An empirical test of the Health Empowerment Model: Does patient empowerment moderate the effect of health literacy on health status?

Náfrádi, Lilla; Nakamoto, Kent; Csabai, Márta; Papp-Zipernovszky, Orsolya; Schulz, Peter

doi:10.1016/j.pec.2017.09.004

Cited by 54 publications

(58 citation statements)

References 24 publications

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“…As finding this equilibrium might be challenging, it requires building a strong collaborative doctor-patient relationship and continuous negotiation during the medical encounter. Moreover, patients’ level of health literacy should be taken into account and facilitated, as a recent paper showed that empowerment has a stronger link to better health status among the adequately health literate patients [ 218 ]. Most importantly, this approach has the capacity to reconcile the notion of an empowered patient and the shared decision making framework [ 219 ], without raising the dilemma of power or imbalanced control in the doctor-patient relationship.…”

Section: Discussionmentioning

confidence: 99%

Is patient empowerment the key to promote adherence? A systematic review of the relationship between self-efficacy, health locus of control and medication adherence

2017

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BackgroundCurrent health policies emphasize the need for an equitable doctor-patient relationship, and this requires a certain level of patient empowerment. However, a systematic review of the empirical evidence on how empowerment affects medication adherence—the extent to which patients follow the physician’s prescription of medication intake—is still missing. The goal of this systematic review is to sum up current state-of-the-art knowledge concerning the relationship between patient empowerment and medication adherence across medical conditions. As our conceptualization defines health locus of control and self-efficacy as being crucial components of empowerment, we explored the relationship between these two constructs and medication adherence.MethodsRelevant studies were retrieved through a comprehensive search of Medline and PsychINFO databases (1967 to 2017). In total, 4903 publications were identified. After applying inclusion and exclusion criteria and quality assessment, 154 articles were deemed relevant. Peer-reviewed articles, written in English, addressing the relationship between empowerment (predictor) and medication adherence (outcome) were included.FindingsHigh levels of self-efficacy and Internal Health Locus of Control are consistently found to promote medication adherence. External control dimensions were found to have mainly negative (Chance and God attributed control beliefs) or ambiguous (Powerful others attributed control beliefs) links to adherence, except for Doctor Health Locus of Control which had a positive association with medication adherence. To fully capture how health locus of control dimensions influence medication adherence, the interaction between the sub-dimensions and the attitudinal symmetry between the doctor and patient, regarding the patient’s control over the disease management, can provide promising new alternatives.DiscussionThe beneficial effect of patients’ high internal and concurrent physician-attributed control beliefs suggests that a so-called “joint empowerment” approach can be suitable in order to foster medication adherence, enabling us to address the question of control as a versatile component in the doctor-patient relationship.

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Section: Discussionmentioning

confidence: 99%

Is patient empowerment the key to promote adherence? A systematic review of the relationship between self-efficacy, health locus of control and medication adherence

2017

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“…Increasing HL is an antecedent of PE [46][47][48]. Strengthening PE without adequate HL may lead patients to harm their health condition by making uninformed decisions, and HL plays a bigger role than PE in determining health status [18].…”

Section: Discussionmentioning

confidence: 99%

“…HL is considered to be positively correlated with SCB [12,14,15], and can also affect SCB via self-efficacy [16,17]. Therefore, HL is widely used in studying patient-related health behaviors [18].…”

Section: Introductionmentioning

confidence: 99%

“…Patient empowerment (PE) is a process designed to facilitate self-directed behavior change [24]. Therefore, PE is another widely researched determinant of healthy behaviors [18]. The WHO defines empowerment as "a process through which people gain greater control over decisions and actions affecting their health" [25], which demonstrates that PE "doesn't mean 'giving' people power.…”

Section: Introductionmentioning

confidence: 99%

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Critical pathways and factors of non-health outcomes affecting self-care behaviors in patients with type 2 diabetes and their differences in patient preference in medical decision-making

Wang

Lin

Hung³

et al. 2020

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Background The effects of patient sustained self-care behaviors (SCB) on glycemic control are even greater than the effects of medical treatment, indicating the value of identifying the factors that influence SCB. To date, these factors have not been placed in one model to clarify the critical path affecting SCB. The aims of this study were to explore the relationships of these factors and the differences by decision-making preference.Methods A cross-sectional study was conducted among outpatients with type 2 diabetes at a regional teaching hospital. Purposive sampling was adopted to recruit 316 eligible patients via self-administered questionnaires. Partial least squares structural equation modeling was used for analysis.Results Significant direct pathways were identified from health literacy (HL) to self-efficacy (SE), patient empowerment (PE), and SCB; from SE to SCB; and from PE to SCB. Indirect pathways were from HL to SCB via SE or PE. The pathway from HL to SE was significantly stronger in those preferring shared decision-making than in those who preferred physician decision-making.Conclusions HL is a critical factor in improving SCB in patients with type 2 diabetes, and the pathway from HL to SE differed the most by patient preference for making decisions. Therefore, developing an effective promotion strategy and application tools to improve the overall HL of diabetic is the cornerstone of enhancing SCB in this population.

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“…Increasing HL is an antecedent of PE [51][52][53]. Strengthening PE without adequate HL may lead patients to harm their health condition by making uninformed decisions, and HL plays a bigger role than PE in determining health status [19].…”

Section: Discussionmentioning

confidence: 99%

Non-health outcomes affecting self-care behaviors and medical decision-making preference in patients with type 2 diabetes: a cross-sectional study

Wang

Lin

Hung³

et al. 2020

Preprint

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Background: The effects of patient sustained self-care behaviors on glycemic control are even greater than the effects of medical treatment, indicating the value of identifying the factors that influence self-care behaviors. To date, these factors have not been placed in a single model to clarify the critical path affecting self-care behaviors. The aims of this study were to explore the relationships of these factors and the differences in patient preference for medical decision-making. Methods:A cross-sectional study was conducted among outpatients with type 2 diabetes at a regional teaching hospital. Purposive sampling was adopted to recruit 316 eligible patients via selfadministered questionnaires. Partial least squares structural equation modeling was used for analysis.Results: Significant direct pathways were identified from health literacy to self-efficacy, patient empowerment, and self-care behaviors; from self-efficacy to self-care behaviors; and from patient empowerment to self-care behaviors. Indirect pathways were from health literacy to self-care behaviors via self-efficacy or patient empowerment. The pathway from health literacy to self-efficacy was significantly stronger in those preferring shared decision-making than in those who preferred physician decision-making. Conclusions:Health literacy is a critical factor in improving self-care behaviors in patients with type 2 diabetes, and the effect of health literacy on self-efficacy was more significant in the shared decision-making than in the physician decision-making. Therefore, developing an effective health strategy to strengthen health literacy awareness and designing friendly, diverse health literacy materials, and application tools is the most important factor to facilitate self-care behaviors in this population. BackgroundDiabetes is a life-long chronic condition that leads to serious consequences. Over 425 million people worldwide are currently living with diabetes [1], with 1.6 million deaths directly attributed to diabetes each year [2]. Therefore, the World Health Organization (WHO) calls on countries to prevent or delay the onset of diabetes by promoting a healthy lifestyle, to reduce the risk of diabetes and effectively manage the disease to decrease the rates of complications and mortality [3].

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An empirical test of the Health Empowerment Model: Does patient empowerment moderate the effect of health literacy on health status?

Cited by 54 publications

References 24 publications

Is patient empowerment the key to promote adherence? A systematic review of the relationship between self-efficacy, health locus of control and medication adherence

Is patient empowerment the key to promote adherence? A systematic review of the relationship between self-efficacy, health locus of control and medication adherence

Critical pathways and factors of non-health outcomes affecting self-care behaviors in patients with type 2 diabetes and their differences in patient preference in medical decision-making

Non-health outcomes affecting self-care behaviors and medical decision-making preference in patients with type 2 diabetes: a cross-sectional study

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