Assessing Diabetes Health Literacy, Knowledge and Empowerment in Northern Portugal

  • Carminda S. Morais
  • Rui E. Pimenta
  • Pedro Lopes Ferreira
  • José M. Boavida
  • José P. Amorim
Part of the Advances in Intelligent Systems and Computing book series (AISC, volume 354)


We evaluated the disease management, knowledge and quality of life (QoL) of people with type 2 diabetes, followed in the ambulatory of a Hospital in the North of Portugal. A questionnaire of socio-demographic and clinical characterization, and Portuguese versions of the DES-SF, DKT and EQ-5D were administered to a random sample of 260 individuals. The results showed that people in general feel able of self-management, with a mean±SD score of 3.7±0.7. DKT registered 63.4±12.3% of correct answers among diabetes non-insulin-treated individuals and 65.7±12.4% among the insulin-treated (p<0.001). The QoL, evaluated through EQ-5D index, presented a mean value of 0.65±0.3.

We evidenced a significant positive correlation between the ability to control, the knowledge and the QoL. The conclusions obtained may help promote QoL and literacy enhancement, as well as the empowerment of individuals with type 2 diabetes.


Empowerment knowledge quality of life individuals with type 2 diabetes 


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  1. 1.
    International Diabetes Federation: Diabetes Atlas,
  2. 2.
    Observatório Nacional da Diabetes: Diabetes. Factos e Números. Portugal 2014 Relatório Anual do Observatório Nacional da Diabetes (2014),
  3. 3.
    Unidade Local de Saúde do Alto Minho: Perfil Local de Saúde (2014),
  4. 4.
    Gil, A.C.: Métodos e técnicas de pesquisa social, 6a edn. Atlas, São Paulo (2008)Google Scholar
  5. 5.
    Nutbeam, D.: Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health Promotion International 5(3), 259–267 (2000)CrossRefGoogle Scholar
  6. 6.
    Nutbeam, D.: Defining and measuring health literacy: what can we learn from literacy studies? Int. J. Public Health 54(5), 303–305 (2009)CrossRefGoogle Scholar
  7. 7.
    Moodley, L.M., Rambiritch, V.: An assessment of the level of knowledge about Diabetes Mellitus among diabetic patients in a primary healthcare setting. South African Family Practice 49(10), 16 (2007)CrossRefGoogle Scholar
  8. 8.
    Terris, R.M.: The impact of health Literacy on clinical outcomes for adulths with type 2 diabetes. Advances in Diabetes Metabolism 2(1) (2014)Google Scholar
  9. 9.
    Pestana, M.H., Gageiro, J.N.: Análise de dados para ciências sociais – a complementaridade do SPSS, 4a edn. Silabo, Lisboa (2005)Google Scholar
  10. 10.
    Anderson, R.M., Funnell, M.M., Fitzgerald, J.T., Marrero, D.G.: The Diabetes Empowerment Scale: a measure of psychosocial self-efficacy. Diabetes Care 23(6), 739–743 (2000)CrossRefGoogle Scholar
  11. 11.
    Fitzgerald, J.T., Funnell, M.M., Hess, G.E., Barr, P.A., Anderson, R.M., Hiss, R.G., Davis, W.K.: The Reliability and Validity of a Brief Diabetes Knowledge Test. Diabetes Care 21(5), 706–710 (1998)CrossRefGoogle Scholar
  12. 12.
    Murata, G.H., Shah, J.H., Adam, K.D., Wendel, C.S., Bokhari, S.U., Solvas, P.A., Duckworth, W.C.: Factors affecting Diabetes knowledge in Type 2 diabetic veterans. Diabetologia 46(8), 1170–1178 (2003)CrossRefGoogle Scholar
  13. 13.
    Ferreira, P.L., Ferreira, L.N., Pereira, L.N.: Contributos para a Validação da Versão Portuguesa do EQ-5D. Acta Médica Portuguesa 26(6), 664–675 (2013)Google Scholar
  14. 14.
    Ferreira, L.N., Ferreira, P.L., Pereira, L.N., Oppe, M.: EQ-5D Portuguese population norms. Quality of Life Research, 1–6 (2014)Google Scholar
  15. 15.
    Plataforma Contra a Obesidade: Calculo do índice de Massa Corporal [em linha]. Plataforma Contra a Obesidade,
  16. 16.
    American Association of Diabetes Educators.: Communication Effectively with patients: The Importance of Adressing Health LyteracY and Numeracy. Journal of Health Disparities Research and Practice 7(2), 109–126 (2014)Google Scholar
  17. 17.
  18. 18.
    Raposo, J.F., Mesquit, A.C., Fona, C., Carvalho, R., Massano-Cardoso, S.: First diabetes prevelance study in Portugal: PREVADIAB Study. Diabetic Medecin UK 17(8), 853–969 (2014)Google Scholar
  19. 19.
    Sayah, A.F., Sumit, R.M., Beverly, W., Sandy, R., Jeffery, A.J.: Health Literacy and Health Outcomes in Diabetes: A Systematic Review. J. Gen. Intern. Med. 28(3), 444–452 (2012)CrossRefGoogle Scholar
  20. 20.
    World Health Organization: Equity, social determinants and public health programmes (2010),
  21. 21.
    Dunn, S.M.: Rethinking the models and modes of diabetes education. Patient Education and Counseling 16(3), 281–286 (1990)CrossRefGoogle Scholar
  22. 22.
    Miller, C., Brown, J.: Knowledge and use of the food label among senior women in the management of type 2 diabetes mellitus. The Journal of Nutrition, Health & Aging 3(3), 152–157 (1998)Google Scholar
  23. 23.
    Snyder, C.F., Aaronson, N.K., Choucair, A.K., Elliott, T.E., Greenhalgh, J., Halyard, M.Y., Santana, M.: Implementing patient-reported outcomes assessment in clinical practice: a review of the options and considerations. Quality of Life Research 21(8), 1305–1314 (2012)CrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Carminda S. Morais
    • 1
    • 2
  • Rui E. Pimenta
    • 1
    • 3
  • Pedro Lopes Ferreira
    • 1
    • 4
  • José M. Boavida
    • 5
  • José P. Amorim
    • 6
  1. 1.CEISUC - Centro de Estudos e Investigação em Saúde da Universidade de CoimbraCoimbraPortugal
  2. 2.ESS/IPVC - Escola Superior de Saúde do Instituto Politécnico de Viana do CasteloViana do CasteloPortugal
  3. 3.ESTSP/IPP - Escola Superior de Tecnologia da Saúde do PortoVila Nova de GaiaPortugal
  4. 4.FEUC – Faculdade de Economia da Universidade de CoimbraCoimbraPortugal
  5. 5.DGS – Direção Geral da SaúdeLisboaPortugal
  6. 6.APNOR – Mestrado de Gestão das Organizações – Ramo de Gestão de Unidades de SaúdeEscola Superior de Saúde do Instituto Politécnico de Viana do CasteloViana do CasteloPortugal

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