Everyday expertise: cognitive demands in diabetes selfmanagement.

OBJECTIVE

To assess the relationship between decision making and successful diabetes self-management.

BACKGROUND

Patients with type II diabetes make routine but critical self-management decisions.

METHOD

We conducted cognitive task analysis interviews with 18 patients to examine problem detection, functional relationships, problem-solving strategies, and types of knowledge used to make self-management decisions. We expected that these decision processes would be related to behavioral adherence and glycemic control.

RESULTS

Verbal reports displaying problem detection skills, knowledge of functional relationships, and effective problem-solving strategies were all related to better adherence. Problem detection skill was linked to greater glycemic control. Participants differed in declarative and applied knowledge.

CONCLUSION

Diabetes self-management draws on the same cognitive skills found in experts from diverse professional domains. Considering diabetes self-management as a form of expertise may support adherence.

APPLICATION

Human factors approaches that support professional expertise may be useful for the decision making of patients with diabetes and other chronic diseases.