Modeling patient empowerment and health literacy to glycemic control in insulin-treated patients: A prospective study. Issue 7 (July 2019)

• Record Type: Journal Article
• Authors: Wang, Ruey-Hsia; Hsu, Hui-Chun; Chen, Shi-Yu; Hsieh, Chang-Hsun; Lee, Yau-Jiunn
• Is Part Of: Patient education and counseling. Volume 102:Issue 7(2019)
• Page Start: 1336
• Page End: 1341
• Publication Date: 2019-07
• Subjects: Insulin-treated -- Patient empowerment -- Health literacy -- Glycemic control; Patient education -- Periodicals; Health counseling -- Periodicals; Health education -- Periodicals; Counseling -- Periodicals; Patient Education -- Periodicals; Éducation des patients -- Périodiques; Counseling -- Périodiques; Éducation sanitaire -- Périodiques; 615.5071
• DOI: 10.1016/j.pec.2019.02.005
• Languages: English
• ISSNs: 0738-3991

Abstract

Highlights: Functional health literacy was not an important health literacy. Patient empowerment was significantly associated with communicative health literacy. Patient empowerment was significantly associated with critical health literacy. Patient empowerment directly affected concurrent health literacy. Health literacy directly affected concurrent glycosylated hemoglobin levels. Abstract: Objective: To model the pathways of patient empowerment (PE) and health literacy (HL) to glycemic control specific to insulin-treated patients by prospective design. Methods: Insulin-treated patients with type 2 diabetes (T2DM) (N = 185) were recruited by convenience sampling. Data of personal characteristics, PE, and HL were collected by questionnaires at baseline and 9 months later. The 9-month glycosylated hemoglobin (HbA1c) levels of each participant were collected from medical records. Structural equation modeling was used to test a hypothesized model. Results: Baseline and 9-month communicative HL and critical HL significantly and negatively correlated with 9-month HbA1c levels. Structural equation modeling supported that baseline and 9-month PE significantly affected HL at corresponding time points. Baseline PE indirectly affected 9-month HL through 9-month PE. The 9-month HL directly affected 9-month HbA1c. Baseline HL indirectly affected 9-month HbA1c through 9-month HL. Conclusion: Communicative HL and critical HL rather than functional HL were crucial in improving glycemic control. PE is essential to improve HL in insulin-treated patients. Practice Implications: Healthcare providers could apply the empowerment approach to educate insulin-treated patients. Through reciprocal dynamic process of PE, insulin-treated patients with T2DM might improve their communicative and critical HL; and finally, glycemic control could be improved.