Analyzing the Impact of Empowerment Model-based Education on Self-efficacy and Self-esteem of Patients with Diabetes

Aims: Traditional education fails to effectively treat patients with chronic diseases. Therefore, educating patients through a more comprehensive approach is required to encourage patients to actively participate in the management of the chronic disease. Empowering the patient is considered as a program for self-care and a change in behavior while caring the diabetics. Self-efficacy and self-esteem are the most important components of empowerment. The rise in self-efficacy and self-esteem has been effective in diabetes care improvement. The current study was conducted to determine the effects of empowerment-based education on self-efficacy and self-esteem in diabetic patients referred to diabetes clinic.

Methodology: This is an interventional study of a randomized clinical trial control type. In this study, 90 diabetic patients were randomly selected and divided into two case and control groups according to the random numbers table. Data collection was carried out by demographic information questionnaire and self-efficacy questionnaire (20 questions) and Cooper Smith's self-esteem questionnaire (35 questions) with Cronbach's alpha coefficients of respectively 94.3% and 93% before training for both Case and Control groups. Then, for the case group, training was performed based on the empowerment model and the control group received the only common care in the diabetes clinic. Six weeks after the intervention, self-efficacy and self-esteem were measured again by Cooper Smith's adult self-esteem questionnaire and diabetes' self-efficacy. Data were analyzed by SPSS 19 software using Chi-square, and T-plus statistic tests.

Results: The two groups were matched in terms of demographic characteristics and mean scores of self-esteem and self-efficacy before intervention, and there was no significant difference between them, but after intervention, the findings showed that the mean score of patients' self-esteem in the case group has been 83.24 before training the empowerment model and it increased to 111.69 (P = 0.000) after implementing empowerment training. Also, the mean score of self-efficacy of patients in the case group before the empowerment model was 100.49, which increased to 139.49 after training (P = 0.000). The findings showed a significant difference between the mean self-esteem (P = 0.000) and self-efficacy (P = 0.000) of patients in the case group before and after the training. However, there was no significant difference in the control group before and after training, so educating patients about empowerment model could increase self-esteem and self-efficacy in diabetic patients.

Conclusion: Empowerment model-based education has increased self-esteem and self-efficacy in diabetic patients. According to the findings of this research, it seems that empowerment is feasible for patients with diabetes and it is associated with improvement of self-efficacy and self-esteem in patients.