Martinez William, Wallston Kenneth A, Schlundt David G, Hickson Gerald B, Bonnet Kemberlee R, Trochez Ricardo J, Elasy Tom A
Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Vanderbilt University School of Nursing, Nashville, Tennessee, USA.
BMJ Open Diabetes Res Care. 2018 May 21;6(1):e000488. doi: 10.1136/bmjdrc-2017-000488. eCollection 2018.
Social comparisons (ie, self-evaluation in comparison with others) influence patients' perspectives of their disease and may impact motivation and health behavior; however, little is known about patients' perspectives toward receiving such information in a clinical context (eg, from their doctor's office or health system). This study aims to understand patients' perspectives and anticipated responses to receiving social comparison information regarding measures of their diabetes-related health status (eg, A1C) and how receiving such information would compare with goal-based comparisons (ie, self-evaluation in comparison with goal).
We conducted semistructured interviews with 25 patients with type 2 diabetes mellitus (T2DM) regarding social and goal-based comparisons involving their diabetes health status and qualitatively analyzed interviews for themes.
We identified seven major themes: self-relevance, motivation, self-concept, emotions, information seeking, medical care, and self-care. Participants commonly anticipated increased motivation and improved health behaviors in response to both social and goal-based comparisons. Subthemes unique to social comparisons included belief that this information would be motivating by engaging some patients' competitiveness, perception that this information was more 'personalized' than comparisons with a standard goal (eg, A1C<7), and desire to learn from individuals similar to oneself who were doing better.
Our findings provide significant insights into the anticipated response of patients with T2DM to receiving social and goal-based comparison information regarding their diabetes health status. Providing patients with diabetes with social and goal-based comparison information may affect motivation, mood, and self-concept in ways that may improve or sustain diabetes self-care behaviors for some patients.
社会比较(即与他人比较进行自我评估)会影响患者对自身疾病的看法,并可能影响其动机和健康行为;然而,对于患者在临床环境(例如从医生办公室或医疗系统)中接收此类信息的看法知之甚少。本研究旨在了解患者对于接收有关其糖尿病相关健康状况指标(例如糖化血红蛋白)的社会比较信息的看法和预期反应,以及接收此类信息与基于目标的比较(即与目标比较进行自我评估)相比会如何。
我们对25名2型糖尿病患者进行了半结构化访谈,内容涉及与他们糖尿病健康状况相关的社会比较和基于目标的比较,并对访谈主题进行了定性分析。
我们确定了七个主要主题:自我相关性、动机、自我概念、情绪、信息寻求、医疗护理和自我护理。参与者普遍预期,无论是社会比较还是基于目标的比较,都会增强动机并改善健康行为。社会比较特有的子主题包括:认为此类信息会激发一些患者的竞争意识从而具有激励作用;认为此类信息比与标准目标(例如糖化血红蛋白<7)的比较更“个性化”;以及渴望向情况较好的类似个体学习。
我们的研究结果为2型糖尿病患者接收有关其糖尿病健康状况的社会比较和基于目标的比较信息的预期反应提供了重要见解。为糖尿病患者提供社会比较和基于目标的比较信息,可能会以某种方式影响动机、情绪和自我概念,从而改善或维持部分患者的糖尿病自我护理行为。