Problem solving and diabetes self-care.

An important objective of diabetes care is to provide patients with self-regulation skills. For patients to assume responsibility for their own regimens, they need to have good problem-solving skills to cope with ongoing personal, social, and environmental barriers to adherence. Therefore, a Diabetes Problem Solving Interview for adults was developed and evaluated with 126 non-insulin-dependent outpatients. Interviewers elicited problem-solving strategies patients would use to cope with a variety of situations potentially interfering with dietary, exercise, and glucose testing adherence. Interviews were tape recorded and coded by trained raters to produce scores on both overall problem-solving skill ratings and frequency of use of different types of strategies. Results revealed only minor influences of patient characteristics on problem-solving measures. Prospective analyses revealed that problem-solving measures were significant and independent predictors of levels of dietary and exercise self-care at a 6-month follow-up.