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 很大一部分糖尿病患者的代谢控制仍然存在 难以捉摸，在很大程度上是因为没有坚持治疗。关怀的典范， 其重点是改善患者与提供者的互动，已被证明是 有效地提高慢性病患者对治疗的依从性。 这个以患者为中心的5年导师研究生涯发展的目标 奖励是为了使申请者能够获得必要的技能和培训 成为改善糖尿病自我管理的独立调查者 关注医疗保健关系。 该职业发展奖将包括课程作业、指导和 监督调查的重点是：1)了解患者-提供者 依恋理论对糖尿病患者自我护理的影响 模型；2)评估穷人的成本和利用率以及社会影响 糖尿病护理中的患者-提供者沟通；以及3)开发和测试 使用基于关系的理论进行高质量的临床干预 改善卫生保健利用率、治疗依从性和结果的模式 糖尿病。 职业发展活动将应用于四项有指导的研究 学习。在研究1中，对主要和第三级的现有数据集进行了分析 护理糖尿病患者将检验这一假设，即 患者与提供者的关系与糖尿病的自我管理有关。在……里面 研究2：一项针对初级保健患者的大型纵向流行病学研究 将评估患者与提供者沟通对 临床结果和医疗保健成本及利用率。研究3：深入研究 将对2型糖尿病患者进行定性和定量评估 评估治疗依从性如何受到治疗模式的影响 患者与提供者之间的互动。在研究4中，前三项研究的数据 将与职业发展培训相结合，以开发和试运行 改善糖尿病护理的临床干预。研究4将测试 以患者-提供者为重点进行此类干预的可行性 临床有效性试验准备过程中的关系(R-01研究)。 该奖项将帮助申请者弥合基于理论的研究之间的差距 论临床与医疗服务的供需关系与传播 以人口为基础的干预措施，旨在提高 糖尿病患者的医患关系与自我护理。这个K-23奖项将 为申请者的持续发展提供关键支持 糖尿病护理领域的研究人员、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.