Patient-Provider Relationship and Diabetes Self-Care

描述（由申请人提供） 临床医生、研究人员和政策规划者已经认识到，尽管 有效药物和自我监测方法的可用性，正常 大部分糖尿病患者的代谢控制仍然是 很大程度上是因为不坚持治疗。护理模式， 它专注于改善患者与提供者的互动，已被证明是 有效改善慢性病患者的治疗依从性。 这个为期5年的指导以患者为导向的研究职业发展的目标 奖励是为了使申请人获得必要的技能和培训， 成为一名独立的研究者，通过以下方式改善糖尿病自我管理 关注医疗保健关系。 这个职业发展奖将包括课程，导师， 监督调查的重点是：1）了解患者-提供者 关系对糖尿病自我护理的影响，使用依恋理论作为 模型; 2）评估成本和利用以及穷人的社会影响 糖尿病护理中的患者-提供者沟通;以及3）开发和测试 高质量的临床干预，使用基于关系的理论 提高卫生保健利用率、治疗依从性和 糖尿病 职业发展活动将适用于四个辅导研究 问题研究在研究1中，分析了小学和高等教育现有的数据集， 护理糖尿病患者将测试的假设，即质量的 患者-提供者关系与糖尿病自我管理相关。在 研究2，一项针对初级保健患者的大型纵向流行病学研究 糖尿病患者将评估患者-提供者沟通对 临床结果和卫生保健成本和利用率。在研究3中， 2型糖尿病患者的定性和定量评估将是 进行评估治疗依从性如何受到 患者-提供者互动。在研究4中，前三项研究的数据 将与职业发展培训相结合，开发和试点测试 改善糖尿病护理的临床干预措施。研究4将测试 以病人-提供者为重点进行这种干预的可行性 为临床有效性试验（R-01研究）做准备。 该奖项将帮助申请人弥合理论研究与实践研究之间的差距。 关于医患关系以及临床和 以人口为基础的干预措施， 糖尿病患者的医患关系和自我护理。K-23奖将 为申请人的持续发展提供关键支持， 糖尿病护理领域的研究者、临床医生和教育工作者。

DESCRIPTION (provided by applicant) Clinicians, researchers and policy planners have recognized that despite the availability of effective medications and self-monitoring methods, normal metabolic control for a great proportion of patients with diabetes remains elusive, in large part because of non-adherence to treatment. Models of care, which focuses on improving patient-provider interactions, have been shown to be effective in improving adherence to therapies in patients with chronic illness. The goal of this 5-year Mentored Patient-Oriented Research Career Development Award is to enable the applicant to obtain the necessary skills and training to become an independent investigator in improving diabetes self-management by focusing on the health care relationship. This career development award will consist of coursework, mentorship, and supervised investigations focusing on: 1) understanding patient-provider relationship influences on diabetes self-care, using attachment theory as a model; 2) assessing cost and utilization and societal implications of poor patient-provider communication in diabetes care; and 3) developing and testing of high quality clinical interventions using relationship-based theoretical models to improve health care utilization, treatment adherence and outcomes in diabetes. Career development activities will be applied to four mentored research studies. In study 1, analyses of existing data sets from primary and tertiary care diabetes patients will test the hypothesis that the quality of the patient-provider relationship is associated with diabetes self-management. In study 2, a large longitudinal epidemiological study of primary care patients with diabetes will assess the impact of patient-provider communication on clinical outcomes and health care costs and utilization. In study 3, in-depth qualitative and quantitative assessment of type 2 diabetes patients will be conducted to assess how treatment adherence is influenced by patterns of patient-provider interactions. In Study 4, data from the first three studies will be integrated with career development training to develop and pilot test clinical interventions for improving care of diabetes. Study 4 will test the feasibility of conducting such interventions focusing on the patient-provider relationship in preparation for a clinical effectiveness trial (R-01 study). This award will help the applicant bridge the gap between theory-based research on the patient-provider relationship and dissemination of clinical and population-based interventions designed to improve the quality of the patient-provider relationship and self-care in diabetes. This K-23 award will provide crucial support for the applicant's ongoing development as an investigator, clinician, and educator in the area of diabetes care.