Yau-Jiunn Lee1, Shyi-Jang Shin2, Ruey-Hsia Wang3, Kun-Der Lin4, Yu-Li Lee5, Yi-Hsien Wang6. 1. Lee's Endocrinology Clinic, Pingtung, Taiwan. Electronic address: t3275@ms25.hinet.net. 2. Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. Electronic address: sjshin@kmu.edu.tw. 3. College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan. Electronic address: wrhsia@kmu.edu.tw. 4. Division of Endocrinology and Metabolism, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan. Electronic address: 890073@ms.kmuh.ors.tw. 5. Division of Endocrinology and Metabolism, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan. Electronic address: jangirl1112@yahoo.com.tw. 6. Research Center for Nonlinear Analysis and Optimization, Kaohsiung Medical University, Kaohsiung, Taiwan. Electronic address: feynmanw@gmail.com.
Abstract
OBJECTIVE: To validate a hypothesized model exploring the influencing pathways of empowerment perceptions, health literacy, self-efficacy, and self-care behaviors to glycosylated hemoglobin (HbA1c) levels in patients with type 2 diabetes (T2DM). METHODS: Overall, 295 patients with T2DM were recruited from five endocrine clinics in Taiwan through convenience sampling. Data regarding personal characteristics, empowerment perceptions, health literacy, self-efficacy, self-care behaviors, and HbA1c levels were collected. A structural equation modeling was used to validate the hypothesized model. RESULTS: Significant direct pathways were determined from empowerment perceptions to health literacy, from health literacy to self-efficacy, from self-efficacy to self-care behaviors, and from self-care behaviors to HbA1c levels. CONCLUSIONS: The empowerment perceptions and health literacy relatively influenced self-efficacy and self-care behaviors. Self-efficacy and self-care behaviors relatively influenced glycemic control in patients with T2DM. PRACTICE IMPLICATIONS: Modifying self-care behaviors have been demonstrated to be the most essential for improving glycemic control. To improve self-care behaviors, healthcare providers should target improving self-efficacy, and enhancing health literacy can be considered to be a potential strategy for improving self-efficacy. To enhance health literacy, healthcare providers could use an empowerment approach rather than an authoritative approach that emphasizes patient compliance in managing patients with T2DM.
OBJECTIVE: To validate a hypothesized model exploring the influencing pathways of empowerment perceptions, health literacy, self-efficacy, and self-care behaviors to glycosylated hemoglobin (HbA1c) levels in patients with type 2 diabetes (T2DM). METHODS: Overall, 295 patients with T2DM were recruited from five endocrine clinics in Taiwan through convenience sampling. Data regarding personal characteristics, empowerment perceptions, health literacy, self-efficacy, self-care behaviors, and HbA1c levels were collected. A structural equation modeling was used to validate the hypothesized model. RESULTS: Significant direct pathways were determined from empowerment perceptions to health literacy, from health literacy to self-efficacy, from self-efficacy to self-care behaviors, and from self-care behaviors to HbA1c levels. CONCLUSIONS: The empowerment perceptions and health literacy relatively influenced self-efficacy and self-care behaviors. Self-efficacy and self-care behaviors relatively influenced glycemic control in patients with T2DM. PRACTICE IMPLICATIONS: Modifying self-care behaviors have been demonstrated to be the most essential for improving glycemic control. To improve self-care behaviors, healthcare providers should target improving self-efficacy, and enhancing health literacy can be considered to be a potential strategy for improving self-efficacy. To enhance health literacy, healthcare providers could use an empowerment approach rather than an authoritative approach that emphasizes patient compliance in managing patients with T2DM.
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