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Abstract：
Rising prevalence of type 2 diabetes (T2D), also among younger adults, constitutes a growing public health challenge. According to the person-centred Chronic Care Model, proactive care and self-management support in combination with community resources enhance quality of healthcare and health outcomes for patients with T2D. However, research is scarce concerning the importance of person-centred care and community resources for such outcomes as empowerment, and the relative impact of various patient support sources for empowerment is not known. Moreover, little is known about the association of age with these variables in this patient-group. This study, carried out among patients with T2D, examined in three age-groups (27-54, 55-64 and 65-75 years) whether person-centred care and diabetes-related social support, including community support and possibilities to influence community health issues, are associated with patient empowerment, when considering possible confounding factors, such as other quality of care indicators and psychosocial wellbeing. We also explored age differentials in empowerment and in the proposed correlates of empowerment.
Individuals from a register-based sample with T2D participated in a cross-sectional survey (participation 56%, n = 2866). Data were analysed by descriptive statistics and multivariate logistic regression analyses.
Respondents in the youngest age-group were more likely to have low empowerment scores, less continuity of care, and lower wellbeing than the other age-groups, and to perceive less social support, but a higher level of person-centred care than the oldest group. Community support, including possibilities to influence community health issues, was independently and consistently associated with high empowerment in all three age-groups, as was person-centred care in the two older age-groups. Community support was the social support variable with the strongest association with empowerment across age-groups. Moreover, vitality was positively and diabetes-related distress negatively associated with high empowerment in all age-groups, whereas continuity of care, i.e. having a family/regular nurse, was independently associated in the youngest age-group only.
Person-centred care and community support, including possibilities to influence community health issues, supports empowerment among adults with T2D. Findings suggest that age is related to most correlates of empowerment, and that younger adults with T2D have specific healthcare needs.
Individuals from a register-based sample with T2D participated in a cross-sectional survey (participation 56%, n = 2866). Data were analysed by descriptive statistics and multivariate logistic regression analyses.
Respondents in the youngest age-group were more likely to have low empowerment scores, less continuity of care, and lower wellbeing than the other age-groups, and to perceive less social support, but a higher level of person-centred care than the oldest group. Community support, including possibilities to influence community health issues, was independently and consistently associated with high empowerment in all three age-groups, as was person-centred care in the two older age-groups. Community support was the social support variable with the strongest association with empowerment across age-groups. Moreover, vitality was positively and diabetes-related distress negatively associated with high empowerment in all age-groups, whereas continuity of care, i.e. having a family/regular nurse, was independently associated in the youngest age-group only.
Person-centred care and community support, including possibilities to influence community health issues, supports empowerment among adults with T2D. Findings suggest that age is related to most correlates of empowerment, and that younger adults with T2D have specific healthcare needs.
摘要：
2型糖尿病（T2D）患病率上升，在年轻人中，构成了日益严重的公共卫生挑战。根据以人为本的慢性护理模式，前瞻性护理和自我管理支持与社区资源相结合，可提高T2D患者的医疗保健质量和健康结果。然而,关于以人为本的护理和社区资源对赋权等成果的重要性的研究很少，各种患者支持来源对赋权的相对影响尚不清楚。此外，在该患者组中,对年龄与这些变量的关联知之甚少.这项研究,在T2D患者中进行，在三个年龄组（27-54岁，55-64岁和65-75岁）中检查了以人为中心的护理和与糖尿病相关的社会支持，包括社区支持和影响社区健康问题的可能性，与患者赋权有关，当考虑可能的混杂因素时，如其他护理质量指标和社会心理健康。我们还探讨了赋权和拟议的赋权相关方面的年龄差异。
来自基于登记的T2D样本的个人参与了一项横断面调查(参与56%，n=2866）。通过描述性统计和多变量逻辑回归分析对数据进行分析。
最年轻年龄组的受访者更有可能获得较低的赋权分数，护理的连续性较差，幸福感低于其他年龄组，感知更少的社会支持，但以人为本的护理水平高于年龄最大的群体。社区支持,包括影响社区健康问题的可能性，在所有三个年龄组中，独立且一致地与高赋权相关，在两个年龄较大的年龄组中，以人为本的护理也是如此。社区支持是社会支持变量，与各年龄组的赋权关系最强。此外，在所有年龄组中，活力呈正相关，糖尿病相关的痛苦与高赋权呈负相关，而护理的连续性，即有一个家庭/正规护士，仅在最年轻的年龄组中独立相关。
以人为本的护理和社区支持，包括影响社区健康问题的可能性，支持T2D成年人的赋权。研究结果表明，年龄与赋权的大多数相关性有关，并且患有T2D的年轻成年人有特定的医疗保健需求。
来自基于登记的T2D样本的个人参与了一项横断面调查(参与56%，n=2866）。通过描述性统计和多变量逻辑回归分析对数据进行分析。
最年轻年龄组的受访者更有可能获得较低的赋权分数，护理的连续性较差，幸福感低于其他年龄组，感知更少的社会支持，但以人为本的护理水平高于年龄最大的群体。社区支持,包括影响社区健康问题的可能性，在所有三个年龄组中，独立且一致地与高赋权相关，在两个年龄较大的年龄组中，以人为本的护理也是如此。社区支持是社会支持变量，与各年龄组的赋权关系最强。此外，在所有年龄组中，活力呈正相关，糖尿病相关的痛苦与高赋权呈负相关，而护理的连续性，即有一个家庭/正规护士，仅在最年轻的年龄组中独立相关。
以人为本的护理和社区支持，包括影响社区健康问题的可能性，支持T2D成年人的赋权。研究结果表明，年龄与赋权的大多数相关性有关，并且患有T2D的年轻成年人有特定的医疗保健需求。
