How to engage type-2 diabetic patients in their own health management: implications for clinical practice

BMC Public Health

Claudio A Bosio¹  Chiara Libreri¹  Serena Barello¹  Guendalina Graffigna¹ 

[1] Faculty of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli 1, Milan 20123, Italy

关键词: Diaries;    Qualitative research;    Patient preference;    Type 2 diabetes;    Chronic disease;    Disengagement;    Patient engagement;   

Others  :  1129111
DOI  :  10.1186/1471-2458-14-648

 received in 2013-07-01, accepted in 2014-06-15,  发布年份 2014

【 摘 要 】

Background

Patient engagement (PE) is increasingly regarded as a key factor in the improvement of health behaviors and outcomes in the management of chronic disease, such as type 2 diabetes. This article explores (1) the reasons for disengagement of diabetic patients and their unique subjective attitudes from their experience and (2) the elements that may hinder PE in health management.

Methods

29 Type-2 uncontrolled diabetes patients were asked to keep a one-week diary related to their experience of disease management, according to the narrative inquiry qualitative approach. They were interviewed to ascertain reasons for PE. The elicited narratives were subjected to interpretive content analysis.

Results

The findings suggest that patients give meaning to their diabetes and its management through a complex frame of subjective experiential dimensions (cognitive/thinking, behavioral/conative and emotional/feeling), which have an impact on the spheres of daily life that are considered to be crucial in the management of diabetes (diet, physical activity, therapy, doctor-patient relationship) for each patient. These results suggest that PE develops along a continuum featuring four subsequent phases (blackout, arousal, adhesion, eudaimonic project). Several unmet needs related to the different phases of the PE continuum were discovered and illuminated possible types of support.

Conclusions

Our findings appear to confirm some features of PE detected by previous research, such as a behavioral component. We were also able to shed light on the synergic roles played by other subjective dimensions of patient experience (the cognitive/thinking and the emotional/feeling components) in orienting PE towards the care process. The article suggests a possible framework to deeply understand the PE process useful to orient really attuned actions to support it. These results suggest the importance of developing patient engagement assessment tools that are more firmly grounded in the individual patient experience.

【 授权许可】

   
2014 Graffigna et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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