title: Impact of empowerment on toothbrushing and diabetes management.
abstract: OBJECTIVE
  To assess the impact of empowerment (health coaching, HC) on toothbrushing self-efficacy (TBSE) and toothbrushing frequency (TB) and their effects on diabetes management (HbA1c, physical activity) and quality of life in comparison to health education (HE) among patients with diabetes type 2 (DM2).
  
  
  METHODS
  The data (HbA1c [glycated haemoglobin], TB, physical activity, TBSE, quality of life) were collected at baseline and at post-intervention at outpatient clinics of two hospitals in Istanbul, Turkey. Participants were allocated randomly to HC (n = 77) and HE (n = 109) groups.
  
  
  RESULTS
  At baseline, there were no statistical differences between HC and HE groups in terms of all measures (P > 0.05). At post-intervention, there was improvement in oral health- and diabetes-related variables in the HC group, whereas only TBSE and TB slightly improved in the HE group (P < 0.05). At post-intervention among patients brushing their teeth at least once a day, HC group patients were more likely to be physically active and to have high self-efficacy than those in HE group (P < 0.01). TBSE was correlated with favourable HbA1c levels (< 6.5%) in the HC group and quality of life (P < 0.05) in both groups.
  
  
  CONCLUSIONS
  The findings show that HC-based empowerment towards improving self-efficacy is more effective at improving toothbrushing behaviour than is HE and that interaction contributes significantly to diabetes management in terms of reduced HbA1c, increased physical activity and quality of life. TBSE can be a practical starting point for empowerment and toothbrushing can be used as an effective and practical behaviour to observe personal success in diabetes management.
authors.forename: Ayse Basak
authors.initials: AB
authors.lastname: Cinar
authors.forename: Lone
authors.initials: L
authors.lastname: Schou
mesh_terms: D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control* / Q000523:psychology; D037001:Directive Counseling; D015444:Exercise; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D015438:Health Behavior; D006267:Health Education, Dental; D006801:Humans; D008875:Middle Aged; D010358:Patient Participation; D011209:Power, Psychological; D011788:Quality of Life; D020377:Self Efficacy; D014099:Toothbrushing / Q000523:psychology* / Q000706:statistics & numerical data
chemical_list: D006442:Glycated Hemoglobin