Health Care and Patient-Reported Outcomes

Abstract

OBJECTIVE -The purpose of this study was to assess the relationship of patients' selfreported well-being, self-management, and diabetes control with factors related to the patient's health care.RESEARCH DESIGN AND METHODS -This was a cross-sectional survey of national samples of patients with diabetes (n ϭ 5,104) from the multinational study of Diabetes Attitudes, Wishes and Needs (DAWN). Patients from 13 countries in Asia, Australia, Europe, and North America reported their level of well-being, self-management, and diabetes control. Hierarchical multiple regression analysis (blocks are countries, respondent characteristics, and health care features) was used to examine predictors of diabetes-related distress and general well-being, adherence to lifestyle and medical treatment recommendations, and perceived diabetes control and hyperglycemic symptoms.RESULTS -Country, respondent demographic and disease characteristics, and health care features were all associated with patient-reported outcomes. Better patient-provider collaboration was associated with more favorable ratings on all outcomes, and better access to the provider and availability of team care were associated with some positive outcomes. Country differences were only partly accounted for by patient and health care factors. Relationships between health care factors and outcomes varied across countries.CONCLUSIONS -Patients' reports of well-being, self-management, and diabetes control were related to the countries in which they live, their demographic and disease characteristics, and features of their health care. Opportunities to enhance patient-provider collaboration, access to care, and availability of team care should be pursued.

Prevalence of Psychological Insulin Resistance among Patients with Type 2 Diabetes at Kenyatta National Hospital, Kenya

“…Therefore it is not surprising that Injection-related anxiety was one of the most common reasons for resisting the idea of starting insulin therapy. [12,13]. About one third (33.5%) of our patients reported injection phobia and 44.3% believed that insulin injections are painful.…”

“…Norbert et al [4] have similarly demonstrated that patients on insulin treatment and those switched to insulin treatment had better appraisal of Insulin therapy than those on oral hypoglycemic agents (mean ITAS score: OAD group 53.6, switched to Insulin 46.2, on insulin at baseline group 44.5). Therefore, a negative appraisal of insulin treatment is probably modifiable by the initiation of insulin therapy and some barriers to uptake of insulin may be temporary [13]. However we were alive to considerations of the care-related context which is unique to countries and healthcare systems.…”

“…The DAWN study [13] reported that approximately 80% of their study population perceived insulin as not beneficial.…”

Insulinoterapia na diabetes mellitus tipo 2

“…Os segundos prendem-se com a ansiedade induzida no do médico para tratar o doente com insulina 10 . Estas cardiovascular, particularmente nos níveis de triglicerídeos e no colesterol das HDL 6,11 .…”

Team Care: The Preferred Approach to Diabetes Treatment

“…In the global Diabetes Attitude Wishes and Needs (DAWN) study, patients who had access to diabetes team members such as nurses reportedly had better outcomes [4,5].…”