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Diabetes Res Clin Pract. 2017 May;127:265-274. doi: 10.1016/j.diabres.2017.03.016. Epub 2017 Mar 22.

Physician-patient communication at diagnosis of type 2 diabetes and its links to patient outcomes: New results from the global IntroDia® study.

Author information

1
Department of Psychiatry, University of California San Diego, 9500 Gilman Dr, La Jolla, CA 92093, USA; Behavioral Diabetes Institute, 5405 Oberlin Drive, Suite 100, San Diego, CA 92121, USA. Electronic address: whp@behavioraldiabetes.org.
2
Rotherham Institute for Obesity, and Clifton Medical Centre, Doncaster Gate, Rotherham, South Yorkshire S65 1DA, United Kingdom.
3
The Michener Institute of Education at UHN, 222 St. Patrick Street, Toronto, Ontario M5T 1V4, Canada.
4
Somerset Partnership NHS Foundation Trust, 2nd Floor, Mallard Court, Express Park, Bristol Road, Bridgwater TA6 4RN, United Kingdom.
5
Prince Sultan Military Medical City, PO Box 7897, Riyadh 11159, Saudi Arabia.
6
Boehringer Ingelheim Pharmaceuticals, Inc., 900 Ridgebury Road, PO Box 368, Ridgefield, CT 06877, USA.
7
Boehringer Ingelheim Pharma GmbH & Co. KG, Binger Straße 173, D-55216 Ingelheim am Rhein, Germany.
8
Division of Endocrinology and Metabolism, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; Veterans Affairs Medical Center, 3350 La Jolla Village Dr, San Diego, CA 92161, USA.

Abstract

AIMS:

To investigate patient experiences during the diagnosis of type 2 diabetes mellitus (T2DM), focusing on how physician-patient communication at diagnosis influences patients' psychosocial stress and subsequent self-management and outcomes.

METHODS:

We surveyed adults with T2DM in 26 countries in a large cross-national study of physician-patient communication during early T2DM treatment (IntroDia®). The self-report questionnaire assessed retrospectively patient experiences during diagnosis conversations (focusing on 43 possible conversational elements, and communication quality) and potential effects on patient-reported outcomes.

RESULTS:

Data from 3628 people with T2DM who had been prescribed oral treatment at diagnosis were analysed. Exploratory factor analyses of the conversational elements yielded four coherent, meaningful factors: Encouraging (Cronbach's α=0.86); Collaborative (α=0.88); Recommending Other Resources (α=0.75); and Discouraging (α=0.72). Patient-perceived communication quality (PPCQ) at diagnosis was positively associated with Encouraging (β=+1.764, p<0.001) and Collaborative (β=+0.347, p<0.001), negatively associated with Discouraging (β=-1.181, p<0.001) and not associated with Recommending Other Resources (β=+0.087, p=0.096), using a stable path model. PPCQ was associated with less current diabetes distress, greater current well-being and better current self-care. Conversation elements comprising factors associated with better PPCQ (Encouraging and Collaborative) were recalled more frequently by patients than elements associated with poor PPCQ (Discouraging).

CONCLUSIONS:

Better physician-patient communication at T2DM diagnosis may contribute to subsequent greater patient well-being and self-care, and may be enhanced by greater physician use of Collaborative and Encouraging conversation elements.

KEYWORDS:

Patient survey; Patient-reported outcomes; Physician–patient communication; Psychological well-being; Type 2 diabetes

PMID:
28407552
DOI:
10.1016/j.diabres.2017.03.016
[Indexed for MEDLINE]

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