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BACKGROUND/RATIONALE:
Type 2 diabetes mellitus is estimated to affect up to 1 in 5 VA patients overall and up to 1 in 4 racial/ethnic minority patients. Racial disparities in diabetes include higher rates of poor diabetes outcomes (e.g. blindness, end stage renal disease) and racial disparities are reported in patients' communication with physicians. Physician treatment recommendations are reported to be similar for white and black patients, but medication adherence seems to be lower among black compared with white patients. Adherence to recommended care is related at least in part to active communication in medical encounters. Encouraging patients to use more active communication with physicians leads to better adherence to treatment and to better biomedical outcomes.
The conceptual framework for this proposal uses the model of communication competence. Patients are competent communicators when they: (1) have self-efficacy to communicate, (2) have some health knowledge, and (3) are prepared to use active participatory communication behaviors in consultations with physicians.
OBJECTIVE(S):
The goal of this proposal is to explore with patients the factors that encourage and discourage patients to use active participatory communication behaviors in medical interactions with primary care providers.
METHODS:
In the proposed 4- month study we will evaluate the salience of potential factors that can influence patients' use of active participatory communication behaviors in medical encounters. We will seek input from patients using focus group interviews for pilot data to inform the design of an acceptable, comprehensible, and culturally appropriate intervention. These semi-structured qualitative interviews (focus groups) will be used to learn about the perspective of patients with diabetes. We are choosing this methodology because it provides a rich source of information by tapping into patients' perspectives. We will use the qualitative interviews to inform the design of an intervention in a future project. Factors important to these patients may include diabetes specific issues (e.g. treatment choices) and general issues related to active participatory communication behavior (e.g., don't know what to ask). The purpose of the interviews is to obtain the patient's perspective on (1) communicating with the provider in general; (2) communicating about diabetes; and (3) communicating about medication adherence.
FINDINGS/RESULTS:
No results at this time.
IMPACT:
Communication in medical interactions is critical and plays an important, but often overlooked role in health-care decision making and quality of care. Patients who have difficulty communicating are less involved in consultations with their physician, receive less information and support, and are less satisfied with their care. In turn, these patients may not understand their treatment options, may have less knowledge, less positive beliefs about treatment and less trust in physician, and may experience poorer health outcomes.
PUBLICATIONS:
None at this time.
DRA:
Chronic Diseases, Special (Underserved, High Risk) Populations
DRE:
Communication and Decision Making, Quality of Care
Keywords:
none
MeSH Terms:
none
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