Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain.
Department of Clinical Psychology, Psychobiology and Methodology, University of La Laguna (ULL), Tenerife, Spain.
Health Expect. 2022 Dec;25(6):2762-2774. doi: 10.1111/hex.13501. Epub 2022 Sep 1.
The aim of the present study is to identify factors associated with patient empowerment in people living with type 2 diabetes mellitus (T2DM) in the Canary Islands (Spain).
Secondary cross-sectional analysis was carried out of data obtained in the INDICA study: A 24-month cluster randomized-controlled trial evaluating the effectiveness of educational interventions supported by new technology decision tools for T2DM patients. Sociodemographic variables, clinical data (years since diagnosis, glycated haemoglobin level, creatine, triglycerides, waist hip index, body mass index and number of comorbidities), diabetes knowledge (DIATEK), affective outcomes (Beck Depression Inventory-II, the State subscale of the State-Trait Anxiety Inventory and The Diabetes Distress Scale) and diabetes-related quality of life (The Audit of Diabetes-Dependent Quality of life) were assessed as potential correlates of patient empowerment, assessed using the Diabetes Empowerment Scale-Short Form. Multilevel mixed linear regression models on patient empowerment were developed.
The analysis included the baseline data of 2334 patients. Results showed that age (B = -0.14; p < .001), diabetes knowledge (B = 0.61; p < .001) and state-anxiety (B = -0.09; p < .001) are significantly associated with patient empowerment. Sex, education level, living alone, employment status, country of birth, time since diagnosis, number of comorbidities, glycated haemoglobin level, depression and distress were not independently associated with patient empowerment in the multivariate analyses.
Younger age, lower state-anxiety and greater diabetes-specific knowledge are important correlates of patient empowerment. In line with the results of the INDICA study, interventions based on patient-centred care might be effective in improving patient empowerment in adults with T2DM. Understanding the factors associated with empowerment may help clinicians and policymakers to identify high-risk groups, prioritize resources and target evidence-based interventions to better support people with T2DM to be actively involved in their own care.
Patients with T2DM were actively involved in the design of the INDICA study. Two patient associations were included as part of the research team and actively participated in designing the interventions and selecting outcome measures.
本研究旨在确定与加那利群岛（西班牙） 2 型糖尿病（T2DM）患者赋权相关的因素。
对 INDICA 研究中的数据进行二次横断面分析：一项为期 24 个月的群组随机对照试验，评估支持新技术决策工具的教育干预对 T2DM 患者的有效性。评估社会人口统计学变量、临床数据（诊断后年限、糖化血红蛋白水平、肌酐、甘油三酯、腰臀比、体重指数和共病数量）、糖尿病知识（DIATEK）、情感结果（贝克抑郁量表第二版、状态特质焦虑量表状态分量表和糖尿病困扰量表）和糖尿病相关生活质量（糖尿病患者依赖生活质量评估），作为患者赋权的潜在相关因素，使用糖尿病赋权量表-简短形式进行评估。建立患者赋权的多水平混合线性回归模型。
分析包括 2334 名患者的基线数据。结果表明，年龄（B=-0.14；p<0.001）、糖尿病知识（B=0.61；p<0.001）和状态焦虑（B=-0.09；p<0.001）与患者赋权显著相关。性别、教育程度、独居、就业状况、出生地、诊断后年限、共病数量、糖化血红蛋白水平、抑郁和困扰在多变量分析中与患者赋权无关。
年龄较小、状态焦虑较低和糖尿病知识较高是患者赋权的重要相关因素。与 INDICA 研究的结果一致，基于以患者为中心的护理的干预措施可能会有效提高 T2DM 成年患者的患者赋权。了解赋权的相关因素可以帮助临床医生和政策制定者识别高风险群体，优先分配资源，并针对基于证据的干预措施，以更好地支持 T2DM 患者积极参与自身护理。
T2DM 患者积极参与了 INDICA 研究的设计。两个患者协会作为研究小组的一部分参与其中，并积极参与设计干预措施和选择结局测量。
