From empowerment to anxiety reduction: The mediating role of self-management capacity in type 2 diabetes mellitus

This randomized controlled trial examined whether an empowerment-based nursing intervention reduces anxiety among hospitalized patients with type 2 diabetes mellitus (T2DM) and whether self-management capacity mediates this association. Between January 2022 and January 2025, 170 adult inpatients with T2DM were randomly assigned to standard care ( n = 85) or empowerment-based nursing plus standard care ( n = 85). Empowerment, self-management capacity, and anxiety were assessed at baseline and post-intervention. Compared with standard care, the intervention group showed significantly higher empowerment and self-management capacity and lower anxiety (all p < 0.001). Empowerment was positively associated with self-management capacity (β = 0.192, p = 0.012) and negatively associated with anxiety (β = −0.330, p < 0.001), whereas the indirect effect through self-management capacity was not significant. These findings suggest that empowerment-based nursing reduces anxiety primarily through direct psychological mechanisms.