title: Patient empowerment interacts with health literacy to associate with subsequent self-management behaviors in patients with type 2 diabetes: A prospective study in Taiwan.
abstract: To examine association of interactions between patient empowerment (PE) and health literacy with 1-year-later self-management behaviors in patients with type 2 diabetes (T2DM).
  
  
  
  A prospective design was employed in this study. Overall, 395 patients with T2DM completed self-reported questionnaires at baseline and 1year later. A hierarchical multiple regression was used to identify the association of interactions between PE and health literacy at baseline with the 1-year-later self-management behaviors.
  
  
  
  Interactions between PE and communicative and critical health literacy (CCHL) at baseline significantly associated with the 1-year-later global self-management behaviors in patients with T2DM. Among the participants who exhibited high PE at baseline, the scores of 1-year-later global self-management behaviors of the participants with a high CCHL at baseline were significantly higher than those with a low CCHL at baseline. Nevertheless, among the participants who exhibited low PE at baseline, no significant differences were identified in the 1-year-later global self-management behaviors between the participants with high vs. low CCHL at baseline.
  
  
  
  PE may improve self-management behaviors in patients with high CCHL, but may prove useless in patients with low CCHL.
  
  
  
  Healthcare providers should ensure that patients with T2DM have adequate CCHL prior to empowering them.
authors.affiliation: College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan. Electronic address: wrhsia@kmu.edu.tw.
authors.forename: Ruey-Hsia
authors.initials: RH
authors.lastname: Wang
authors.affiliation: College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan; Lee's Endocrinology Clinic, Pingtung, Taiwan. Electronic address: huichun.hsu@leesclinic.org.
authors.forename: Hui-Chun
authors.initials: HC
authors.lastname: Hsu
authors.affiliation: Lee's Endocrinology Clinic, Pingtung, Taiwan. Electronic address: t3275@ms25.hinet.net.
authors.forename: Yau-Jiunn
authors.initials: YJ
authors.lastname: Lee
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. Electronic address: sjshin@kmu.edu.tw.
authors.forename: Shyi-Jang
authors.initials: SJ
authors.lastname: Shin
authors.affiliation: Division of Endocrinology and Metabolism, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan. Electronic address: 890073@ms.kmuh.ors.tw.
authors.forename: Kun-Der
authors.initials: KD
authors.lastname: Lin
authors.affiliation: Department of Medical Education, Beijing Ruijing Diabetes Hospital, Beijing, China. Electronic address: 962917477@qq.com.
authors.forename: Ling-Wang
authors.initials: LW
authors.lastname: An
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000523:psychology* / Q000628:therapy; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D011209:Power, Psychological; D011446:Prospective Studies; D012648:Self Care / Q000523:psychology*; D020377:Self Efficacy; D057566:Self Report; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013624:Taiwan
chemical_list: D001786:Blood Glucose
keywords: Health literacy; Patient empowerment; Self-management behaviors; Type 2 diabetes