用（β=0.062；95%CI，0.030，0.095）和足部护理（β=0.279；95%CI，0.217，0.342）。此外，患者赋权是 HbA1c 的统计学显著预测因素（β=-0.094；95%CI，-0.123，-0.065）。
本研究表明，感知到的糖尿病赋权是中国 2 型糖尿病患者自我护理行为和 HbA1c 的预测因素。因此，增强和促进患者赋权的干预措施应该是糖尿病教育计划的重要组成部分，以改善自我护理行为和血糖控制。
