Title : The relationship between empowerment and quality of health among clients with chronic health conditions
Abstract:
Purpose: This study focuses on the correlation between clients' empowerment and quality of life. The purpose of this study is to determine whether higher levels of empowerment in clients with chronic health conditions are associated with better quality of life and improved health outcomes.
Objective: Chronic health conditions; such as diabetes, chronic kidney disease, and cardiovascular disease, affect millions of individuals and significantly impact their quality of life (QoL). Empowerment—a person's sense of control and involvement in managing their health—has been identified as a key factor in improving health outcomes and reducing healthcare burdens. Empowered clients are more likely to engage in self-care, follow treatment plans, and experience improved physical and emotional well-being. The relevant review of literature revealed a paucity of research studies focused on examining the correlation between the empowerment construct and QoL among clients with chronic health conditions.
Sample: This study was conducted by senior nursing graduates as part of a capstone project at Bloomfield College of Montclair State University. Participants were recruited from northeastern New Jersey, United States, particularly from hospitals, long-term care facilities, and online chronic illness support groups. Recruitment materials, such as flyers and online posts, were distributed with a permission from support group administrators and facility managers. This study included adults aged 18 years or older and who have been diagnosed with one or more chronic health conditions. However, the exclusion criteria included adults with: 1) developmental disabilities, 2) active substance use disorders, 3) speech impairments, and 4) ife expectancy of less than six months. The study sample consists of 135 participants recruited from hospitals, nursing homes, and online support groups in New Jersey.
Methods: This study utilized a mixed methodology (triangulation) in which quantitative data and qualitative data have been collected. The quantitative data was collected using the Client Empowerment Scale (CES) and the WHO-5 (World Health Organization) Well-Being Index. The CES consists of 44- items developed to measure clients’ perceptions of empowerment. The 5-items WHO Well-Being Index (WHO-5) used to assess participants' personal perceptions of well-being. The quantitative data was analyzed using the most recent version of the SPSS program. The participants’ responses to open-ended questions was collected as qualitative data; which has been analyzed using Colaizzi's thematic analysis approach.
Results: After data cleaning, the sample included 59 participants, primarily females (n = 39, 67.2%). Most participants were aged 30–49 years (n = 23, 39%), followed by 18–29 years (n = 17, 28.8%), 50–64 years (n = 14, 23.7%), and 65+ years (n = 5, 8.5%). Participants identified primarily as Hispanic/Latino (n = 26, 46.4%), followed by White (n = 18, 32.1%), Asian (n = 8, 14.3%), Black (n = 3, 5.4%), and Middle Eastern (n = 1, 1.8%). Educational backgrounds varied: college degree (n = 21, 35.6%), some college (n = 14, 23.7%), high school/GED (n = 11, 18.6%), and master's or doctoral degree (n = 10, 16.9%). Most participants were employed full-time (n = 40, 69%). Reported annual income levels included over $60,000 (n = 23, 40.4%), $20,000–$39,999 (n = 11, 19.3%), $40,000–$59,999 (n = 10, 17.5%), and under $5,000 (n = 5, 8.8%). Physicians (n = 43, 72.9%) were the most commonly reported primary care providers, followed by nurse practitioners (n = 13, 22%). The most frequently reported chronic conditions were comorbidities (n = 16, 35.6%), psychiatric disorders (n = 9, 20%), and heart disease (n = 7, 15.6%). Use of online support groups varied: rarely (n = 33, 57.9%), never (n = 13, 22.8%), and daily (n = 10, 17.5%). After careful analysis of the qualitative responses using Colaizzi's method, three major themes emerged: Support, Client Control, and The Paradox of Empowerment and Quality of Life. These themes reflect the emotional, relational, and behavioral aspects of empowerment experienced by individuals managing chronic conditions.
Conclusion: This study investigated the relationship between empowerment and quality of life (QoL) in individuals with chronic health conditions. While empowerment is generally seen as a positive factor in healthcare, this study found a significant negative correlation between empowerment and QoL. Participants who reported higher levels of empowerment also reported lower perceived QoL, suggesting a complex dynamic between control and emotional well-being.
