Provider communication and patient participation in diabetes self-care
Provider communication and patient participation in diabetes self-care
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DOI：
10.1016/j.pec.2010.09.025
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发表时间：
2011-11-01
影响因子：
3.5
通讯作者：
Kaplowitz, Stan A.
中科院分区：
文献类型：
--
作者：
Bundesmann, Ragnhild;Kaplowitz, Stan A.
目的：确定提供者关于自我护理的沟通以及提供者遵循的治疗指南对 2 型糖尿病 (T2DM) 患者自我护理行为的影响大小。 方法：数据来自对密歇根州接受管理护理的 T2DM 患者 (n = 1438) 进行的 TRIAD 电话调查。该调查询问了患者的自我护理和提供者对血糖监测、锻炼、足部护理、流感疫苗接种和年度视网膜筛查的沟通情况。结果：在控制患者的社会人口统计特征和疾病严重程度后，记住已收到提供者有关这些活动的信息，进行血糖监测和足部检查的几率增加了一倍多。它还显着增加了患者的运动量。提供者建模与足部护理密切相关。糖尿病教育者的咨询与每年进行视网膜检查和接受流感疫苗接种呈正相关。结论：记住自我护理信息与患者及其家人增加的家庭自我护理有关。咨询糖尿病教育者可以大大改善患者的自我护理。实践意义：医疗保健提供者应鼓励患者教育。然而，医生的时间成本很高，而且大多数护士并不专门从事患者教育；一种解决方案是将患者转介给糖尿病教育者。 (C) 2010 Elsevier Ireland Ltd. 保留所有权利。
Objective: To determine the effect size of provider communication about self-care and the provider's following treatment guidelines on the self-care behaviors of people with Type 2 diabetes (T2DM).Methods: Data were from the TRIAD telephone surveys of Michigan patients in managed care with T2DM (n = 1438). The survey asked about the patients' self-care and provider communication about blood glucose monitoring, exercise, foot care, flu vaccination and annual retina screening.Results: After controlling for patient socio-demographics and disease severity, remembering having received provider information on these activities more than doubled the odds of performing blood glucose monitoring, and performing foot examinations. It also significantly increased the amount of exercise the patient performed. Provider modeling had a strong association with foot care. Counseling by a diabetes educator was positively and significantly associated with having an annual retina examination and receiving an influenza vaccination.Conclusions: Remembering self-care information is associated with increased home based self-care by patients and their families. Consulting with a diabetes educator can substantially improve patient self-care. Practice implications: Health care providers should encourage patient education. However, physician time is costly and most nurses do not specialize in patient education; one solution is to refer patients to a diabetes educator. (C) 2010 Elsevier Ireland Ltd. All rights reserved.