Provider-patient communication and metabolic control.
OBJECTIVE
To determine whether nurses' and NIDDM patients' communication styles during consultations are related to subsequent metabolic control and to examine factors influencing patterns of communication in these consultations.


METHODS
A total of 47 NIDDM patients participated in the study and completed the following procedures: 1) assessment of baseline HbA1, 2) attended 3.5 days of diabetes education, 3) returned in 1 mo for a follow-up consultation with a nurse, and (4) returned in 9-12 wk for a follow-up HbA1 assessment. The communication variables coded from the consultations were the frequency with which nurses produced controlling, informative, and patient-centered utterances and the frequency with which patients sought information, engaged in decision making, and expressed negative affect.


RESULTS
The results were as follows: 1) patients experienced poorer metabolic control after interacting with nurses who were more controlling and directive in their communication with patients (r = 0.39, P < 0.01); 2) the nurses' use of patient-centered responses was directly related to the degree to which patients expressed feelings (r = 0.34, P < 0.01) and exhibited decision-making behavior (r = 0.62, P < 0.01); and 3) several of the nurses' and patients' communicative behaviors were related to patient characteristics such as age, sex, education, and baseline HbA1 levels.


CONCLUSIONS
The results suggest that providers' attempts to exert considerable control during consultations with NIDDM patients may be counterproductive and contribute to poorer outcomes. The findings also indicate that patient-centered behaviors (e.g., encouraging the patient's involvement, respecting the patient's opinion, and offering support) facilitate the patient's ability to be an active participant in the consultation.
Department of Speech Communication, Texas A & M University College of Medicine, College Station 77843-4234.
R L
RL
Street
V K
VK
Piziak
W S
WS
Carpentier
J
J
Herzog
J
J
Hejl
G
G
Skinner
L
L
McLellan
D000367:Age Factors; D003142:Communication; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000451:nursing* / Q000534:rehabilitation*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009723:Nurse-Patient Relations; D010353:Patient Education as Topic; D010551:Personality; D012737:Sex Factors
D006442:Glycated Hemoglobin