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Dimensions of Patient-provider Communication and Diabetes Self-care in an Ethnically Diverse Population
dc.contributor.authorPiette, John D.en_US
dc.contributor.authorSchillinger, Deanen_US
dc.contributor.authorPotter, Michael B.en_US
dc.contributor.authorHeisler, Michele M.en_US
dc.date.accessioned2010-06-01T20:05:08Z
dc.date.available2010-06-01T20:05:08Z
dc.date.issued2003-08en_US
dc.identifier.citationPiette, John D.; Schillinger, Dean; Potter, Michael B.; Heisler, Michele (2003). "Dimensions of Patient-provider Communication and Diabetes Self-care in an Ethnically Diverse Population." Journal of General Internal Medicine 18(8): 624-633. <http://hdl.handle.net/2027.42/73211>en_US
dc.identifier.issn0884-8734en_US
dc.identifier.issn1525-1497en_US
dc.identifier.urihttps://hdl.handle.net/2027.42/73211
dc.identifier.urihttp://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=12911644&dopt=citationen_US
dc.description.abstractPatient-provider communication is essential for effective care of diabetes and other chronic illnesses. However, the relative impact of general versus disease-specific communication on self-management is poorly understood, as are the determinants of these 2 communication dimensions. DESIGN: Cross-sectional survey. SETTING: Three VA heath care systems, 1 county health care system, and 1 university-based health care system. PATIENTS: Seven hundred fifty-two diabetes patients were enrolled. Fifty-two percent were nonwhite, 18% had less than a high-school education, and 8% were primarily Spanish-speaking. MEASUREMENTS AND MAIN RESULTS: Patients' assessments of providers' general and diabetes-specific communication were measured using validated scales. Self-reported foot care; and adherence to hypoglycemic medications, dietary recommendations, and exercise were measured using standard items. General and diabetes-specific communication reports were only moderately correlated ( r = .35) and had differing predictors. In multivariate probit analyses, both dimensions of communication were independently associated with self-care in each of the 4 areas examined. Sociodemographically vulnerable patients (racial and language minorities and those with less education) reported communication that was as good or better than that reported by other patients. Patients receiving most of their diabetes care from their primary provider and patients with a longer primary care relationship reported better general communication. VA and county clinic patients reported better diabetes-specific communication than did university clinic patients. CONCLUSIONS: General and diabetes-specific communication are related but unique facets of patient-provider interactions, and improving either one may improve self-management. Providers in these sites are communicating successfully with vulnerable patients. These findings reinforce the potential importance of continuity and differences among VA, county, and university health care systems as determinants of patient-provider communication.en_US
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dc.format.extent3109 bytes
dc.format.mimetypeapplication/pdf
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dc.publisherBlackwell Science Incen_US
dc.rights2003 by the Society of General Internal Medicineen_US
dc.subject.otherDiabetes Mellitusen_US
dc.subject.otherSelf-careen_US
dc.subject.otherCommunication Barriersen_US
dc.subject.otherAccess to Careen_US
dc.subject.otherChronic Disease Managementen_US
dc.subject.otherQuality of Careen_US
dc.titleDimensions of Patient-provider Communication and Diabetes Self-care in an Ethnically Diverse Populationen_US
dc.typeArticleen_US
dc.subject.hlbsecondlevelInternal Medicine and Specialtiesen_US
dc.subject.hlbtoplevelHealth Sciencesen_US
dc.description.peerreviewedPeer Revieweden_US
dc.contributor.affiliationumReceived from the Center for Practice Management and Outcomes Research, VA Ann Arbor Health Care System (JDP, MH), and the Department of Internal Medicine, University of Michigan (JDP, MH), Ann Arbor, Mich; the Primary Care Research Center, San Francisco General Hospital (DS), and the Department of Family and Community Medicine (MBP), University of California–San Francisco, San Francisco, Calif.en_US
dc.identifier.pmid12911644en_US
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/73211/1/j.1525-1497.2003.31968.x.pdf
dc.identifier.doi10.1046/j.1525-1497.2003.31968.xen_US
dc.identifier.sourceJournal of General Internal Medicineen_US
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dc.owningcollnameInterdisciplinary and Peer-Reviewed


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