Empowerment of patients with type 2 diabetes: current perspectives

Figures & data

Table 1 Behavior change models

Model	Description
Health beliefs	It is important to evaluate the grade of perception about sickness. This will determine the success or failure of the treatment. The perception about diabetes is different, and fear is a main barrier to obtain the necessary knowledge to reach glucose control and prevent complications.
Perceived self-efficacy	Bandura et al defined self-efficacy such as “people’s beliefs about their capabilities to exercise control over their own level of functioning and over events that affect their lives”.
Locus of control theory	This theory helps to explain the results and consequences by three factors: 1) internal locus of control (personal effort); 2) external locus of control (social environment and health professionals); and 3) orientation by change or by luck.
Cognitive theory (Prochaska)	This theory proposes five stages of motivation that the person experiences to achieve change: 1) pre-contemplation; 2) contemplation; 3) preparation; 4) action; and 5) maintenance.
Empowerment	The aim of this model is promote self-care developing the innate capacity of responsibility; in other words, to have an active participation in each process of care. The principal tools in empowerment is education and motivation.

Table 2 Outcomes positively impacted by self-management interventions based on empowerment

HbA1c
Total cholesterol
LDL-cholesterol
HDL-cholesterol
Systolic and diastolic blood pressure
Weight
Body mass index
Waist circumference
Self-care practices: 1) healthy nutritional choices; 2) consuming fruits and vegetables; 3) physical activity; 4) monitoring self-glucose; and 5) inspecting feet
Quality of life
Prevention of acute health crisis
Psychosocial functioning
Perceived health status
Satisfaction with care

Figure 1 Proposed algorithm of empowerment. Algorithm proposal where the protagonist is the active participation of the patient. Starting with the identification of the characteristics of the patient’s environment, the stage in which the patient is in terms of acceptance of the disease, the knowledge about the care that the patient must have to control T2D, and the identification of doubts and/or barriers to be able to direct them with the corresponding health professional. It is intended that the patient’s active participation is the center of the management, with the support of their social environment (family, friends, and work). Between the educator and the patient, they must establish goals, and follow-up on their control. The role of the educator is to serve as a guide for their maintenance and/or support in a day-to-day basis.

Table 3 Health professional and patient roles

Health professional	Patient
The health professional functions as guide and support for the patient to: Help identifying problems Help managing his/her diabetes Help establishing goals Help resolving problems related to their chronic disease Support to make informed decisions	The patient is responsible for: Identifying strengths and barriers to reach goals Prioritizing goals Have an active participation for achieving control and improving quality of life Evaluating and analyzing the management plan with the health professional