Does Patient Empowerment Predict Self-Care Behavior and Glycosylated Hemoglobin in Chinese Patients with Type 2 Diabetes?

Background: 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. Subjects and Methods: 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), beta, 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. Results: 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 (beta=0.449; 95% CI, 0.370, 0.528), exercise (beta=0.222; 95% CI, 0.164, 0.279), blood glucose testing (beta=0.152; 95% CI, 0.106, 0.199), medication taking (beta=0.062; 95% CI, 0.030, 0.095), and foot care (beta=0.279; 95% CI, 0.217, 0.342). Additionally, patient empowerment was a statistically significant predictor of HbA1c (beta=-0.094; 95% CI, -0.123, -0.065). Conclusions: 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.