Maria Chiara Rossi1, Giuseppe Lucisano2, Martha Funnell3, Basilio Pintaudi4, Angela Bulotta5, Sandro Gentile6, Marco Scardapane2, Soren Eik Skovlund7, Giacomo Vespasiani8, Antonio Nicolucci2. 1. CORE-Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy; Laboratory of Clinical Epidemiology of Diabetes and Chronic Diseases, Fondazione Mario Negri Sud, S. Maria Imbaro (CH), Italy. Electronic address: rossi@coresearch.it. 2. CORE-Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy; Laboratory of Clinical Epidemiology of Diabetes and Chronic Diseases, Fondazione Mario Negri Sud, S. Maria Imbaro (CH), Italy. 3. Department of Medical Education, University of Michigan Medical School, Ann Arbor, MI, USA. 4. Laboratory of Clinical Epidemiology of Diabetes and Chronic Diseases, Fondazione Mario Negri Sud, S. Maria Imbaro (CH), Italy; S.S.D. Diabetologia, Niguarda Ca' Granda Hospital, Milan, Italy. 5. NovoNordisk SpA, Rome, Rome, Italy. 6. Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy. 7. NovoNordisk A/S, Bagsvaerd, Denmark. 8. Diabetes Unit, Madonna del Soccorso Hospital, San Benedetto del Tronto, Italy.
Abstract
OBJECTIVE: We evaluated empowerment in T2DM and identified its correlates. METHODS: A sample of individuals self-administered the Diabetes Empowerment Scale-Short Form (DES-SF) and other 9 validated instruments (person-centered outcomes). Correlates of DES-SF were identified through univariate and multivariate analyses. For person-centered outcomes, ORs express the likelihood of being in upper quartile of DES-SF (Q4) by 5 units of the scale. RESULTS: Overall, 2390 individuals were involved. Individuals in Q4 were younger, more often males, had higher levels of school education, lower HbA1c levels and prevalence of complications as compared to individuals in the other quartiles. The likelihood of being in Q4 was directly associated with higher selfreported self-monitoring of blood glucose (SDSCA6-SMBG) (OR=1.09; 95% CI: 1.03-1.15), higher satisfaction with diabetes treatment (GSDT) (OR=1.15; 95% CI: 1.07-1.25), perceived quality of chronic illness care and patient support (PACIC-SF) (OR=1.23; 95% CI: 1.16-1.31), and better person-centered communication (HCC-SF) (OR=1.10; 95% CI: 1.01-1.19) and inversely associated with diabetes-related distress (PAID-5) (OR=0.95; 95% CI: 0.92-0.98). Adjusted DES-SF mean scores ranged between centers from 69.8 to 93.6 (intra-class correlation=0.10; p<0.0001). CONCLUSIONS: Empowerment was associated with better glycemic control, psychosocial functioning and perceived access to person-centered chronic illness care. Practice of diabetes center plays a specific role. PRACTICE IMPLICATIONS: DES-SF represents a process and outcome indicator in the practice of diabetes centers.
OBJECTIVE: We evaluated empowerment in T2DM and identified its correlates. METHODS: A sample of individuals self-administered the Diabetes Empowerment Scale-Short Form (DES-SF) and other 9 validated instruments (person-centered outcomes). Correlates of DES-SF were identified through univariate and multivariate analyses. For person-centered outcomes, ORs express the likelihood of being in upper quartile of DES-SF (Q4) by 5 units of the scale. RESULTS: Overall, 2390 individuals were involved. Individuals in Q4 were younger, more often males, had higher levels of school education, lower HbA1c levels and prevalence of complications as compared to individuals in the other quartiles. The likelihood of being in Q4 was directly associated with higher selfreported self-monitoring of blood glucose (SDSCA6-SMBG) (OR=1.09; 95% CI: 1.03-1.15), higher satisfaction with diabetes treatment (GSDT) (OR=1.15; 95% CI: 1.07-1.25), perceived quality of chronic illness care and patient support (PACIC-SF) (OR=1.23; 95% CI: 1.16-1.31), and better person-centered communication (HCC-SF) (OR=1.10; 95% CI: 1.01-1.19) and inversely associated with diabetes-related distress (PAID-5) (OR=0.95; 95% CI: 0.92-0.98). Adjusted DES-SF mean scores ranged between centers from 69.8 to 93.6 (intra-class correlation=0.10; p<0.0001). CONCLUSIONS: Empowerment was associated with better glycemic control, psychosocial functioning and perceived access to person-centered chronic illness care. Practice of diabetes center plays a specific role. PRACTICE IMPLICATIONS: DES-SF represents a process and outcome indicator in the practice of diabetes centers.
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Authors: Maria Chiara Rossi; Giuseppe Lucisano; Basilio Pintaudi; Angela Bulotta; Sandro Gentile; Marco Scardapane; Soren Eik Skovlund; Giacomo Vespasiani; Antonio Nicolucci Journal: Health Qual Life Outcomes Date: 2017-02-21 Impact factor: 3.186