Fisher L, Chesla C A, Skaff M A, Gilliss C, Kanter R A, Lutz C P, Bartz R J
University of California, San Francisco, USA.
Behav Med. 2000 Summer;26(2):53-66. doi: 10.1080/08964280009595752.
The number of indicators of chronic disease management is large and no practical framework is available to guide selection for use in intervention programs. In addition, it is often difficult to integrate multiple disease management indicators into a comprehensive picture of patient functioning. The authors present a heuristic framework for creating a profile of disease management and an empirically based descriptive typology of disease management behavior. From the literature, they identified 5 domains of disease management indicators: biologic, general health and functional status, emotional tone, quality of life, and behavioral. They selected 11 scales and assessed 187 patients with type 2 diabetes. Five statistically replicable patient disease management types were derived from exploratory and confirmatory cluster analyses and a descriptive narrative was created for each: balanced (33%), problematic (6%), coasters (34%), discouraged (16%), and distressed (11%). The typology describes different presentations of disease management that can be linked with patient-tailored interventions for patients with type 2 diabetes.
