Background: Active participation in medical decision-making is promoted for patients with diabetes but little is known about diabetic patients' actual interaction styles or the impact of these styles on other outcomes.
Purpose: To describe diabetic patients' interaction styles with providers and assess the association between these styles and patients' satisfaction with care and regimen adherence.
Methods: In a prospective study of 239 inner-city clinic patients with type II diabetes and 61 physicians, we conducted patient interviews and chart reviews to assess demographic, clinical and psychosocial characteristics and audiotaped 110 English-speaking and 50 Spanish-speaking patient-provider visits. We used a theoretically-based disease-specific coding scheme with 4 coders to evaluate 110 English-speaking interactions for affective and verbal behaviors. We measured post-visit satisfaction using a previously-validated 14-item scale, and self-reported adherence 4 weeks later, by phone, using a previously-validated 6-point 8-item scale.
Results: Interrater agreement on patient-provider interaction style codes was: 84%(affective components), 97% (topics), 94% (who introduced), 84% (presence of response and discussion) and 48% (manner of introduction). On average, 36% of topics were about diabetic self-care, 20% diabetic complications and 37% nondiabetes issues. Overall, patients were less satisfied with their care than comparable national samples. In bivariate analyses, emotional warmth of the provider was associated with patient satisfaction (p<.05) and regimen adherence (p<.10). Additional results regarding specific verbal decision-making processes and their independent association to patient satisfaction and adherence will be presented.
Conclusion: Patient-provider rapport may importantly influence diabetic patients' satisfaction with care and adherence to their self-care regimen.
Learning Objectives: Participants in this session will gain an understanding of diabetic patients' communication styles in making medical decisions with their providers. This session will provide methodologic information about a new disease-specific, but adaptable, interactional analysis system to assess patient-provider interactions for type and degree of patient participation in medical decision making. Participants will aquire information about factors that are associated with patient satisfaction and adherence among patients with type II diabetes
Keywords: Diabetes, Communication
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.