Physician and Nurse Use of Psychosocial Strategies in Diabetes Care
Results of the cross-national Diabetes Attitudes, Wishes and Needs (DAWN) study
- Mark Peyrot, PHD12,
- Richard R. Rubin, PHD23,
- Linda M. Siminerio, PHD4 and
- on behalf of the International DAWN Advisory Panel *
- 1Department of Sociology, Loyola College, Baltimore, Maryland
- 2Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
- 3Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
- 4University of Pittsburgh Diabetes Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
- Address correspondence and reprint requests to Mark Peyrot, Loyola College, 4501 North Charles St., Baltimore, MD 21210-2699. E-mail: mpeyrot{at}loyola.edu
Abstract
OBJECTIVE—To determine the use of psychosocial strategies by health care providers in treating patients with diabetes and the factors associated with use of these strategies.
RESEARCH DESIGN AND METHODS—Cross-sectional survey of national samples of generalist and diabetes specialist physicians (n = 2,705) and nurses (n = 1,122) from the multinational study of Diabetes Attitudes, Wishes and Needs. Respondents were from 13 countries in Asia, Australia, Europe, and North America. Two psychosocial strategies were examined: provider psychosocial care, which provides psychosocial support by diabetes care providers to their own patients, and psychosocial specialist care, which refers diabetic patients to psychosocial specialists.
RESULTS—Compared with physicians, nurses perceived significantly higher prevalence and severity of psychosocial problems and used psychosocial strategies significantly more frequently, even though they rated their own psychosocial skills lower. Among both physicians and nurses, diabetes specialists were significantly more likely than generalists to utilize psychosocial strategies. Physicians and nurses used psychosocial strategies significantly more when they believed that more patients have psychosocial problems and that problems interfere more with diabetes control. Referral to psychosocial specialists was significantly more likely when physicians and nurses perceived that professional psychological resources were more available. There were substantial country differences in all factors studied. Compared with other countries, U.S. providers provided more psychosocial care themselves but were less likely to refer to psychosocial specialists.
CONCLUSIONS—Psychosocial strategies are important parts of the diabetes care provider repertoire; understanding their determinants may facilitate efforts to increase their use.
Footnotes
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↵* A complete list of International DAWN Advisory Panel members can be found in the appendix.
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M.P. and R.R.R. 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 16, 2006.
- Received December 13, 2005.
- DIABETES CARE
