Folkhälsan Research Center, Public Health Research Program, P.O. Box 211, 00251, Helsinki, Finland.
Department of Public Health, University of Helsinki, Helsinki, Finland.
BMC Public Health. 2021 May 1;21(1):844. doi: 10.1186/s12889-021-10855-0.
Rising prevalence of type 2 diabetes (T2D), also among younger adults, constitutes a growing public health challenge. According to the person-centred Chronic Care Model, proactive care and self-management support in combination with community resources enhance quality of healthcare and health outcomes for patients with T2D. However, research is scarce concerning the importance of person-centred care and community resources for such outcomes as empowerment, and the relative impact of various patient support sources for empowerment is not known. Moreover, little is known about the association of age with these variables in this patient-group. This study, carried out among patients with T2D, examined in three age-groups (27-54, 55-64 and 65-75 years) whether person-centred care and diabetes-related social support, including community support and possibilities to influence community health issues, are associated with patient empowerment, when considering possible confounding factors, such as other quality of care indicators and psychosocial wellbeing. We also explored age differentials in empowerment and in the proposed correlates of empowerment.
Individuals from a register-based sample with T2D participated in a cross-sectional survey (participation 56%, n = 2866). Data were analysed by descriptive statistics and multivariate logistic regression analyses.
Respondents in the youngest age-group were more likely to have low empowerment scores, less continuity of care, and lower wellbeing than the other age-groups, and to perceive less social support, but a higher level of person-centred care than the oldest group. Community support, including possibilities to influence community health issues, was independently and consistently associated with high empowerment in all three age-groups, as was person-centred care in the two older age-groups. Community support was the social support variable with the strongest association with empowerment across age-groups. Moreover, vitality was positively and diabetes-related distress negatively associated with high empowerment in all age-groups, whereas continuity of care, i.e. having a family/regular nurse, was independently associated in the youngest age-group only.
Person-centred care and community support, including possibilities to influence community health issues, supports empowerment among adults with T2D. Findings suggest that age is related to most correlates of empowerment, and that younger adults with T2D have specific healthcare needs.
2 型糖尿病（T2D）的发病率不断上升，包括在年轻人中，这构成了一个日益严重的公共卫生挑战。根据以患者为中心的慢性病护理模式，积极主动的护理和自我管理支持与社区资源相结合，可以提高 T2D 患者的医疗保健质量和健康结果。然而，关于以患者为中心的护理和社区资源对授权等结果的重要性的研究很少，并且不知道各种患者支持来源对授权的相对影响。此外，对于这个患者群体，年龄与这些变量的关系知之甚少。本研究在三个年龄组（27-54、55-64 和 65-75 岁）中进行，在考虑其他质量护理指标和心理社会健康等可能的混杂因素的情况下，检查以患者为中心的护理和与糖尿病相关的社会支持（包括社区支持和影响社区健康问题的可能性）是否与患者授权相关，我们还探讨了授权和所提出的授权相关因素的年龄差异。
来自 T2D 登记样本的个体参加了一项横断面调查（参与率为 56%，n=2866）。数据通过描述性统计和多变量逻辑回归分析进行分析。
最年轻年龄组的受访者更有可能获得低授权评分、护理连续性较低和幸福感低于其他年龄组，并且比最年长组感知到更少的社会支持，但以患者为中心的护理水平更高。在所有三个年龄组中，社区支持，包括影响社区健康问题的可能性，与高授权独立且一致相关，而在两个年龄较大的年龄组中，以患者为中心的护理也是如此。在所有年龄组中，社区支持是与授权关联最强的社会支持变量。此外，活力与所有年龄组的高授权呈正相关，而与糖尿病相关的困扰呈负相关，而连续性护理，即有家庭/常规护士，仅与最年轻的年龄组独立相关。
以患者为中心的护理和社区支持，包括影响社区健康问题的可能性，支持 T2D 成年患者的授权。研究结果表明，年龄与大多数授权相关因素有关，并且 T2D 的年轻成年人有特定的医疗保健需求。
