Diabetes Educators' Perspectives on Barriers for Patients and Educators in Diabetes Education

Sprague, Maureen A.; Shultz, Jill Armstrong; Branen, Laurel J.; Lambeth, Suzanne; Hillers, Virginia N.

doi:10.1177/014572179902500608

Cited by 31 publications

(44 citation statements)

References 10 publications

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“…45,46 In this study, the main barriers across most self-care behaviors were cost and depression. These 2 variables were highly correlated with each other.…”

Section: Discussionmentioning

confidence: 80%

An Assessment of Attitudes, Behaviors, and Outcomes of Patients with Type 2 Diabetes

Daly¹,

Hartz²,

Xu³

et al. 2009

The Journal of the American Board of Family Medicine

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Objectives: Patient self-care behaviors, including taking medication, following a meal plan, exercising regularly, and testing blood glucose, influence diabetes control. The purpose of this research was to identify (1) which barriers to diabetes management are associated with problem behaviors and (2) which patient behaviors and barriers are associated with diabetes control.Methods: This was a cross-sectional study of linked medical record and self-reported information from patients with type 2 diabetes. A randomly selected sample of 800 clinic patients was mailed an investigator-developed survey. The study sample consisted of 253 (55%) individuals who had measured glycosylated hemoglobin (HbA1c) within 3 months of the survey date.Results: The barriers to each diabetes self-care behavior differed. Cost was the most common barrier to the 4 self-care behaviors. In a multivariable regression model, the belief that type 2 diabetes is a serious problem and depression were strongly associated with higher HbA1c levels. Lower HbA1c levels were significantly associated with being married and greater self-reported adherence-satisfaction with taking medication and testing blood glucose.Conclusion: This study expanded earlier research by focusing on 4 specific self-care behaviors, their barriers, and their association with HbA1c. Barriers that were significantly associated with HbA1c were specific to the behavior and varied across behaviors. Although the importance of glycemic control is well established, 1 it is often not achieved. 2 Factors contributing to poor control include inadequacies in patient self-care behaviors, medical management, or both. [3][4][5][6][7] Physicians know that patient self-care behaviors influence diabetes control but may lack training for and interest in motivating their patients to improve these behaviors. 8 Contributing to poor control is a paucity of information available about the frequency of problem behaviors, barriers to appropriate care behaviors, or the relationship of specific patient self-care behaviors to glycemic control. 9,10 Our conceptual model for this study is shown in Figure 1, adapted from the works of Glasgow. 11Factors that influence diabetes adherence in our model include personal factors, such as type and duration of diabetes, illness, and other health conditions and psychosocial factors. Glasgow's model places primary emphasis on the variables of the patient-health care provider interactions, compliance, and outcomes. The patient-provider interactions are composed of the patient's perspective and participation, appropriateness of prescriptions, and clarity and specificity of recommendations. The social/environmental influences included barriers to adherence, community resources, social support, and economic factors. The primary emphases of this study were the performance of 4 primary self-care behaviors and specific barriers to these behaviors: (1) medication use, (2) meal plans, (3) exercise, and (4) home glucose testing. In addition, our model attempts to include many ...

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“…45,46 In this study, the main barriers across most self-care behaviors were cost and depression. These 2 variables were highly correlated with each other.…”

Section: Discussionmentioning

confidence: 80%

An Assessment of Attitudes, Behaviors, and Outcomes of Patients with Type 2 Diabetes

Daly¹,

Hartz²,

Xu³

et al. 2009

The Journal of the American Board of Family Medicine

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“…5 Factors preventing access to diabetes education are multifaceted and include travel to attend DSME, limited insurance reimbursement for DSME, difficulty attending classes due to work schedule or child care issues, or disabilities that make travel to DSME services challenging. 5,6 The increasing prevalence of diabetes is resulting in limited availability and access to diabetes care services, including access to certified diabetes educators. It is estimated that there is about one certified diabetes educator per 1,400 patients with diabetes in the United States.…”

Section: Introductionmentioning

confidence: 99%

Internet Delivered Diabetes Self-Management Education: A Review

Pereira

Phillips

Johnson

et al. 2015

Diabetes Technology & Therapeutics

138

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“…Barriers to self-management expressed by patients with diabetes are strongly associated with adherence to treatment regimens Glasgow, 1994;Polly, 1992;Wilson et al, 1986) and patients' subjective estimates of diabetes control (Lewis, Jennings, Ward, & Bradley,1990). Barriers to physical activity and diet occur most often , the regimen areas most closely associated with lifestyle changes (Rubin, Peyrot, & Saudek, 1991;Sprague et al, 1999). Although assessing patient barriers to learning is a standard of practice for diabetes educators (American Association of Diabetes Educators, 1992), no research was found that compares and contrasts patients' perceptions about diet and exercise barriers with diabetes educators' perceptions of those barriers.…”

mentioning

confidence: 99%

A Comparison of Views of Individuals with Type 2 Diabetes Mellitus and Diabetes Educators About Barriers to Diet and Exercise

Shultz

Sprague²,

Branen³

et al. 2001

Journal of Health Communication

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Diet and exercise are the cornerstones of treatment for persons with type 2 diabetes mellitus, yet patients find these areas of self-management to be the most difficult. Considerable research has indicated that barriers to diet and exercise are critical influences determining adherence to diet and exercise plans. Standards of practice require educators to assess patient barriers to self-management. However, little research has investigated whether patients and educators perceive these barriers similarly. This project's objectives were to compare and contrast patients' and educators' perspectives of patient barriers to following a meal or exercise plan, and to identify differences in patients' perceived barriers as related to patient characteristics. Patients with type 2 diabetes mellitus (n = 97) from three eastern Washington area hospitals and diabetes educators (n = 143) from the Washington Association of Diabetes Educators (WADE) were recruited for a mail survey. From the patient survey, the proportion of patients on meal plan (52%) or exercise plan (26%) was low. Certain barriers were prominent for both patients and educators relative to diet (difficulty maintaining a diet away from home, liking foods not in the meal plan) and exercise (not a high priority, weather). However, multivariate analyses indicated that patients and educators view barriers differently. Similarities and differences between educators and patients in response to barriers are discussed relative to enhancing diabetes counseling and education, and overall communication between educators and patients.

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Diabetes Educators' Perspectives on Barriers for Patients and Educators in Diabetes Education

Cited by 31 publications

References 10 publications

An Assessment of Attitudes, Behaviors, and Outcomes of Patients with Type 2 Diabetes

An Assessment of Attitudes, Behaviors, and Outcomes of Patients with Type 2 Diabetes

Internet Delivered Diabetes Self-Management Education: A Review

A Comparison of Views of Individuals with Type 2 Diabetes Mellitus and Diabetes Educators About Barriers to Diet and Exercise

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