Observational Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Jul 15, 2019; 10(7): 403-413
Published online Jul 15, 2019. doi: 10.4239/wjd.v10.i7.403
Diabetes empowerment scores among type 2 diabetes mellitus patients and its correlated factors: A cross-sectional study in a primary care setting in Malaysia
Thew Hui Zhu, Ching Siew Mooi, Nurainul Hana Shamsuddin, Ching Siew Mooi
Thew Hui Zhu, Ching Siew Mooi, Nurainul Hana Shamsuddin, Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia
Ching Siew Mooi, Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Serdang 43400, Malaysia, Department of Medical Sciences, School of Healthcare and Medical Sciences, Sunway University, Bandar Sunway, Selangor, Malaysia
Author contributions: Mooi CS and Zhu TH contributed to the conceptualizing the paper, data entry and writing of the manuscript while Zhu TH and Shamsuddin NH contributed data analysis and writing of the manuscripts; Mooi CS is the corresponding author; all the authors read and approved the final manuscript.
Supported by research grant from University Putra Malaysia, No. GP-IPS/2018/9612600. The funder had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.
Institutional review board statement: Ethical approval was obtained from the Medical Research and Ethics Committee (MREC), Ministry of Health Malaysia (NMRR-17-3085-38099) and MREC JKEUPM, University Putra Malaysia before data collection.
Informed consent statement: All participants gave informed written consent prior to the study.
Conflict-of-interest statement: There are no conflicts of interest to report.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Siew Mooi Ching, MD, MHSc, Associate Professor, Doctor, Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia. sm_ching@upm.edu.my
Telephone: +60-3-89472538 Fax: +60-3-89472328
Received: April 19, 2019
Peer-review started: April 22, 2019
First decision: May 8, 2019
Revised: May 16, 2019
Accepted: June 11, 2019
Article in press: June 11, 2019
Published online: July 15, 2019
Abstract
BACKGROUND

There are limited studies on diabetes empowerment among type 2 diabetes patients, particularly in the primary care setting.

AIM

To assess the diabetes empowerment scores and its correlated factors among type 2 diabetes patients in a primary care clinic in Malaysia.

METHODS

This is a cross sectional study involving 322 patients with type 2 diabetes mellitus (DM) followed up in a primary care clinic. Systematic sampling method was used for patient recruitment. The Diabetes Empowerment Scale (DES) questionnaire was used to measure patient empowerment. It consists of three domains: (1) Managing the psychosocial aspect of diabetes (9 items); (2) Assessing dissatisfaction and readiness to change (9 items); and (3) Setting and achieving diabetes goal (10 items). A score was considered high if it ranged from 100 to 140. Data analysis was performed using SPSS version 25 and multiple linear regressions was used to identify the predictors of total diabetes empowerment scores.

RESULTS

The median age of the study population was 55 years old. 56% were male and the mean duration of diabetes was 4 years. The total median score of the DES was 110 [interquartile range (IQR) = 10]. The median scores of the three subscales were 40 with (IQR = 4) for “Managing the psychosocial aspect of diabetes”; 36 with (IQR = 3) for “Assessing dissatisfaction and readiness to change”; and 34 with (IQR = 5) for “Setting and achieving diabetes goal”. According to multiple linear regressions, factors that had significant correlation with higher empowerment scores among type 2 diabetes patients included an above secondary education level (P < 0.001), diabetes education exposure (P = 0.003), lack of ischemic heart disease (P = 0.017), and lower glycated hemoglobin (HbA1c) levels (P < 0.001).

CONCLUSION

Diabetes empowerment scores were high among type 2 diabetes patients in this study population. Predictors for high empowerment scores included above secondary education level, diabetes education exposure, lack of ischemic heart disease status and lower HbA1c.

Keywords: Diabetes, Empowerment, Scores, Diabetes Empowerment Scale, Type 2 diabetes, Primary care, Malaysia

Core tip: This study aims to assess the diabetes empowerment scores and its correlated factors among type 2 diabetes patients in a primary care clinic in Malaysia. Median age of the study population was 55 years old, 56% were male and mean duration of diabetes was 4 years. The total median score of the Diabetes Empowerment Scale was 110 (interquartile range = 10). Diabetes empowerment scores were high among type 2 diabetes patients in this study population. The predictors for high empowerment score were those who had above secondary education level, diabetes education exposure, no ischemic heart disease status and lower glycated hemoglobin.