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Problem Solving and Diabetes Self-Management

Investigation in a large, multiracial sample

¹ Clinical Research Unit, Kaiser Permanente Colorado, Denver, Colorado
² Department of Family and Community Medicine, University of California, San Francisco, California
³ Oregon Research Institute, Eugene, Oregon

Address correspondence and reprint requests to Russell E. Glasgow, PhD, Kaiser Permanente Colorado, P.O. Box 378066, Denver, CO 80237-8066; or 335 Road Runner Rd., Penrose, CO 81240. E-mail: russg{at}ris.net

OBJECTIVE—Problem solving is a core aspect of effective diabetes and chronic illness self-management, yet there are relatively few objective evaluations of problem-solving skills, especially in large, multiracial samples.

RESEARCH DESIGN AND METHODS—A multiracial sample of 506 adults who have type 2 diabetes were assessed on a variety of patient characteristics, self-management behaviors, and biological and psychosocial measures. They also completed the Diabetes Problem-Solving Interview (DPSI).

RESULTS—DPSI scores revealed significant variability across patients in problem-solving skill and were related to a number of comorbid conditions and complications but not to several other demographic factors, including race/ethnicity. Problem solving was also related to self-management behaviors (eating and exercise patterns), biological variables (A1C and lipids), and psychosocial measures (Diabetes Distress Scale) in multivariable analyses controlling for a variety of potential confounding factors.

CONCLUSIONS—Diabetes problem solving, as measured by the DPSI, is an important patient skill related to several key diabetes management variables that appears applicable across racial and ethnic groups. Future research is needed to identify the generality versus specificity of diabetes problem solving and practical interventions to enhance problem-solving skills.

Abbreviations: DPSI, Diabetes Problem-Solving Interview

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