{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T16:56:06Z","timestamp":1781283366300,"version":"3.54.1"},"reference-count":44,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["72164010"],"award-info":[{"award-number":["72164010"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["12561049"],"award-info":[{"award-number":["12561049"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Endocrino Diabet &amp;amp; Metabol"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This multicenter cross\u2010sectional study was designed to verify whether patient empowerment mediates the relationship between psychosocial factors and diabetes self\u2010management behaviours and HbA1c. Patient empowerment is a key factor improving diabetes management. The mechanism underneath is less clear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a multicenter cross\u2010sectional study of 2005 type 2 diabetes from five university hospitals across diverse Chinese regions between December 2022 and May 2023. Demographic and lab values came from electronic medical record systems (EMS) while psychological factors were assessed via self\u2010administered digital scales on a WeChat mini\u2010program. The study examined patient empowerment's mediating role between psychological factors (Type D personality, DD, attitudes, subjective norms, perceived control, behaviour change intentions) and diabetes outcomes using mediation and chain mediation analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients with lower empowerment scores had shorter disease duration, poorer glycemic control, a higher prevalence of dyslipidemia and multiple complications, and greater socioeconomic disadvantage. Type D personality (OR\u2009=\u20092.201,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and diabetes distress (DD, OR\u2009=\u20091.053,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) were identified as independent risk factors for low empowerment. Moreover, patient empowerment significantly mediated the associations between psychosocial factors and both self\u2010management behaviours and HbA1c. Mediation analyses showed significant indirect effects of Type D personality (\n                      <jats:italic>\u03b3<\/jats:italic>\n                      \u2009=\u2009\u22120.794,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), DD (\n                      <jats:italic>\u03b3<\/jats:italic>\n                      \u2009=\u2009\u22120.050,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.024), attitude toward behaviour change (\n                      <jats:italic>\u03b3<\/jats:italic>\n                      \u2009=\u20090.470,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), subjective norm (\n                      <jats:italic>\u03b3<\/jats:italic>\n                      \u2009=\u20090.287,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), perceived behavioural control (\n                      <jats:italic>\u03b3<\/jats:italic>\n                      \u2009=\u20090.489,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and behavioural intention (\n                      <jats:italic>\u03b3<\/jats:italic>\n                      \u2009=\u20090.458,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) on self\u2010management behaviours through empowerment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patient empowerment functions as a critical mediator linking psychosocial factors to self\u2010management behaviours and glycemic control in individuals with type 2 diabetes. Type D personality and DD represent important risk factors for low empowerment. These findings suggest that patient empowerment\u2010focused interventions may enhance diabetes self\u2010management and glycemic control.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/edm2.70183","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T14:10:33Z","timestamp":1772979033000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bridging Minds and Behaviours: Patient Empowerment Mediates Psychological Factors and Diabetes Self\u2010Management"],"prefix":"10.1002","volume":"9","author":[{"given":"Shujie","family":"Liu","sequence":"first","affiliation":[{"name":"Hainan Clinical Research Center for Metabolic Disease The First Affiliated Hospital of Hainan Medical University  Haikou Hainan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Chen","sequence":"additional","affiliation":[{"name":"College of Nursing Henan University of 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