Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, USA.
Augusta University, Augusta, USA.
Patient Educ Couns. 2019 Nov;102(11):2097-2101. doi: 10.1016/j.pec.2019.05.023. Epub 2019 May 27.
This study aims to identify differences in how patients living with prediabetes (preDM) or type 2 diabetes (T2DM) perceive their illness.
Following chart review, a cross-sectional survey was administered to patients diagnosed with preDM or T2DM at two US medical centers.
Among 757 respondents, multivariate tests demonstrate that patients living with T2DM have an overall different personal model of disease than patients living with preDM. Patients who have been diagnosed with T2DM report a better understanding of their disease and perceive it to be more chronic in nature than patients living with preDM. Findings revealed a potential but less significant difference in perceived seriousness.
In this first application of personal models of disease to prediabetes, results inform implications for clinicians to talk with patients about preDM. Patients living with preDM indicate less understanding of the "disease" and perceive it to be less "chronic," which may result from unclear clinician communication about preDM.
When clinicians talk to patients about prediabetes, they should present the risk factor within the spectrum of glucose tolerance. Although labeled a risk factor, clinicians should emphasize that prediabetes remains a serious concern that will not lessen without intervention.
本研究旨在识别患有前驱糖尿病(preDM)或 2 型糖尿病(T2DM)的患者对疾病的感知差异。
在病历回顾后,我们在美国的两个医疗中心对 preDM 或 T2DM 患者进行了横断面调查。
在 757 名应答者中,多元检验表明,与 preDM 患者相比,T2DM 患者的疾病个人模型总体上存在差异。与 preDM 患者相比,被诊断患有 T2DM 的患者对自己的疾病有更好的了解,并且认为疾病更具有慢性特征。研究结果还显示出在感知严重性方面存在潜在但不太显著的差异。
在首次将疾病个人模型应用于前驱糖尿病的研究中,结果为临床医生与患者讨论前驱糖尿病提供了启示。与 preDM 患者相比,患有前驱糖尿病的患者对“疾病”的理解较少,并且认为它的慢性程度较低,这可能是由于临床医生对前驱糖尿病的沟通不明确所致。
当临床医生与患者讨论前驱糖尿病时,他们应将该风险因素放在葡萄糖耐量谱内呈现。尽管前驱糖尿病被标记为风险因素,但临床医生应强调前驱糖尿病仍然是一个严重的问题,如果不进行干预,它不会减轻。