Abstract
Objectives: This study aimed to evaluate the effectiveness of an empowerment-based, self-management intervention among middle-aged patients with poorly controlled type 2 diabetes. Methods: This is a secondary data analysis of an assessor-masked, multi-center, randomized controlled trial. A total of 166 middle-aged patients with poorly controlled type 2 diabetes were randomized to either intervention or control group. Participants in the intervention group received a patient-centered self-management intervention program guided by the Empowerment Process Model with emphasis on personally-meaningful goal-setting and action-reflection dynamics. Generalized estimating equation (GEE) was used to compare the changes in glycemic control, self-management behaviors, and psychological distress over the study periods. Results: Participants in the intervention (n= 80) and control (n= 86) groups were homogeneous at the baseline. The intervention group demonstrated a significant and clinical meaningful reduction in HbA1c value mean (SD) from baseline (10.11% [1.76]) to 3-month (9.19% [2.06]) post-intervention (p< 0.001). Participants in the intervention groups showed significant between-group differences in diet management (p= 0.001), frequency of blood glucose self-monitoring (p= 0.005), and distress level (p< 0.001) at three-month after the completion of the intervention. However, GEE showed non-significant differences on outcome parameters. Discussion: Middle-aged patients with poor diabetes control did not benefit from the empowerment-based self-management intervention. Considering the deteriorated consequence of poor glycemic control and expected long-term trajectory of disease management, special attention should be paid to optimize the biochemical and patient-centered outcomes of middle-aged patients with poor diabetes control. Disclosure L. Cheng: None. J. Sit: None. Q. Xie: None.
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