An empowerment-based educational program improves psychological well-being and health-related quality of life in Type 1 diabetes

Abstract

Educational programs are reported to improve metabolic control and well-being in Type 1 diabetes mellitus (DM), but the effects of newly- structured interventions, aimed at promoting empowerment in educated patients in active selfcare, have received little attention. Ninety patients with Type 1 DM in intensive insulin treatment were invited to an empowerment-based educational intervention. Changes in quality of life and psychological well-being in the 54 patients participating in the program (median age, 44 yr) were compared with those measured in patients who refused. The following questionnaires were administered at baseline and 12 months later: Psychological General Well-Being (PGWB), Medical Outcome Survey Short-Form 36 (SF-36), and Well-Being Enquiry for Diabetics (WED). Baseline values were indicative of moderate, but significant, psychological distress in the whole cohort. At follow-up, the experimental group had a better metabolic control {glycosylated hemoglobin, -0.4% [time x treatment analysis of variance (ANOVA), p = 0.005 vs controls]}, and a general improvement in comprehensive indices and most scales of PGWB and SF-36. Vitality (p = 0.042) and Social Functioning (p = 0.039) were no longer different from population norm. Similarly, the Symptoms (p = 0.005), Discomfort (p = 0.043) and Impact scales (p = 0.032) of WED, reflecting physical functioning, diabetes-related worries and familial relationships, role functioning and social network, improved significantly in treated patients. An educational empowerment-based intervention significantly improves the psychosocial aspects of diabetes and quality of life also in patients in active and effective self-care. Repeated educational interventions are the way towards a normal life with Type 1 DM.