Phramongkutklao College of Medicine, Bangkok, Thailand.
Cosmopolitan International Diabetes and Endocrinology Center, Columbia, Missouri, USA.
J Eval Clin Pract. 2025 Feb;31(1):e14234. doi: 10.1111/jep.14234. Epub 2024 Nov 4.
This feasibility study evaluated the effectiveness of Support-Engage-Empower-Diabetes (SEE-Diabetes), a patient-centered educational tool designed to promote shared decision-making of diabetes management in older adults. We aimed to assess SEE-Diabetes's ability to facilitate patient engagement and collaborative goal setting, as measured by the Observational Patient Involvement (OPTION) scale and Shared Decision-Making Questionnaire (SDM-Q-Doc). We hypothesized that these instruments would effectively differentiate between healthcare providers who actively leveraged SEE-Diabetes to guide patient-centric conversations and set goals compared to those who did not.
SEE-Diabetes, developed through a 4-year user-centered design process, was employed in simulated clinical encounters at the University of Missouri Health Care. We conducted an analysis of 12 clinical encounters using video recordings. This analysis involved three simulated patients and four providers, two internals and two externals, utilizing a mixed-methods approach. We assessed the decision-making process using SEE-Diabetes by SDM-Q-Doc, OPTION scale, and conversation analysis.
The average scores for the SDM-Q-Doc and the OPTION scale, out of a possible 100, were 52.6 and 75.9, respectively. Our findings revealed that active provider engagement with SEE-Diabetes during patient interactions served as an effective medium to facilitate shared decision-making and to set patient-centered goals. Providers who actively utilized SEE-Diabetes to guide conversations, ask open-ended questions, and incorporate patient input into goal setting demonstrated significantly higher OPTION and SDM-Q-Doc scores compared to those who used the tool less frequently or primarily for documentation purposes. Providers expressed positive feedback, highlighting its conciseness, patient-centricity, and optimism about integrating SEE-Diabetes into their future practices.
SEE-Diabetes showed considerable promise in improving interactions between patients and providers, presenting an innovative approach to diabetes management for older adults. This tool has the potential to not only close communication gaps but also enable patients to take a more active role in their healthcare decisions.
本可行性研究评估了支持-参与-授权-糖尿病（SEE-Diabetes）的有效性，这是一种以患者为中心的教育工具，旨在促进老年糖尿病患者管理中的共同决策。我们旨在评估 SEE-Diabetes 通过观察性患者参与（OPTION）量表和共享决策问卷（SDM-Q-Doc）促进患者参与和共同目标设定的能力。我们假设，这些工具将有效地区分积极利用 SEE-Diabetes 指导以患者为中心的对话和设定目标的医疗保健提供者与不这样做的提供者。
通过 4 年的以用户为中心的设计过程开发的 SEE-Diabetes，在密苏里大学卫生保健中心的模拟临床环境中使用。我们对 12 次临床遭遇进行了视频记录分析。这项分析涉及三个模拟患者和四个提供者，两个内部和两个外部，采用混合方法。我们使用 SDM-Q-Doc、OPTION 量表和对话分析评估了 SEE-Diabetes 的决策过程。
SDM-Q-Doc 和 OPTION 量表的平均得分为 52.6 和 75.9（满分 100）。我们的研究结果表明，提供者在患者互动中积极参与 SEE-Diabetes，是促进共同决策和设定以患者为中心的目标的有效媒介。与那些较少或主要出于记录目的使用工具的提供者相比，积极利用 SEE-Diabetes 指导对话、提出开放式问题并将患者的意见纳入目标设定的提供者，其 OPTION 和 SDM-Q-Doc 得分显著更高。提供者表示了积极的反馈，强调了它的简洁性、以患者为中心和对将 SEE-Diabetes 纳入他们未来实践的乐观态度。
SEE-Diabetes 在改善患者与提供者之间的互动方面显示出相当大的前景，为老年糖尿病患者提供了一种创新的管理方法。该工具不仅有可能弥合沟通差距，而且还使患者能够在他们的医疗保健决策中发挥更积极的作用。
