Substantial effects of empowerment case management on physical health of type 2 diabetic patients

Abstract

Aims and objectives: To evaluate the effects of empowerment case management on the physical health of patients with type 2 diabetes.

Background: Diabetes is a global health issue. Case management is often used on diabetes management at various levels. Empowerment has been used for chronic situation management, but its effects have not been widely studied in diabetic populations.

Design: Purposive sampling was used to recruit 125 participants with type 2 diabetes aged 18 years or older from a regional teaching hospital in Taiwan.

Methods: Empowerment case management was applied for 42 participants, while the other 83 received normal case management. Survey items included demographics, preprandial (AC) and postprandial (PC) blood sugar levels, glycated haemoglobin (HbA1C), systolic and diastolic blood pressure, total cholesterol, and the presence or absence of acute and chronic complications. Descriptive statistics and a generalised estimating equation were used to analyse the model's effects on the two groups.

Results: The PC blood sugar levels of patients receiving empowerment case management declined at 3 months (B = -34.26, p < .01), and this decrease was maintained at 6 months (B = -83.66, p < .001). As of 6 months after starting the intervention, patients receiving empowerment case management enjoyed better physical health. These patients' AC blood sugar levels (B = -50.16, p < .001), HbA1C (B = -0.98, p < .001), systolic blood pressure (B = -8.24, p < .001), diastolic blood pressure (B = -5.73, p < .01) and total cholesterol (B = -13.74, p < .05) all experienced a continuous drop and were controlled well, and no diabetes-related acute or chronic complications were observed either. Patients with type 2 diabetes who received empowerment case management managed their physical health better. Moreover, its greatest effect was that patients were able to form exercise groups and continue to maintain their health.

Conclusions: Empowerment case management was shown to have a substantial effect on the physical health and self-care of patients with diabetes, thus making it a suitable intervention tool for managing diabetes cases.

Relevance to clinical practice: The study results showed that empowerment case management is suitable for managing diabetes cases. It has a substantial effect on the maintenance of physical health, occurrence of complications and effectiveness of self-care among patients with diabetes. For better care outcomes, empowerment case management should be integrated into the guidelines of diabetes management.

Keywords: case management; empowerment; patient with diabetes; physical health; type 2 diabetes.