Empowerment in diabetes care: towards measuring empowerment

The aim of this study was to measure validity and reliability of the Icelandic version of the Diabetes Empowerment Scale (DES) among people with diabetes and to develop knowledge about Icelandic people with diabetes. For this purpose, DES was distributed along with the Diabetes Knowledge Test and the Problem Area in Diabetes scale in four diabetes clinics in Iceland after the study received ethical approval from the National Bioethical Committee. Of the 101 allocated questionnaires, 92 were returned and 90 questionnaires were useable, resulting in 89% response rate. The Cronbach's alpha coefficient for DES was 0.84, and for the three subscales: Managing the Psychosocial Aspects of Diabetes (alpha = 0.76), Assessing Dissatisfaction and Readiness to Change (alpha = 0.63) and Setting and Achieving Diabetes Goals (alpha = 0.79). There was a criterion validity between level of education and DES. Mean value for DES was 3.68 +/- 0.52 on a scale of 1-5 where a higher score indicates increased empowerment. Range was from 2.43 to 4.68, indicating that the instrument demonstrates neither floor nor ceiling effects. This study indicates that the DES, the only available instrument to measure the concept of empowerment in diabetes care, is a sufficiently reliable and valid instrument in the Icelandic culture. However, it needs further testing. Empowerment is highly valued within the clinical arena, as well as when health professionals study patients' capacity to deal with health problems.