Department of Family and Community Medicine, Eisenhower Army Medical Center, Fort Gordon, GA, USA.
Department of Family and Community Medicine, Eisenhower Army Medical Center, Fort Gordon, GA, USA.
Patient Educ Couns. 2018 May;101(5):894-899. doi: 10.1016/j.pec.2017.12.007. Epub 2017 Dec 9.
Prediabetes (preDM) and diabetes are complex conditions that place significant strain on medical providers. This can have a negative impact on providers' wellbeing and could impact clinical decisions. We investigated the interplay of caring for patients with prediabetes, physician mental wellbeing, and clinical care.
Using the theory of planned behavior, we conducted a secondary analysis to evaluate physicians' self-reported provision of care to patients with preDM. We evaluated the effect of mental wellbeing and perceived barriers to caring for patients with preDM.
Among 1015 academic physicians, a greater perception of barriers to care and a higher percentage of patients seen with preDM were both significantly associated with a less positive physician state of mind. Physician state of mind was not associated with self-reported clinical behavior. Physician perception of patient barriers has a positive correlation with their likelihood of prescribing metformin for preDM.
Caring for a larger proportion of patients with preDM is associated with worse mental wellbeing. Physician attitudes and subjective norms may predict adherence to guidelines, while physician attitudes and wellbeing affect self-reported prescribing behavior.
Future research should evaluate ways to lessen the psychological burden of caring for patients with diabetes and preDM.
前驱糖尿病（preDM）和糖尿病是复杂的病症，给医疗服务提供者带来了巨大的压力。这可能对提供者的幸福感产生负面影响，并影响临床决策。我们研究了照顾前驱糖尿病患者、医生心理健康和临床护理之间的相互作用。
我们使用计划行为理论进行二次分析，评估医生自我报告的为前驱糖尿病患者提供的护理情况。我们评估了心理健康和照顾前驱糖尿病患者的感知障碍对医生的影响。
在 1015 名学术医生中，更多的照顾障碍感知和更多的前驱糖尿病患者就诊与医生心态更消极显著相关。医生心态与自我报告的临床行为无关。医生对患者障碍的感知与他们为前驱糖尿病开二甲双胍的可能性呈正相关。
照顾更多的前驱糖尿病患者与心理健康状况恶化有关。医生的态度和主观规范可能预示着对指南的遵守，而医生的态度和幸福感则影响自我报告的处方行为。
未来的研究应该评估减轻照顾糖尿病和前驱糖尿病患者的心理负担的方法。
