2.50
Hdl Handle:
http://hdl.handle.net/10755/157293
Type:
Presentation
Title:
PATIENT EXPERIENCES OF SELF-MANAGEMENT SUPPORT AND DIABETES OUTCOMES
Abstract:
PATIENT EXPERIENCES OF SELF-MANAGEMENT SUPPORT AND DIABETES OUTCOMES
Conference Sponsor:Western Institute of Nursing
Conference Year:2010
Author:Wallace, Andrea S., PhD, ND, APRN-BC, ADM
P.I. Institution Name:University of Iowa
Title:Assistant Professor
Contact Address:7740 Cedar Canyon Road NE, Albuquerque, NM, 87122, USA
Co-Authors:John R. Carlson; Robert M. Malone; James Joyner; Darren A. DeWalt
PURPOSE:
The purpose of this study was to examine the association between patient-reported experiences of the quality of diabetes self-management support they receive in clinical settings and behavioral, functional, and clinical outcomes.
BACKGROUND:
Since a significant component of diabetes care depends on patient self-management, understanding variability in diabetes outcomes may rest on learning more about how patients' experiences of self-management support affect self-management activities and outcomes. To date, studies examining the association between patient experiences of self-management support and diabetes outcomes have relied on self-reported outcomes and have not considered OBJECTIVE: data regarding the quality of care delivered to patients.
METHODS:
A cross-sectional survey was administered to 208 adult patients with type 2 diabetes seen in a multidisciplinary disease management program. Bivariate analyses were used to test associations between patient-rated experiences of self-management support (Patient Assessment of Chronic Illness Care [PACIC]), and behavioral (self-efficacy, self-care behaviors), functional (health-related quality of life [SF12]), and clinical outcomes (glycemic control [A1C] and non-HDL lipids). Tailored intervention guidelines used by the disease management program, determined by clinical status and resulting in extra support services and more frequent visits, provided evidence of the intensity of chronic illness management actually delivered to patients.
RESULTS:
Better ratings of self-management support were associated with behavioral outcomes (r=0.35, p <0.01 for self-efficacy; r=0.19, p=0.01 for self-care), but were not associated with functional status (r=0.05, p= 0.48 for SF12 MCS; r= 0.10, p=0.16 for SF12 PCS) or non-HDL lipids (r=0.01, p=0.90). In addition, better ratings were actually associated with higher A1Cs, or poorer glycemic control (r=0.21, p<0.01). While those who are more intensively managed are those with worse glycemic control (A1C= 8.12 for those intensively managed vs 6.52 for those who are not, p<0.01), these differences were not reflected in self-management support ratings (3.87 for those intensively managed vs 3.83 for those who are not, p=0.78).
IMPLICATIONS:
While there was an association between patient ratings of self-management support, self-efficacy and self-care, better patient ratings are unassociated with health related quality of life and were, in fact, related to poorer glycemic control. A possible explanation for these findings is that those who experience poor outcomes are also those who receive more intensive management, a common practice in disease management programs. However, our data do not support this hypothesis: although those who receive more intensive treatment were those with poorer glycemic control, they did not rate their self-management support higher than those receiving less intensive management. Our findings suggest a continued need to understand the role of self-efficacy in diabetes outcomes, but also the need to proceed cautiously when adopting consumer-based surveys as a measure health care quality.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titlePATIENT EXPERIENCES OF SELF-MANAGEMENT SUPPORT AND DIABETES OUTCOMESen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157293-
dc.description.abstract<table><tr><td colspan="2" class="item-title">PATIENT EXPERIENCES OF SELF-MANAGEMENT SUPPORT AND DIABETES OUTCOMES</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Wallace, Andrea S., PhD, ND, APRN-BC, ADM</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Iowa</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">7740 Cedar Canyon Road NE, Albuquerque, NM, 87122, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">andi.wallace@gmail.com</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">John R. Carlson; Robert M. Malone; James Joyner; Darren A. DeWalt</td></tr><tr><td colspan="2" class="item-abstract">PURPOSE:<br/>The purpose of this study was to examine the association between patient-reported experiences of the quality of diabetes self-management support they receive in clinical settings and behavioral, functional, and clinical outcomes.<br/>BACKGROUND:<br/>Since a significant component of diabetes care depends on patient self-management, understanding variability in diabetes outcomes may rest on learning more about how patients' experiences of self-management support affect self-management activities and outcomes. To date, studies examining the association between patient experiences of self-management support and diabetes outcomes have relied on self-reported outcomes and have not considered OBJECTIVE: data regarding the quality of care delivered to patients. <br/>METHODS:<br/>A cross-sectional survey was administered to 208 adult patients with type 2 diabetes seen in a multidisciplinary disease management program. Bivariate analyses were used to test associations between patient-rated experiences of self-management support (Patient Assessment of Chronic Illness Care [PACIC]), and behavioral (self-efficacy, self-care behaviors), functional (health-related quality of life [SF12]), and clinical outcomes (glycemic control [A1C] and non-HDL lipids). Tailored intervention guidelines used by the disease management program, determined by clinical status and resulting in extra support services and more frequent visits, provided evidence of the intensity of chronic illness management actually delivered to patients.<br/>RESULTS:<br/>Better ratings of self-management support were associated with behavioral outcomes (r=0.35, p &lt;0.01 for self-efficacy; r=0.19, p=0.01 for self-care), but were not associated with functional status (r=0.05, p= 0.48 for SF12 MCS; r= 0.10, p=0.16 for SF12 PCS) or non-HDL lipids (r=0.01, p=0.90). In addition, better ratings were actually associated with higher A1Cs, or poorer glycemic control (r=0.21, p&lt;0.01). While those who are more intensively managed are those with worse glycemic control (A1C= 8.12 for those intensively managed vs 6.52 for those who are not, p&lt;0.01), these differences were not reflected in self-management support ratings (3.87 for those intensively managed vs 3.83 for those who are not, p=0.78).<br/>IMPLICATIONS: <br/>While there was an association between patient ratings of self-management support, self-efficacy and self-care, better patient ratings are unassociated with health related quality of life and were, in fact, related to poorer glycemic control. A possible explanation for these findings is that those who experience poor outcomes are also those who receive more intensive management, a common practice in disease management programs. However, our data do not support this hypothesis: although those who receive more intensive treatment were those with poorer glycemic control, they did not rate their self-management support higher than those receiving less intensive management. Our findings suggest a continued need to understand the role of self-efficacy in diabetes outcomes, but also the need to proceed cautiously when adopting consumer-based surveys as a measure health care quality. <br/></td></tr></table>en_GB
dc.date.available2011-10-26T19:44:28Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T19:44:28Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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