Department of Medical Psychology, VU University Medical Centre, Amsterdam, The Netherlands.
Patient Educ Couns. 2011 Nov;85(2):258-63. doi: 10.1016/j.pec.2010.08.019. Epub 2010 Oct 6.
To explore across countries the extent to which physicians understand Type 2 diabetes patients' perceptions of seriousness, worries about complications, emotional distress, and needs for care improvement.
Cross-sectional data were collected in a multinational survey (SHARED). Type 2 diabetes patients (n=1609), general practitioners (n=818) and diabetes specialists (n=697) from eight countries were included. Data were gathered online and via telephone interviews. Responses from patients and professionals were compared using descriptive statistics and multilevel analyses.
Patients generally perceived diabetes as a serious condition and reported moderate distress. Physicians tended to underestimate patients' perceived seriousness, while overestimating their level of distress. Physicians had difficulty estimating which diabetes complications concerned patients most, and what they needed to feel more confident about their diabetes. Patients did not wish for more consultation time, but rather active involvement, information and easy access to their physician.
Results of this large survey highlight the importance of patient involvement and shared decision making.
Further improvement of patient-provider communication as a basis for shared responsibilities and achieving optimal treatment outcomes is needed. With the growing numbers of diabetes patients worldwide, task delegation should be considered, in the framework of a multidisciplinary diabetes care model.
探索各国医生对 2 型糖尿病患者对疾病严重程度、并发症担忧、情绪困扰以及改善护理需求的认知程度。
采用多国横断面调查(SHARED)收集数据。纳入来自 8 个国家的 1609 例 2 型糖尿病患者、818 例全科医生和 697 例糖尿病专科医生。数据通过在线和电话访谈收集。使用描述性统计和多水平分析比较患者和医生的反应。
患者普遍认为糖尿病是一种严重的疾病,并报告中度困扰。医生往往低估患者对疾病的严重程度的认知,而高估其困扰程度。医生难以估计哪些糖尿病并发症最令患者担忧,以及患者对自身糖尿病治疗需要哪些方面的信心。患者并不希望增加咨询时间,而是希望更积极地参与治疗、获得信息并方便地与医生联系。
这项大型调查的结果强调了患者参与和共同决策的重要性。
需要进一步改善医患沟通,作为共同承担责任和实现最佳治疗效果的基础。随着全球糖尿病患者数量的增加,应考虑在多学科糖尿病护理模式框架内进行任务分工。