Date of Graduation

1997

Document Type

Dissertation/Thesis

Abstract

The overall goal of the study was to assess the characteristics of empowered type II diabetes patients and delineate an operational definition of empowerment. In addition, the study explored the role of empowerment on diabetes self-management, quality of life, and selected health resource utilization of these patients. The study was conducted in two phases. In Phase I, "empowerment" was operationalized into two domains: "first stage" and "second stage." Additionally, it was found that these two domains had three subdomains each. The "first stage" of empowerment subdomains were: (i) instrumental beliefs, (ii) outcome expectancy, and (iii) perceived self-efficacy; while the "second stage" of empowerment subdomains were (i) motivation, (ii) communication assertiveness, and (iii) knowledge. The 106 item Characteristics of Empowerment (CEPS) scale that was developed to measure the subdomains had a content validity index of 0.86. In Phase II, a total of 854 type II diabetes patients from two sampling sources in West Virginia were surveyed. A total of 337 completed responses (42.71%) were obtained out of a total of 789 good addresses. Confirmatory factor analysis of the developed measurement models indicated that all items measuring the latent constructs in the CEPS and QOL scale were valid. Subsequently, a causal model was used to explore relationships among empowerment characteristics, diabetes self-management, quality of life, and health resource utilization. While "first stage" of empowerment influenced diabetes self-management directly (r = {dollar}-{dollar}.102, p {dollar}\\le{dollar} 0.05) and also indirectly through "second stage" of empowerment (r = 0.749, p {dollar}\\le{dollar} 0.05). Both stages of empowerment together explained 43.5% of the variance in diabetes self-management (p {dollar}\\le{dollar} 0.05). Also, people who manage diabetes better reported having a higher level of empowerment characteristics. Furthermore, both diabetes self-management and empowerment characteristics had no significant influence on quality of life and health resource utilization. Overall, the study provided an operational definition of "empowerment" through the development and validation of CEPS. Results of this study may be useful for the development of empowerment strategies in future.

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