McLaren Regional Medical Center, Flint, MI 48532, USA.
Patient Educ Couns. 2011 Nov;85(2):143-7. doi: 10.1016/j.pec.2010.09.025. Epub 2010 Oct 29.
To determine the effect size of provider communication about self-care and the provider's following treatment guidelines on the self-care behaviors of people with Type 2 diabetes (T2DM).
Data were from the TRIAD telephone surveys of Michigan patients in managed care with T2DM (n=1438). The survey asked about the patients' self-care and provider communication about blood glucose monitoring, exercise, foot care, flu vaccination and annual retina screening.
After controlling for patient socio-demographics and disease severity, remembering having received provider information on these activities more than doubled the odds of performing blood glucose monitoring, and performing foot examinations. It also significantly increased the amount of exercise the patient performed. Provider modeling had a strong association with foot care. Counseling by a diabetes educator was positively and significantly associated with having an annual retina examination and receiving an influenza vaccination.
Remembering self-care information is associated with increased home based self-care by patients and their families. Consulting with a diabetes educator can substantially improve patient self-care.
Health care providers should encourage patient education. However, physician time is costly and most nurses do not specialize in patient education; one solution is to refer patients to a diabetes educator.
确定关于自我护理的提供者沟通和提供者遵循治疗指南对 2 型糖尿病（T2DM）患者自我护理行为的效果大小。
数据来自密歇根州接受管理式护理的 T2DM 患者的 TRIAD 电话调查（n=1438）。调查询问了患者的自我护理以及关于血糖监测、运动、足部护理、流感疫苗接种和年度视网膜检查的提供者沟通情况。
在控制了患者的社会人口统计学和疾病严重程度后，记住接受过这些活动的提供者信息，使进行血糖监测的几率增加了一倍以上，并且进行足部检查的几率也显著增加。患者进行的运动量也显著增加。提供者示范与足部护理有很强的关联。糖尿病教育者的咨询与每年进行视网膜检查和接种流感疫苗呈正相关且显著相关。
记住自我护理信息与患者及其家属在家中进行更多自我护理有关。咨询糖尿病教育者可以大大改善患者的自我护理。
医疗保健提供者应鼓励患者教育。然而，医生的时间成本很高，而且大多数护士都不专门从事患者教育；一种解决方案是将患者转介给糖尿病教育者。
