Effectiveness of Empowerment Education in Patients with Type 2 Diabetes Mellitus: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

LAN Xuefen ¹ ,  YIN Zhiqin ¹ , NING Xiangxiang ² , ZANG Yuantong ¹ , CHEN Xiaolin ¹

1. School of Nursing, Wenzhou Medical University, Wenzhou 325000, China;2. School of Nursing, Ningbo Health Vocational Technical College, Ningbo 315100, China;

Corresponding author：

YIN Zhiqin, Email: yzq@wzmc.edu.cn

Keywords：

Type 2 diabetes mellitus; Empowerment education; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20130250

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective 　To systematically review the effectiveness of empowerment education in patients with type 2 diabetes.
Methods 　Databases including The Cochrane Library (Issue 12, 2012), PubMed, Ovid, EMbase, Web of Science, CNKI, WanFang Data, VIP, CBM, digital journals of the Chinese Medical Association and Google Scholar were electronically searched for the randomized controlled trials (RCTs) on empowerment education in patients with type 2 diabetes from inception to January 2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality. Then, meta-analysis was performed using RevMan 5.2 software.
Results 　A total of seven RCTs involving 749 Type 2 diabetic patients were finally included. The results of meta-analysis showed that, compared with the control group, the empowerment education group was better in decreasing HbA1c levels, with a significant difference (MD= –0.27, 95%CI –0.51 to –0.03, P=0.03), but no significant difference was found between the two groups in improving body mass index (BMI) (MD= 0.25, 95%CI –1.07 to 1.57, P=0.71).
Conclusion 　The program of empowerment education could improve HbA1c levels of diabetic patients, patients’ knowledge and illness attitudes on diabetes mellitus, but its influence on patients’ BMI, LDL and self-efficacy is still unclear.

Citation： LAN Xuefen,YIN Zhiqin,NING Xiangxiang,ZANG Yuantong,CHEN Xiaolin. Effectiveness of Empowerment Education in Patients with Type 2 Diabetes Mellitus: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2013, 13(12): 1463-1469. doi: 10.7507/1672-2531.20130250 Copy

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7.	Anderson RM, Fitzgerald J, Gruppen LD, et al. The diabetes empowerment scale-short form (DES-SF). Diabetes Care, 2003, 5(26): 1641-1643.
8.	Isabelle A, William H, Alain D. Patient empowerment in theory and practice: Polysemy or cacophony? Patient Education and Counseling, 2007, 66(1): 13-20.
9.	Tang TS, Gillard ML, Funnell MM, et al. Developing a new generation of ongoing diabetes self-management support interventions:a preliminary report. Diabetes Education, 2005, 31(1): 91-97.
10.	牟利宁, 王克芳, 王淑芳, 等. 运用授权理论对糖尿病糖调节受损患者实行行为改变的研究. 中国实用护理杂志, 2008, 24(25): 20-22.
11.	Spencer MS, Rosland AM, Kieffer EC, et al. Effectiveness of a Community Health Worker Intervention Among African American and Latino Adults With Type 2 Diabetes: A Randomized Controlled Trial. Am J Public Health, 2011, 101(12): 2253-2260.
12.	叶会玲. 授权理论在社区2型糖尿病老年患者教育中的应用. 中华护理杂志, 2011, 46(3): 223-236.
13.	Adolfsson ET, Walker-Engstrom ML, Smide B, et al. Patient education in type 2 diabetes - A randomized controlled 1-year follow-up study. Diabetes Research and Clinical Practice, 2007, 76(3): 341-350.
14.	Cooper H, Booth K, Gill G, et al. A trial of empowerment-based education in type 2 diabetes-Global rather than glycaemic benefits. Diabetes Research and Clinical Practice, 2008, 82(2): 165-171.
15.	Naik AD, Palmer N, Petersen NJ, et al. Comparative effectiveness of goal setting in diabetes mellitus group clinics: randomized clinical trial. Arch Intern Med, 2011, 171(5): 453-459.
16.	Anderson RM, Funnell MM, Nwankwo R, et al. Evaluating a problem-based empowerment program for African Americans with diabetes: results of a randomized controlled trial. Ethnicity and Disease, 2005, 15(4): 671-678.
17.	Anderson RM, Funnell MM, Butler PM, et al. Patient empowerment. Results of a randomized controlled trial. Diabetes Care, 1995, 18(7): 943-949.
18.	Higgins JPT, Green S (editors). Cochrance Handbook for Systematic Reviews of Interventions Version 5.1.0[updated March 2011]. The Cochrane Collaboration, 2011. Available from: www.cochrane-handbook.org.
19.	Fazekas C, Semlitsch B, Pieringer W. Empowerment in diabetes mellitus: theory and practice. Wiener Medizinische Wochenschrift, 2003, 153(21-22): 459-463.
20.	Funnell MM, Brown TL, Childs BP, et al. National Standards for Diabetes Self-Management Education. Diabetes Care, 2008, 31(1): S97-S99.
21.	牟利宁. 授权教育在糖尿病健康教育中的研究进展. 中华护理杂志, 2010, 45(4): 372-374.
22.	刘家红, 郑显兰, 郭蓉, 等. 健康教育路径对住院糖尿病患者疗效影响的Meta分析. 中国全科医学, 2011, 14(2A): 431-434.
23.	Pibernik-Okanovic M, Prasek M, Poljicanin-Filipovic T, et al. Effects of an empowerment-based psychosocial intervention on quality of life and metabolic control in type 2 diabetic patients. Patient Education and Counseling, 2004, 52(2): 193-199.
24.	Shearer A, Bagust A, Sanderson D, et al. Cost‐effectiveness of flexible intensive insulin management to enable dietary freedom in people with Type 1 diabetes in the UK. Diabetic Medicine, 2004, 5(21): 460-475.
25.	胡贝贝, 楼青青, 田园, 等. 住院糖尿病患者授权能力及影响因素分析, 中华护理杂志, 2011, 46(3): 225-227.

1. 马尔蒂尼, 主编. 内分泌百科全书, 第四分册-糖尿病. 北京: 科学出版社, 2008: 32.
2. 卫生部疾病控制司, 中华医学会糖尿病分学会. 中国糖尿病防治指南(试行本)(节选), 2009, 17: 331-333.
3. 王文娟. 我国糖尿病的防控策略: 抓住关键环节预防为主防治结合. 中国慢性病预防与控制, 2004, 12(6): 283.
4. 中国糖尿病防治指南编写组. 中国糖尿病防治指南. 北京: 北京大学医学出版社, 2004: 10.
5. 叶会玲. 授权理论在糖尿病教育中的应用现状. 护理研究, 2010, 24(1): 97-100.
6. Funnell MM, Anderson RM. Empowerment and self-management of diabetes. Clinical Diabetes, 2004, 22( 3): 123-127.
7. Anderson RM, Fitzgerald J, Gruppen LD, et al. The diabetes empowerment scale-short form (DES-SF). Diabetes Care, 2003, 5(26): 1641-1643.
8. Isabelle A, William H, Alain D. Patient empowerment in theory and practice: Polysemy or cacophony? Patient Education and Counseling, 2007, 66(1): 13-20.
9. Tang TS, Gillard ML, Funnell MM, et al. Developing a new generation of ongoing diabetes self-management support interventions:a preliminary report. Diabetes Education, 2005, 31(1): 91-97.
10. 牟利宁, 王克芳, 王淑芳, 等. 运用授权理论对糖尿病糖调节受损患者实行行为改变的研究. 中国实用护理杂志, 2008, 24(25): 20-22.
11. Spencer MS, Rosland AM, Kieffer EC, et al. Effectiveness of a Community Health Worker Intervention Among African American and Latino Adults With Type 2 Diabetes: A Randomized Controlled Trial. Am J Public Health, 2011, 101(12): 2253-2260.
12. 叶会玲. 授权理论在社区2型糖尿病老年患者教育中的应用. 中华护理杂志, 2011, 46(3): 223-236.
13. Adolfsson ET, Walker-Engstrom ML, Smide B, et al. Patient education in type 2 diabetes - A randomized controlled 1-year follow-up study. Diabetes Research and Clinical Practice, 2007, 76(3): 341-350.
14. Cooper H, Booth K, Gill G, et al. A trial of empowerment-based education in type 2 diabetes-Global rather than glycaemic benefits. Diabetes Research and Clinical Practice, 2008, 82(2): 165-171.
15. Naik AD, Palmer N, Petersen NJ, et al. Comparative effectiveness of goal setting in diabetes mellitus group clinics: randomized clinical trial. Arch Intern Med, 2011, 171(5): 453-459.
16. Anderson RM, Funnell MM, Nwankwo R, et al. Evaluating a problem-based empowerment program for African Americans with diabetes: results of a randomized controlled trial. Ethnicity and Disease, 2005, 15(4): 671-678.
17. Anderson RM, Funnell MM, Butler PM, et al. Patient empowerment. Results of a randomized controlled trial. Diabetes Care, 1995, 18(7): 943-949.
18. Higgins JPT, Green S (editors). Cochrance Handbook for Systematic Reviews of Interventions Version 5.1.0[updated March 2011]. The Cochrane Collaboration, 2011. Available from: www.cochrane-handbook.org.
19. Fazekas C, Semlitsch B, Pieringer W. Empowerment in diabetes mellitus: theory and practice. Wiener Medizinische Wochenschrift, 2003, 153(21-22): 459-463.
20. Funnell MM, Brown TL, Childs BP, et al. National Standards for Diabetes Self-Management Education. Diabetes Care, 2008, 31(1): S97-S99.
21. 牟利宁. 授权教育在糖尿病健康教育中的研究进展. 中华护理杂志, 2010, 45(4): 372-374.
22. 刘家红, 郑显兰, 郭蓉, 等. 健康教育路径对住院糖尿病患者疗效影响的Meta分析. 中国全科医学, 2011, 14(2A): 431-434.
23. Pibernik-Okanovic M, Prasek M, Poljicanin-Filipovic T, et al. Effects of an empowerment-based psychosocial intervention on quality of life and metabolic control in type 2 diabetic patients. Patient Education and Counseling, 2004, 52(2): 193-199.
24. Shearer A, Bagust A, Sanderson D, et al. Cost‐effectiveness of flexible intensive insulin management to enable dietary freedom in people with Type 1 diabetes in the UK. Diabetic Medicine, 2004, 5(21): 460-475.
25. 胡贝贝, 楼青青, 田园, 等. 住院糖尿病患者授权能力及影响因素分析, 中华护理杂志, 2011, 46(3): 225-227.

Chinese Journal of Evidence-Based Medicine

Effectiveness of Empowerment Education in Patients with Type 2 Diabetes Mellitus: A Systematic Review

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