Does physician communication influence older patients' diabetes self-management and glycemic control? Results from the Health and Retirement Study (HRS)
Does physician communication influence older patients' diabetes self-management and glycemic control? Results from the Health and Retirement Study (HRS)
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DOI：
10.1093/gerona/62.12.1435
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发表时间：
2007-12-01
影响因子：
5.1
通讯作者：
Hayward, Rodney A.
中科院分区：
文献类型：
--
作者：
Heisler, Michele;Cole, Ian;Hayward, Rodney A.
背景。有效的老年人慢性病自我管理对改善临床结果至关重要。我们评估了医生沟通的两个维度——提供信息（PCOM）和参与性决策（PDM）——对老年糖尿病患者自我管理和血糖控制的相对重要性。我们对1588名居住在社区的老年糖尿病患者进行了全国性的横断面调查（应答率：81%）。研究了患者对医生PCOM和PDM评分与患者报告的糖尿病自我管理（药物依从性、饮食、运动、血糖监测和足部护理）之间的独立关联，并根据患者的社会人口统计学、疾病严重程度和合并症进行了调整。在可获得血红蛋白Alc （HbAlc）值的应答者中（n = 1233），评估患者自我管理与HbAlc值之间的关系。在单独的多变量回归中，PCOM和PDM均与糖尿病总体自我管理相关(p
Background. Effective chronic disease self-management among older adults is crucial for improved clinical outcomes. We assessed the relative importance of two dimensions of physician communication-provision of information (PCOM) and participatory decision-making (PDM)-for older patients' diabetes self-management and glycemic control.Methods. We conducted a national cross-sectional survey among 1588 older community-dwelling adults with diabetes (response rate: 81 %). Independent associations were examined between patients' ratings of their physician's PCOM and PDM with patients' reported diabetes self-management (medication adherence, diet, exercise, blood glucose monitoring, and foot care), adjusting for patient sociodemographics, illness severity, and comorbidities. Among respondents for whom hemoglobin Alc (HbAlc) values were available (n = 1233), the relationship was assessed between patient self-management and HbAlc values.Results. In separate multivariate regressions, PCOM and PDM were each associated with overall diabetes self-management (p