Diabetes Empowerment Scale-Short Form Research Articles

Serial mediation roles of empowerment and self-care activities connecting health literacy, quality of life, and glycemic control in people with type 2 diabetes.

Health literacy, empowerment, and self-care activities are likely the crucial concepts affecting the quality of life and glycemic control in people with type 2 diabetes (T2D). However, evidence demonstrating the mechanisms underlying these concepts is scarce. The aim of this study was to test the serial mediation roles of empowerment and self-care activities on the relationships between health literacy and quality of life and between health literacy and hemoglobin A1c (HbA1c) in people with T2D. A cross-sectional study was conducted among 319 people with T2D in Guangzhou, China, from July 2019 to January 2020. Data were collected using the Health Literacy Scale, the Diabetes Empowerment Scale-Short Form, the Summary of Diabetes Self-Care Activities Measure, and the Adjusted Diabetes-Specific Quality of Life Scale. RStudio 4.2.1 was used for serial mediation analysis. The dimension of communicative health literacy accounted for the most total variance (β = 0.810, p < .001) in the construct of health literacy. The serial multiple mediation of empowerment and self-care activities in the associations between health literacy and quality of life (β = -.046, p = .019) and between health literacy and HbA1c (β = -.045, p = .005) were statistically significant. This study emphasized the vital role of communicative health literacy when improving health literacy in people with T2D. Diabetes care and education specialists could implement empowerment approaches and flexible self-care strategies to improve the quality of life and glycemic control in people with T2D. Enhancing health literacy was suggested as a favorable strategy for promoting empowerment and self-care activities in people with T2D.

Characterizing Diabetes Empowerment and Motivation for Changing Health Behaviors Among People with Type 2 Diabetes: A Cross-Sectional Survey.

Effectively engaging people with type 2 diabetes (T2D) earlier in their health journeys is critical to prevent downstream complications. Digitally based diabetes programs are a growing component of care delivery that have the potential to engage individuals outside of traditional clinic-based settings and use personalized data to pair people to tailored diabetes self-management interventions. Knowing an individuals' diabetes empowerment and health-related motivation can help drive appropriate recommendations for personalized interventions. We aimed to characterize diabetes empowerment and motivation towards changing health behaviors among participants in Level2, a T2D specialty care organization in the USA that combines wearable technology with personalized clinical support. A cross-sectional online survey was conducted among people enrolled in Level2 (February-March 2021). Distributions of respondent-reported diabetes empowerment and health motivation were analyzed using Motivation and Attitudes Toward Changing Health (MATCH) and Diabetes Empowerment Scale Short Form (DES-SF) scales, respectively. Associations between MATCH and DES-SF scores with Level2 engagement measures and glycemic control were analyzed. The final analysis included 1258 respondents with T2D (mean age 55.7 ± 8.4years). Respondents had high average MATCH (4.19/5) and DES-SF (4.02/5) scores. The average MATCH subscores for willingness (4.43/5) and worthwhileness (4.39/5) were higher than the average ability subscore (3.73/5). Both MATCH and DES-SF scores showed very weak correlations with Level2 engagement measures and glycemic control (ρ = -0.18-0.19). Level2 survey respondents had high average motivation and diabetes empowerment scores. Further research is needed to validate sensitivity of these scales to detect changes in motivation and empowerment over time and to determine whether differences in scores can be used to pair people to personalized interventions.

Empowerment and Knowledge as Determinants for Quality of Life: A Contribution to a Better Type 2 Diabetes Self-Management.

The purpose of this study was to assess how knowledge and empowerment impact the quality of life (QoL) of a person with type 2 diabetes, leading to better communication and disease management. We conducted a descriptive and observational study of individuals with type 2 diabetes. The Diabetes Empowerment Scale-Short Form (DES-SF), Diabetes Knowledge Test (DKT), and EQ-5D-5L were used, in addition to sociodemographic and clinical characteristics. Evaluating the variability in the DES-SF and DKT in relation to the EQ-5D-5L and identifying possible sociodemographic and clinical determinants were conducted using univariate analyses followed by a multiple linear regression model to test whether the factors significantly predicted QoL. A total of 763 individuals were included in the final sample. Patients aged 65 years or older had lower QoL scores, as well as patients who lived alone, had less than 12 years of education, and experienced complications. The insulin-treated group showed higher scores in DKT than the non-insulin-treated group. It was also found that being male, being under 65 years of age, having no complications present, and having higher levels of knowledge and empowerment predicted higher QoL. Our results show that DKT and DES are still determinants of QoL, even after adjusting for sociodemographic and clinical characteristics. Therefore, literacy and empowerment are important for the improvement of the QoL of people with diabetes, by enabling them to manage their health conditions. New clinical practices focused on education, increasing patients' knowledge, and empowerment may contribute to better health outcomes.

Investigating the Relationship between Empowerment and Chronic Pain Acceptance and the Resulting Limitations in the Elderly with Diabetes Living Southwest of Iran

Background AimConsidering the importance of pain acceptance in adjusting to chronic pain among diabetic patients, this study was conducted to determine the relationship between the empowerment scale and the level of chronic pain acceptance among the elderly with diabetes and the resulting limitations. MethodThis is a descriptive-analytical study on 250 older patients (65 years and older) with diabetes. The samples were selected through random convenience sampling, performed during 2019 to 2020 in the health centers of Ahvaz, Iran. The data were collected using the demographic information checklist and standard questionnaires including chronic pain acceptance questionnaire (CPAQ), the scale of chronic pain-related limitations, and the diabetes empowerment scale-short form (DES-SF). The data were analyzed using SPSS V24. ResultsThe majority of the samples were male (56%) and the mean age of the participants was 70.96 ± 8.95 years. The results showed that the mean and standard deviation were reported to be 20.04 ± 4.63 for pain acceptance, 46.16 ± 10.85 for chronic pain-related limitations, and 27.24 ± 9.65 for the empowerment scale. According to regression coefficients, the mean score of empowerments of patients with diabetes has no significant relationship with pain acceptance (p = .199, b = -0.327) and pain-related limitations (p = .925, b = 0.004). ConclusionsBased on the results of this study, the level of empowerment, pain acceptance, and pain-related limitations in the older patients with diabetes was moderate and there was no significant relationship between them. Identifying vulnerable groups in the field of chronic pain and preventive, educational and therapeutic interventions will help increase patients’ self-care capacity and reduce the limitations and the disability caused by pain.

Exploration of the health needs of patients with poorly controlled type 2 diabetes using a user-centred co-production approach in the area of mHealth: an exploratory sequential mixed-method protocol

IntroductionResearch on the needs and preferences of patients with poorly controlled type 2 diabetes mellitus (T2DM) with mobile health (mHealth) service is limited. With the principles of co-production, this study...

Influence of Literacy, Self-Efficacy, and Social Support on Diabetes-Related Outcomes Following Hospital Discharge.

ObjectiveTo evaluate the relationship between health literacy, social support, and self-efficacy as predictors of change in A1c and readmission among hospitalized patients with type 2 diabetes (T2D).MethodsThis is a secondary analysis of patients with T2D (A1c >8.5%) enrolled in a randomized trial in which health literacy (Newest Vital Sign), social support (Multidimensional Scale of Perceived Social Support), and empowerment (Diabetes Empowerment Scale-Short Form) was assessed at baseline. Multivariable models evaluated whether these concepts were associated with A1c reduction at 12 weeks (absolute change, % with >1% reduction, % reaching individualized target) and readmission (14 and 30 days).ResultsA1c (N=108) decreased >1% in 60%, while individualized A1c target was achieved in 31%. After adjustment for baseline A1c and potential confounders, health literacy was associated with significant reduction in A1c (Estimate −0.21, 95% CI −0.40, −0.01, p=0.041) and >1% decrease in A1c (OR 1.37, 95% CI 1.08, 1.73, p=0.009). However, higher social support was associated with greater adjusted odds of reaching the individualized A1c target (OR 1.63, 95% CI 1.04, 2.55, p=0.32). Both higher empowerment (OR 0.23, 95% CI 0.08, 0.64, p=0.005) and social support (OR 0.57, 95% CI 0.36, 0.91, p=0.018) were associated with fewer readmissions by 14 days, but not 30 days.ConclusionThe study indicates that health literacy and social support may be important predictors of A1c reduction post-discharge among hospitalized patients with T2D. Social support and diabetes self-management skills should be addressed and early follow-up may be critical for avoiding readmissions.Clinical TrialNCT03455985.

587-P: Discrepancies in Patient Perceptions of Health Care Interactions and Diabetes Empowerment Reveal Potential Impact of Weight Bias in Type 2 Diabetes Care

Background: Weight bias is associated with adverse health consequences and may be experienced by people with type 2 diabetes (T2D) from multiple sources, including healthcare providers (HCPs) . This study assessed T2D patients’ sentiments surrounding their most recent visit with their HCP and psychosocial self-efficacy related to diabetes management across body mass index (BMI) range. Methods: In September 2020, 2,975 adults with T2D in the United States completed an online questionnaire, including a series of questions about experiences at their last healthcare visit and the Diabetes Empowerment Scale-Short Form (DES-SF) to assess diabetes-related psychosocial self-efficacy. Health and demographic information were collected. BMI was calculated using patient-reported measures for height and weight. Results: Respondents with a BMI of 40.0 or higher were more likely to feel blamed by their HCP for having diabetes (9%) compared to those with BMIs of 18.5-24.9 (4%) , 25.0-25.9 (5%) , and 30.0-34.9 (5%) , and more likely to feel as though their provider doubted their ability to manage their diabetes or follow their treatment plan (17%) compared to those with BMIs of 25.0-25.9 (11%) and 30.0-34.9 (12%) . Adults with T2D and a BMI of 35.0 or higher scored significantly lower on the DES-SF than those with BMIs of 18.5-24.9 and 25.0-29.9. Respondents with a BMI ≥40.0 were less likely to agree with the DES-SF subitem that they can ask for support surrounding having and caring for diabetes when they need it (63%) , compared to those with BMIs of 18.5-24.9 (74%) , 25.0-25.9 (68%) , and 30.0-34.9 (69%) . Conclusions: These findings suggest that T2D patients with higher body mass index scores are more likely to feel stigma when interacting with HCPs, which may negatively impact diabetes empowerment and patient-provider relationships, emphasizing the need for increased focus on weight neutrality in diabetes care. Disclosure J.Stevenson: Other Relationship; Abbott Diabetes, Ascensia Diabetes Care, Beta Bionics, Inc., Dexcom, Inc., Eli Lilly and Company, Insulet Corporation, LifeScan, Medtronic, Roche Diabetes Care, Tandem Diabetes Care, Inc. R.Gowen: Other Relationship; Abbott Diabetes, Ascensia Diabetes Care, Beta Bionics, Inc., Dexcom, Inc., Eli Lilly and Company, Insulet Corporation, LifeScan, Medtronic, Roche Diabetes Care, Tandem Diabetes Care, Inc., Virta Health Corp. E.Ye: Employee; dQ&amp;A. R.Wood: Other Relationship; Multiple companies and patient organizations (&amp;gt;10) .

Assessing the mechanisms contributing to self-care behaviours in young and usual-onset diabetes.

Context: Young-onset diabetes (YOD) (age of onset 21-39 years) is associated with a poorer metabolic profile and a higher risk of complications, and poor self-care behaviours play a significant role. However, few studies have comprehensively examined the mechanisms (self-efficacy, dietary barriers, illness perceptions, knowledge, diabetes-related distress) that may contribute to poor self-care behaviours in YOD. Objectives: Our study aims to compare these mechanisms and self-care behaviours between participants with YOD and usualonset diabetes (age of onset 40-59 years). Study design: A cross-sectional survey was conducted in primary care clinics in participants with YOD or UOD, and type 2 diabetes for 10 years or less. Survey tools included the Diabetes Empowerment Scale short-form (DES-SF), dietary barriers of the Personal Diabetes Questionnaire (PDQ-DB), Brief Illness Perceptions Questionnaire (BIPQ), revised Michigan Diabetes Knowledge Test (DKT), diabetes distress scale (DDS), Summary of Diabetes Self-care Activities (SDSCA), International Physical Activity Questionnaire (IPAQ-SF) and medication adherence report scale (MARS-5), and means of both groups were compared using independent T-tests and effect sizes were analysed (Cohen's d). Results: 97 participants with YOD and 312 with UOD completed the survey. Compared with UOD, participants with YOD reported a lower adherence to a specific diet (d=0.45), with no significant differences in levels of physical activity or medication adherence. Participants with YOD experienced greater diabetes-related distress (d=0.35), especially with emotional (d=0.37), regimen-related (d=0.43) and interpersonal (d=0.39) distress. At the same time, perception of self-efficacy was significantly lower (d=0.27) and more dietary barriers were perceived (d=0.76). Participants with YOD also perceived that diabetes affected their lives more severely (consequence) (d=0.26), had a larger effect on their emotions (emotional representation) (d=0.28), will last longer (timeline) (d=0.37), and perceived that treatment was less likely help their diabetes (treatment control) (d=0.26). Conclusions: Participants with YOD experienced greater diabetes-related distress, lower self-efficacy and reported lower dietary adherence with more dietary barriers than those with UOD. Patients with YOD have distinctly different issues from UOD, and in providing care for YOD, clinicians should actively seek to identify and address these issues.

An Enhanced SMS Text Message-Based Support and Reminder Program for Young Adults With Type 2 Diabetes (TEXT2U): Randomized Controlled Trial.

BackgroundClinic attendance, metabolic control, engagement in self-management, and psychological health are suboptimal in young-onset (age of onset <40 years) type 2 diabetes.ObjectiveWe examined the effectiveness of an enhanced SMS text message–based support and reminder program in improving clinic attendance, metabolic control, engagement in self-management, and psychological health in young-onset type 2 diabetes.MethodsA 12-month, parallel-arm, randomized controlled trial comparing an enhanced, semipersonalized SMS text message–based intervention (incorporating 1-8 supportive and/or informative text messages per month) against standard care was conducted in a specialized clinic for young adult type 2 diabetes. The primary outcome was maintenance of 100% attendance at scheduled quarterly clinical appointments. Secondary outcomes included (1) metabolic indices, (2) pathology and self-monitored blood glucose (SMBG) data availability, and (3) psychosocial well-being.ResultsA total of 40 participants were randomized, and 32 completed their 12-month study visit. The average participant age was 32.7 (SD 5.1) years, 50% (20/40) were male, and baseline glycated hemoglobin A1c (HbA1c) was 7.3% (SD 1.9%) (56 mmol/mol, SD 20). A higher proportion of the intervention group achieved 100% attendance (12/21, 57%, vs 5/19, 26%, for the control group); Kaplan-Meier analysis demonstrated significantly greater cumulative attendance in the intervention group (P=.04). There were no between-group differences in HbA1c, BMI, lipids, or availability of pathology and SMBG data. Odds of recording an improvement in the Diabetes Empowerment Scale–Short Form score were higher in the intervention group at 6 months (odds ratio [OR] 4.3, 95% CI 1.1-17), with attenuation of this effect at study end (OR 3.1, 95% CI 0.9-11). Program acceptability was high; >90% of participants would recommend the program to new patients.ConclusionsAn enhanced SMS text message–based support and reminder program doubled scheduled clinic attendance rates for patients with young-onset type 2 diabetes. The program was highly acceptable and provided early support for patient empowerment but had no significant effect on measures of metabolic control or self-management.Trial RegistrationAustralian and New Zealand Clinical Trials Registry (ACTRN12618000479202); https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373579

Efficacy and Safety of a Decision Support Intervention for Basal Insulin Self-Titration Assisted by the Nurse in Outpatients with T2DM: A Randomized Controlled Trial.

ObjectiveThe main aim of this study was to evaluate a combined fasting blood glucose based dosage self-titration setting and decision supported telephone coaching intervention on glycemic control and diabetes self-management skills, compared to the conventional care.MethodsA 12-week, single-blinded, randomized controlled trial was conducted on adults with type 2 diabetes (T2DM) primarily treated with basal insulin. After randomization, the intervention group (IG, n = 426) received a basal insulin self-titration decision support intervention administered by the Diabetes Specialty Nurses while the control group (CG, n = 423) received conventional care for 12 weeks, both included five telephone interviews. The primary efficacy endpoint was the effect of intervention on glycemic control, measured as the change in glycated hemoglobin (HbA1c) from baseline to Week 12 (after intervention) compared to the control group. Other endpoints included comparisons of the effects of intervention on fasting plasma glucose (FPG), postprandial plasma glucose (PPG), body weight, Michigan diabetes knowledge test (MDKT), diabetes empowerment scale-short Form (DES-DSF), and summary of diabetes self-care activities (SDSCA). Changes in the primary and secondary outcomes were compared using the t-test for continuous variables with a normal distribution and χ2-test for categorical variables.ResultsThe IG showed more improvements on mean HbA1c, compared to the CG (−2.8% vs −1.8%), so did the FPG, PPG, MDKT, DES-DSF and SDSCA (all P<0.01) after the 12-week follow up. Though the final mean insulin dose in the IG was higher than the CG at the end of the study (0.32 U/kg vs 0.28 U/kg), the changes of body weight were similar between the two groups (0.46kg vs 0.40kg, P=0.246), and the proportion of patients with hypoglycemia events during the whole trial were similar (20.65% vs 17.73%, P=0.279).ConclusionDecision supporting of basal insulin glargine self-titration assisted by Diabetes Specialty Nurses is effective and safe in patients with T2DM. Decision supported telephone coaching intervention offers ongoing encouragement, guidance, and determination of relevant sources of decisional conflict, facilitating adjusting the insulin dose.

The effectiveness of a smartphone-based online peer group on type II diabetes mellitus patients self-empowerment in a primary healthcare center in Indonesia

Objective: Self-empowerment is an important factor that influences a person's ability to perform effective diabetes management. One effort that can be done to improve self-empowerment is by providing a smartphone-based online peer-group. This research determined the effect of smartphone-based online peer groups on type 2 diabetes mellitus (T2DM) patients self-empowerment in four primary healthcare centers in Indonesia. Methods: This quasi-experimental research was conducted in four healthcare centers in Indonesia. The total sample was 71 divided into two groups (control and intervention). The control group received standard education from the healthcare center, whereas the intervention group underwent an online peer-group. Self-empowerment was measured before and after intervention using the Diabetes Empowerment Scale-Short Form (DES-SF) questionnaire (Indonesian version). General Linear Model was used in statistical analysis. Results: The mean age of respondents was 56.4 ± 8.8 and 56.9 ± 7.1 years old, 59.5%, and 76.5% had good family support, and 70.3% and 50% of respondents had not received diabetes education for the control and intervention groups, respectively. The average pretest self-empowerment score was 27.03 ± 3.73 and 27.59 ± 3.53 (diff. 0.56; 95%CI -1.16; 2.29), and the post-test score was 27.43 ± 4.13 and 32.76 ± 4.38 (diff. 5.33; 95%CI 3.32; 7.35) for the control and intervention groups, respectively. Online peer-group improve self-empowerment significantly in the intervention group. Conclusion: Smartphone-based online peer-group can improve self-empowerment in patients with T2DM.

Assessment of the complexity of drug therapy and psychosocial and behavioral aspects in people living with type 2 diabetes mellitus.

Background Type 2 diabetes mellitus is a public health problem worldwide. The complexity of drug therapy and behavioral aspects are important factors in its management. Objective To characterize the complexity of drug therapy, attitudes, empowerment and self-care in people with type 2 diabetes mellitus. Methods Observational descriptive study involving people with type 2 diabetes mellitus recruited in eight public primary care settings in Brazil, 2018. We used validated instruments to determine the complexity of drug therapy employing the Medication Regimen Complexity Index, and to describe the behavioral aspects, encompassing Diabetes Attitudes Questionnaires, Diabetes Empowerment Scale-Short Form and Diabetes Mellitus Care Self-Management. Results The 119 participants showed median age of 64years (Quartile 1 57.0; Quartile 3 71.0) with predominance of women (68.1%). We found high percentages of participants with low scores on attitudes (87.9%) and self-care (84.8%) questionnaires, but with high scores on empowerment questionnaire (81.8%) in groups with high complexity of drug therapy. Conclusion High complexity of drug therapy concentrated low scores for attitudes and self-care, even though presenting elevated empowerment scores. Further studies are needed to investigate the effect of these aspects on the behavior of people with type 2 diabetes mellitus on drug therapies of high complexity.

Adaptation of Diabetic Empowerment Scale-Short Form to Older Individuals and to Turkish Language: Validity and Reliability Study.

The empowerment of old people is important in order for them to gain control over their own lives and to raise their quality of life. The purpose of this study was to adapt the Diabetes Empowerment Scale-Short Form (DES-SF) to old people and to the Turkish language, and to determine its validity and reliability. This methodological type study was conducted between 1 January and 30 March 2017 with 106 old people fitting the criteria of acceptance in the study who attended the geriatrics clinic of a university hospital. In determining validity, language equivalence, content, and predictive validity were used, while reliability was tested with temporal invariance, Cronbach's alpha coefficient, and item total correlation. We examined its reliability and validity via item analyses, content validity (expert panel), confirmatory factor analyses, and construct validity (exploratory factor analyses). The Cronbach's alpha of the scale was 0.883. The scale items were grouped under a single factor in accordance with the original. Confirmatory and exploratory factor analysis showed good fit signs. After conducting validity and reliability testing on the adaptation of the Diabetic Empowerment Scale-Short Form to old people and the Turkish language, it is was concluded that it is a reliable scale to determine the empowerment levels of old people. Based on the statistical analyses applied to evaluate the validity and reliability of the scale obtained by adapting the DES-SF to old people, it was inferred that it is an instrument with high validity and reliability. The scale is a short and practical instrument to evaluate the empowerment levels of old people. The new name of the scale is the elderly empowerment scale.

The association between self-efficacy and self-management behaviors among Chinese patients with type 2 diabetes.

BackgroundSelf-management is the cornerstone of diabetes care, however, despite the numerous recommendations available for self-management, type-2 diabetes mellitus (T2DM) patients’ performance is suboptimal in China. This study aimed to explore the association between self-efficacy and self-management behaviors among Chinese T2DM patients, which might provide evidence to inform effective self-management interventions for these patients.MethodsA cross-sectional survey was conducted using a multi-stage stratified randomized sampling in Shandong Province, China. The Diabetes Empowerment Scale-Short Form (DES-SF) was used to measure patients’ self-efficacy to manage diabetes. Latent class analysis (LCA) was used to explore the observed classes of self-management behaviors (dietary control, physical exercise, regular medication and self-monitoring of blood glucose). A two-class solution for self-management behaviors was tested to be the fittest based on LCA; we labelled active and inactive self-management groups. Univariate and multivariate logistic regression analysis were used to examine the associations between self-efficacy and self-management behaviors.ResultsA total of 2166 T2DM patients were included in the analysis. The mean DES-SF score was 31.9 (standard deviation: 5.2). The estimated proportions of T2DM in the active and inactive groups were 54.8% and 45.2%, respectively. The multivariate logistic regression showed that higher DES-SF score was significantly associated with higher possibility of active self-management behaviors (odds ratio = 1.06; 95% confidence interval: 1.04–1.08).ConclusionsSelf-efficacy in managing diabetes is associated with self-management behaviors among Chinese T2DM patients. To improve self-management behaviors, multiple strategies should be conducted to improve patients’ self-efficacy.

676-P: The Efficacy and Safety of Careful Management of Self-Dose-Adjustment Intervention of Basal Insulin by the Nurse in Outpatients with T2DM

Background: Basal insulin therapy is widely used in patients with type 2 diabetes mellitus (T2DM). After giving the initial dose, the follow-up of the patients from the doctors, including the dose adjustment and the hypoglycemia, is not sufficient in China, which influences the glucose control obviously. Thus, we intended to invest if the patients with T2DM would benefit from careful follow-up and management of the basal insulin therapy by the nurse. Methods: The patients with T2DM who were ≥ 18 years old and glycosylated hemoglobin A1c (HbA1c) &amp;gt; 7% were eligible for the 12-week study. After they were randomized to the control group and the careful care group, glargine was added to them. All of the patients accepted the routine guidance by the doctor. In addition to that, patients in the careful care group were guided to adjust their insulin dose 2-6U to reach the glucose target and followed-up at the 1, 2, 4, 8, 12 weeks by the Diabetes Specialist Nurses. The laboratory indices and questionnaire were assessed at baseline and at the end of the study. Results: Four hundred and twenty-three patients (53.6 ± 14.3 years) in the control group and four hundred and twenty-six patients (54.7 ±13.4 years) in the careful care group finished the 12-week study. The patients in the careful care group had greater reduction of fasting plasma glucose (-2.64±0.44mmol/L vs. -1.63±0.53mmol/L, P&amp;lt;0.05) and HbA1c (-2.8±0.5% vs. -1.8±0.5%, P&amp;lt;0.05), higher improvements of the score of diabetes knowledge (6.10 ± 0.76 vs. 2.87± 1.72, P&amp;lt;0.001), the score of Diabetes Empowerment Scale-Short Form (39.07 ± 17.82 vs. 26.93 ± 19.17, P&amp;lt;0.05), and the score of self-management ability (including diet, exercise, etc., P&amp;lt;0.05), compared with the control group. The hypoglycemic percentages were similar between them (17.73% vs. 20.65%, P=0.279). Conclusions: The careful follow-up and management of self-insulin dose adjustment by Diabetes Specialty Nurses is effective and safe in patients with T2DM. Disclosure X. Hu: None. X. Yang: None. H. Deng: None. X. Guo: None. B. Yao: None.

Reliability and validity of Chinese version of the Hypertensive Intracerebral Hemorrhage Empowerment Scale-Short Form (C-HICHES-SF)

Objective To evaluate the reliability and validity of Chinese version of the Hypertensive Intracerebral Hemorrhage Empowerment Scale-Short Form (C-HICHES-SF). Methods A total of 207 hypertensive intracerebral hemorrhage patients treated in the Department of Neurology inpatients of a three-grade hospital in Tianjin from August 2017 to January 2018 were selected by convenient sampling method. Chinese Diabetes Empowerment Scale-Short Form (C-DES-SF) was adapted into C-HICHES-SF by expert enquiry and the patients were surveyed. SPSS 24.0 and AMOS 24.0 were used for data processing. Results C-HICHES-SF contains 8 items. Its Cronbach α was 0.833, Sperman's half-reliability was 0.797, Guttman's half-reliability was 0.742, test-retest reliability was 0.787, content validity was 0.943. one common factor was extracted by exploratory factor analysis, and could explain 52.36% of the variance contribution.the confirmatory factor analysis revealed a good fit of the model to the date based on various fit indices (χ2/df ratio=1.172, GFI=0.997, AGFI= 0.949, NFI= 0.980, CFI=0.980, TLI=0.994, RMSEA=0.029). Conclusion C-HICHES-SF has fewer articles and easy to use. It has good reliability and validity in patients with hypertensive intracerebral hemorrhage, It can be used as an effective tool to measure empowerment ability. Key words: Hypertensive intracerebral hemorrhage; Empowerment; Reliability; Validity

Low empowerment and diabetes regimen distress are related to HbA1c in low income type 1 diabetes patients in a Brazilian tertiary public hospital

BackgroundAdults with type 1 diabetes (T1D) have a high risk of developing depressive symptoms and diabetes-related distress (DD). Low socioeconomic level is associated with increased risk of poor self-management, treatment difficulties and psychological distress. The goals of this study were to document the frequency of major depressive disorder (MDD), high depressive symptoms and high DD, to assess levels of empowerment and to determine the association with each of these measures and glycemic control in a low-income Brazilian sample of adults with T1D.MethodsIn a cross-sectional study, inclusion criteria were age > 18 years and diagnosis of T1D > 6 months. Exclusion criteria were cognitive impairment, history of major psychiatric disorders, severe diabetes-related complications and pregnancy. Diagnoses of MDD were made using interview-based DSM-5 criteria. Depressive symptoms were evaluated by the depression subscale of the Hospital Anxiety and Depression Scale (HAD-D). The Diabetes Distress Scale (DDS) assessed DD. Empowerment levels were evaluated by the Diabetes Empowerment Scale short form (DES-SF). Glycemic control was measured by HbA1c. The latest lipid panel results were recorded. Number of complications was obtained from medical records.ResultsOf the 63 T1D patients recruited, 36.5% were male, mean age was 31.5 (± 8.9), mean number of complications was 1 (± 1.1), and mean HbA1c was 10.0% (± 2). Frequency of MDD was 34.9% and 34.9% reported high depressive symptoms. Fifty-seven percent reported clinically meaningful DD. High diabetes regimen distress and low empowerment were associated to HbA1c (p = 0.003; p = 0.01, respectively). In multivariate analyses, lower empowerment levels were associated to higher HbA1c (beta − 1.11; r-partial 0.09; p value 0.0126). MDD and depressive symptoms were not significantly correlated with HbA1c in this expected direction (p = 0.72; p = 0.97, respectively).ConclusionsThis study showed high rates of MDD, high depressive symptoms and high DD and low levels of empowerment in this low income population. Empowerment and diabetes regimen distress were linked to glycemic control. The results emphasize the need to incorporate the psychological and psychosocial side of diabetes into strategies of care and education for T1D patients.

Reliability and Validity of Korean version of Diabetes Empowerment Scale Short Form

Reliability and Validity of Korean version of Diabetes Empowerment Scale Short Form

Declining structured diabetes education in those with type 2 diabetes: A plethora of individual and organisational reasons

Objectiveto identify the expressed reasons adults with type 2 diabetes decline structured diabetes education (SDE). Methodscross sectional survey of 335 adults with type 2 diabetes who had declined SDE within the past two years, from across Northern Ireland and England.Standardised instruments comprising The Diabetes Attitude Scale, Diabetes Empowerment Scale (Short Form), and Diabetes Knowledge Test plus a questionnaire to elicit the reasons for declining SDE were used. ResultsMean age 57.6 years (±21.1) 50.7% males, predominantly of White ethnicity (85.7%). They were most frequently invited to attend by a diabetes specialist nurse (36%), general practitioner (27%) or practice nurse (19%).Although a diversity of reasons for declining SDE were cited the most common were; ‘The course was too long’ (47.2%), ‘I have other health problems’ (41.2%) and they had other priorities (33.4%).Hierarchical cluster analysis revealed that expressed reasons for declining SDE were highly individualised. ConclusionThe wide range of reasons that impeded attendance suggests there is no simple solution that will improve attendance rates. Practice implicationsIn the same way that medical treatment for diabetes is becoming increasingly individualised, educational provision should be encouraged to move away from a one size fits all model.

Avaliação da visita domiciliar para o empoderamento do autocuidado em diabetes

Resumo Objetivo Avaliar o efeito da visita domiciliar na adesão e empoderamento das práticas de autocuidado em diabetes mellitus tipo 2. Métodos Ensaio clínico randomizado por clusters, com a participação de 145 usuários com diabetes mellitus tipo 2, sendo 34 do Grupo intervenção e 111 do Grupo controle. Foram utilizados os questionários de Autocuidado com o diabetes e Diabetes Empowerment Scale-Short Form para comparação entre grupos na linha de base, assim como entre o antes e depois intragrupo. O nível de significância foi 0,05. Resultados O grupo intervenção apresentou aumento estatisticamente significativo do escore mediano referente à adesão às práticas de autocuidado em diabetes (p=0,005) e à escala de empoderamento (p&lt;0,001). Conclusão A visita domiciliar promoveu à adesão às práticas de autocuidado com diabetes mellitus tipo 2.