Physicians' Ability to Influence the Life-Style Behaviors of Diabetic Patients

Abstract

Diabetes is aggravated by a sedentary lifestyle, obesity and smoking. Based on a theoretical model relating attitudes and behavior, this study examined the association between physicians' self efficacy in counseling diabetic patients on life style behaviors and their counseling practices. Data were gathered from a representative sample of 743 primary care physicians in Israel's two largest health plans. The main findings were that only a small percentage of physicians felt capable of influencing their patients' life-style behaviors. Self-efficacy had an independent effect on the likelihood of counseling diabetic patients on life style behaviors, controlling for other background variables. We conclude that there is a need for enhancing physicians' life-style counseling skills, and that social workers could expand their role by training physicians to counsel effectively. This could both improve the care of diabetic patients, and strengthen the status of the social work profession in the healthcare system.

The biopsychosocial model and quality of life in persons with active epilepsy

“…Social workers have unique skill sets with regards to mental health screening and treatment that are not provided by medically-focused nursing care, especially in area of discharge planning(333). Social workers are also critical through their training in the biopsychosocial model in terms of providing psychoeducation and life-style counseling(334). Patient education via social workers has been shown to be effective for improving health outcomes such as reduced medication needs, reduced duration of treatment and hospitals stays, improvements in risk-reducing behavior, and reduction of risk factors(335).As pay for performance measures are quickly moving forward in the health care system, the recent American Academy of Neurology (AAN) report Quality improvement in neurology: AAM epilepsy quality measures failed to go beyond the strictly biological-biomedical approach (336) called for by the IOM.…”

Clinicians’ perceived barriers and enablers to the dietary management of adults with type 2 diabetes in primary care: A systematic review

“…Although all studies included a qualitative approach, four studies chose to analyse their questionnaires quantitatively. [39][40][41][42] Olivarius et al 43 comprised a mixed methods study and Hooper and Barker 44 focused on nutrition education rather than solely diabetes dietary advice. The studies were considered trustworthy, although half did not offer detail concerning the role of the researcher.…”

“…The task of changing a patient's dietary habits was generally considered to be more challenging than medical management, although the studies were older or considered of lesser quality to this review. 39,42,43,48 Knowledge With further exploration of that confidence in a clinician's ability to give diabetes dietary advice, gaps in nutritional knowledge have been documented. Hooper and Barker 44 reported that half of nurses correctly answered a series of diet-related questions compared with a fifth of general practitioners.…”

“…No conflicts of interest were declared. Gross et al 42 and Jansink et al 14 benefited from national research monies. Olivarius et al 43 part funded their study through the Health Insurance Foundation.…”

Increasing Diabetes Educators' Confidence in Physical Activity and Exercise Counselling: The Effectiveness of the “Physical Activity and Exercise Toolkit” Training Intervention

“…confidence to manage specific situational demands to achieve a desired goal) (21) to prescribe or counsel patients regarding physical activity and exercise (17,18) and to appropriately refer patients requiring additional clearance for physical activity (17). Self-efficacy is a key determinant of behaviour (21) and such low confidence may influence the likelihood that DEs will counsel individuals with diabetes regarding lifestyle behaviours (22). Recent work by Dillman et al (17) supports this relationship because DEs who included physical activity and exercise in less than 25% of their sessions with patients reported lower efficacy for physical activity and exercise counselling than those who counselled more often on the topic.…”