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- Title
Provider-patient communication and metabolic control.
- Authors
STREET, JR., RICHARD L.; PIZIAK, VERONICA K.; CARPENTIER, WLLMA S.; HERZOG, JEAN; HEJL, JOYCE; SKINNER, GLADYS; MCLELLAN, LYNN; Street, R L Jr; Piziak, V K; Carpentier, W S; Herzog, J; Hejl, J; Skinner, G; McLellan, L
- Abstract
<bold>Objective: </bold>To determine whether nurses' and NIDDM patients' communication styles during consultations are related to subsequent metabolic control and to examine factors influencing patterns of communication in these consultations.<bold>Research Design and Methods: </bold>A total of 47 NIDDM patients participated in the study and completed the following procedures: 1) assessment of baseline HbA1, 2) attended 3.5 days of diabetes education, 3) returned in 1 mo for a follow-up consultation with a nurse, and (4) returned in 9-12 wk for a follow-up HbA1 assessment. The communication variables coded from the consultations were the frequency with which nurses produced controlling, informative, and patient-centered utterances and the frequency with which patients sought information, engaged in decision making, and expressed negative affect.<bold>Results: </bold>The results were as follows: 1) patients experienced poorer metabolic control after interacting with nurses who were more controlling and directive in their communication with patients (r = 0.39, P < 0.01); 2) the nurses' use of patient-centered responses was directly related to the degree to which patients expressed feelings (r = 0.34, P < 0.01) and exhibited decision-making behavior (r = 0.62, P < 0.01); and 3) several of the nurses' and patients' communicative behaviors were related to patient characteristics such as age, sex, education, and baseline HbA1 levels.<bold>Conclusions: </bold>The results suggest that providers' attempts to exert considerable control during consultations with NIDDM patients may be counterproductive and contribute to poorer outcomes. The findings also indicate that patient-centered behaviors (e.g., encouraging the patient's involvement, respecting the patient's opinion, and offering support) facilitate the patient's ability to be an active participant in the consultation.
- Publication
Diabetes Care, 1993, Vol 16, Issue 5, p714
- ISSN
0149-5992
- Publication type
journal article
- DOI
10.2337/diacare.16.5.714