Problem Solving and Diabetes Self-Management
Investigation in a large, multiracial sample
- Russell E. Glasgow, PHD1,
- Lawrence Fisher, PHD2,
- Marilyn Skaff, PHD2,
- Joe Mullan, PHD2 and
- Deborah J. Toobert, PHD3
- 1Clinical Research Unit, Kaiser Permanente Colorado, Denver, Colorado
- 2Department of Family and Community Medicine, University of California, San Francisco, California
- 3Oregon 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
Abstract
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.
Footnotes
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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 September 29, 2006.
- Received July 3, 2006.
- DIABETES CARE
