Increased Patient Empowerment Is Associated with Improvement in Anxiety and Depression Symptoms in Type 2 Diabetes Mellitus: Findings from the INDICA Study

Andrea Duarte-Díaz, Himar González-Pacheco, Amado Rivero-Santana, Yolanda Ramallo-Fariña, Lilisbeth Perestelo-Pérez, Yolanda Álvarez-Pérez, Wenceslao Peñate, Carme Carrion, Pedro Serrano-Aguilar and on behalf of the INDICA Team
Additional contact information
Andrea Duarte-Díaz: Canary Islands Health Research Institute Foundation (FIISC), 38109 El Rosario, Spain
Himar González-Pacheco: Canary Islands Health Research Institute Foundation (FIISC), 38109 El Rosario, Spain
Amado Rivero-Santana: Canary Islands Health Research Institute Foundation (FIISC), 38109 El Rosario, Spain
Yolanda Ramallo-Fariña: Canary Islands Health Research Institute Foundation (FIISC), 38109 El Rosario, Spain
Lilisbeth Perestelo-Pérez: Research Network on Health Services in Chronic Diseases (REDISSEC), 38109 El Rosario, Spain
Yolanda Álvarez-Pérez: Canary Islands Health Research Institute Foundation (FIISC), 38109 El Rosario, Spain
Wenceslao Peñate: Department of Clinical Psychology, Psychobiology and Methodology, Universidad de La Laguna (ULL), 38200 San Cristóbal de La Laguna, Spain
Carme Carrion: eHealth Lab Research Group, School of Health Sciences, Universitat Oberta de Catalunya (UOC), 08035 Barcelona, Spain
Pedro Serrano-Aguilar: Research Network on Health Services in Chronic Diseases (REDISSEC), 38109 El Rosario, Spain
on behalf of the INDICA Team: Collaborators of the INDICA Team are provided in the Supplementary Materials.

IJERPH, 2022, vol. 19, issue 8, 1-14

Abstract: Introduction. In cross-sectional analyses, higher levels of patient empowerment have been related to lower symptoms of anxiety and depression. The aims of this study are: (1) to assess if patient empowerment predicts anxiety and depression symptoms after 12 and 24 months among patients with type 2 diabetes mellitus, and (2) to analyze whether a change in patient empowerment is associated with a change in anxiety and depression level. Methods. This is a secondary analysis of the INDICA study, a 24 month-long, multi-arm randomized controlled trial. Patient empowerment (DES-SF), depression (BDI-II), and state-anxiety (STAI-S) were assessed at the baseline (pre-intervention) and after 12 and 24 months. Multilevel mixed linear models with a random intercept were performed to correct for our clustered data. Results. The multilevel regression models showed that the baseline empowerment did not significantly predict anxiety and depression after 12 and 24 months. However, a higher increase in patient empowerment was significantly associated with reductions of anxiety ( p < 0.001) and depression levels ( p < 0.001). This association was not significantly different between the two follow-ups. Conclusion. This study contributes to the knowledge on how to reduce affective symptoms in patients with uncomplicated T2DM through comprehensive patient-centered interventions, and it highlights patient empowerment as a significant contributor.

Keywords: empowerment; patient-centered care; type 2 diabetes mellitus; anxiety; depression (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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