The Patient-Doctor Relationship and Metabolic Control in Patients with Type 1 (Insulin-Dependent) Diabetes Mellitus

Viinamäki, Heimo; Niskanen, Leo; Korhonen, Timo; Tähkä, Veikko

doi:10.2190/glkj-1g71-ncd6-dp6k

Cited by 19 publications

(11 citation statements)

References 39 publications

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“…A positive collaboration between patient and provider has been found to be associated with improved patient participation in their care (5-7), improved treatment adherence and outcomes (5,7-9), fewer cancellations and failures to attend appointments (10), and increased negotiation and compromise about treatment (11). In diabetes, patient satisfaction with the patient-provider relationship is significantly associated with better adherence to treatment (12) and metabolic control (13).…”

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confidence: 99%

Interpersonal Predictors of HbA1c in Patients With Type 1 Diabetes

2002

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OBJECTIVE -Research suggests that increased collaboration and satisfaction in the patientprovider relationship is associated with better outcomes in patients with diabetes. In adults, an interpersonal style characterized by low trust of others and excessive self-reliance is known as "dismissing attachment style." We hypothesized that diabetic patients with dismissing attachment style, due to a decreased ability to collaborate with providers and others, would have significantly higher HbA 1c levels than patients with secure attachment style. RESEARCH DESIGN AND METHODS-From 276 adult tertiary care patients with type 1 diabetes, we obtained mean HbA 1c levels over the prior year and assessed patient attachment style, demographics, and clinical characteristics. We used 2 tests and logistic regression to determine whether attachment style was associated with HbA 1c levels.RESULTS -We found that 62% of patients with dismissing attachment style had mean HbA 1c levels Ն8% compared with 34% of patients with secure attachment style (P ϭ 0.002). After adjusting for demographics, diabetes severity, medical comorbidity, and depression, dismissing attachment style remained significantly associated with HbA 1c levels Ն8%, compared with secure attachment style (odds ratio 2.5, 95% CI 1.1-6.0).CONCLUSIONS -We have found that dismissing attachment style is associated with a higher risk for poor glycemic control. This has relevance from a population-based perspective because ϳ25% of the general population has a dismissing attachment style. Attachment style is easily measured using self-report instruments and may inform clinicians how to work with patients who are less engaged in the health care relationship. Diabetes Care 25:731-736, 2002

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Interpersonal Predictors of HbA1c in Patients With Type 1 Diabetes

2002

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“…Increasingly, psychological, psychosocial and attitudinal factors have been studied as possible contributors to illness and death in a variety of diseases [4–7], as well as asthma [8]. Hypothesised pathways include effects on lung function directly [9], on symptom reporting [10,11], on healthcare use [12] and compliance with treatment [13].…”

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confidence: 99%

Psychological factors in severe chronic asthma

Vamos

Kolbe

1999

Aust N Z J Psychiatry

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Levels of asthma knowledge were dangerously low, despite apparently adequate educational initiatives. In addition, patients with severe asthma have high levels of distress, particularly of anxiety, even between attacks. Their attitudes to their illness are multifactorial, and are significantly correlated with emotional distress, morbidity indices and some demographic factors. While this may point the way to interventions designed to relieve patients' distress, the hypothesis that this might in turn relate to practical asthma knowledge was not confirmed.

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“…As Measured by the Wai-O-S / Agreement-Confidence Van Thiel et al [140] Maastricht History -Taking and Advice Checklist (Maas) Viinamaki et al [141] Illustrative Items Waitzkin [45] Doctor -Patient Communication Waldvogel et al [142] Core Conflictual Relationship Theme (CCRT) Wallston et al [143] Health Locus of Control Scale Items Ware and Snyder [30] The Patient Satisfaction Scale Ware et al [144,145] Ware Satisfaction Scale findings of this study generally suggest that in the presence of a common language between doctors and patients, doctor-patient relationship can be measured independently of the technical characteristics of the relationship due to roles and medical specialty. Until now, the numerous instruments concerning the therapeutic relationship are based largely on different frameworks and theories and their use has been limited to the investigation of the relationship as coloured by roles and specialty.…”

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confidence: 99%

The Development of an Instrument for the Assessment of Doctor-Patient Relationship (Dopraq-16)

Koutsosimou

Adamidis²,

Liakos³

et al. 2013

J Psychol Psychother

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The objective was to assess the quality of the doctor-patient relationship, following a clinical consultation, through the development of a questionnaire that asks identical questions to doctors and patients. Therefore, a systematic search of the world literature in eight languages to include all available questionnaires measuring aspects of the doctor-patient relationship led to two separate comprehensive sets of questions, which were administered separately to doctor and patient pairs following clinical consultations. Principal component and factor analyses were performed to identify common factors in the doctor-patient relationship. On the basis of results and review of common questions in doctor and patient questionnaires, a questionnaire was constructed, with identical questions for doctors and patients. Concurrent validity was assessed through a 1-10 analogue scale and correlation between doctor and patient responses was studied. As an outcome, sets of 122 and 137 questions for doctors and patients respectively have been identified and administered to 461 doctor-patient pairs following clinical consultation. Principal component analyses revealed 24 factors for doctors and 31 factors for patients, accounting for 73.3 and 70.8% of variance respectively. A series of factor analyses showed that factors vary for patients, doctors and medical specialties. A final analysis including only common questions for doctors and patients led to a two-factor solution, resulting to a 16item questionnaire. Together these findings suggest that the Doctor-Patient Relationship Assessment Questionnaire (DoPRAQ-16) has good psychometric properties, while common questions provide a common language, for measuring the doctor-patient relationship.

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The Patient-Doctor Relationship and Metabolic Control in Patients with Type 1 (Insulin-Dependent) Diabetes Mellitus

Abstract: Patient's positively-experienced patient-doctor relationship was associated with good metabolic control of diabetes.

Cited by 19 publications

References 39 publications

Interpersonal Predictors of HbA1c in Patients With Type 1 Diabetes

Interpersonal Predictors of HbA1c in Patients With Type 1 Diabetes

Psychological factors in severe chronic asthma

The Development of an Instrument for the Assessment of Doctor-Patient Relationship (Dopraq-16)

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