title: Development of a novel, short, self-completed questionnaire on empowerment for patients with type 2 diabetes mellitus and an analysis of factors affecting patient empowerment.
abstract: BACKGROUND
  Patient empowerment has recently been proposed as an important concept in self-management for effective glycemic control. A concise self-completed questionnaire for patients with type 2 diabetes mellitus was created to comprehensively evaluate their empowerment on the basis of self-managed dietary/exercise behaviors, psychological impact, and family support. The reliability and validity of this short questionnaire were tested and factors relating to patient empowerment were analyzed.
  
  
  METHODS
  The self-completed empowerment questionnaire was based on questionnaires for self-managed dietary and exercise behaviors, the Appraisal of Diabetes Scale, and the Diabetes Family Behavior Checklist. The questionnaire was trialed on 338 male and female patients with type 2 diabetes mellitus who lived with family. The validity and reliability of the questionnaire were investigated and stepwise multiple linear regression analysis was used to identify factors that affect patient empowerment.
  
  
  RESULTS
  The self-completed patient empowerment questionnaire included 13 questions on background data (e.g., age, gender, and HbA1c) and 18 questions within five scales to assess self-managed dietary behaviors, self-managed exercise behaviors, and psychological impact of diabetes, as well as positive and negative feedback in patient-family communication. The questionnaire showed sufficient internal consistency, construct validity, reproducibility, factorial construct validity, and concurrent validity. The results were generally satisfactory, and the questionnaire reflected the particular characteristics of treatment methods. Multiple linear regression analysis showed that patient empowerment was strongly affected by the number of disease-related symptoms, age, and gender.
  
  
  CONCLUSIONS
  The results suggest that the concise self-completed empowerment questionnaire developed here is useful for measuring the empowerment of individual patients and evaluating the impact of symptoms and therapies on empowerment.
authors.affiliation: School of Nursing, Kurume University, Higashikushiharamachi 777-1, Kurume, Fukuoka 830-0003, Japan.
authors.forename: Yoriko
authors.initials: Y
authors.lastname: Hara
authors.affiliation: Chidoribashibyouin Sue Clinic, Fukuoka, Japan.
authors.forename: Sanae
authors.initials: S
authors.lastname: Iwashita
authors.affiliation: Okada Clinic, Fukuoka, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Okada
authors.affiliation: Department of Endocrinology and Metabolism, School of Medicine, Kurume University, Fukuoka, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Tajiri
authors.affiliation: Department of Endocrinology and Metabolism, School of Medicine, Kurume University, Fukuoka, Japan.
authors.forename: Hitomi
authors.initials: H
authors.lastname: Nakayama
authors.affiliation: Department of Endocrinology and Metabolism, School of Medicine, Kurume University, Fukuoka, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Kato
authors.affiliation: Department of Public Health, School of Medicine, Kurume University, Fukuoka, Japan.
authors.forename: Motoyuki
authors.initials: M
authors.lastname: Nakao
authors.affiliation: Department of Psychosomatic Medicine, School of Medicine, Toho University, Tokyo, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Tsuboi
authors.affiliation: Department of Medical Education, Tokyo Medical University, Tokyo, Japan.
authors.forename: Raoul
authors.initials: R
authors.lastname: Breugelmans
authors.affiliation: Department of Public Health, School of Medicine, Kurume University, Fukuoka, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Ishihara
keywords: Appraisal of diabetes scale; Diabetes family behavior checklist; Empowerment questionnaire; Self-managed behavior; Type 2 diabetes mellitus