Health Care and Patient-Reported Outcomes
Results of the cross-national Diabetes Attitudes, Wishes and Needs (DAWN) study
- Richard R. Rubin, PHD12,
- Mark Peyrot, PHD13,
- Linda M. Siminerio, PHD, RN4 and
- on behalf of the International DAWN Advisory Panel*
- 1Department of Medicine, The Johns Hopkins University, Baltimore, Maryland
- 2Department of Pediatrics, The Johns Hopkins University, Baltimore, Maryland
- 3Department of Sociology, Loyola College
- 4University of Pittsburgh Diabetes Institute, Pittsburgh, Pennsylvania
- Address correspondence and reprint requests to Richard R. Rubin, PhD, 946 East Piney Hill Rd., Monkton, MD 21111. E-mail: rrubin443{at}aol.com
Abstract
OBJECTIVE—The purpose of this study was to assess the relationship of patients’ self-reported 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 = 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.
Footnotes
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↵* A complete list of International DAWN Advisory Panel members can be found in the appendix.
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R.R.R. and M.P. have served on advisory boards for and have received honoraria, consulting fees, and grant/research support from Novo Nordisk. L.M.S. has served on advisory boards for Novo Nordisk, Eli Lilly, Takeda, Sanofi-Aventis, and Amylin.
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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- Accepted March 8, 2006.
- Received December 19, 2005.
- DIABETES CARE
