title: Patient-centered outcomes of diabetes self-care. Associations with satisfaction and general health in a community clinic setting.
abstract: BACKGROUND
  Despite the recognition of strategies for diabetes care management, information systems that screen patient diabetes self-care problems are not commonplace, especially among low-income patients. This study examined correlates of three patient-centered outcomes of diabetes self-care (awareness of self-care components, difficulties in diabetes self-care, and adherence to self-care) among low-income diabetic patients.
  
  
  METHODS
  Clinical and patient survey data were obtained on 249 participants from 11 primary care community health clinics serving low-income populations in North Carolina in Project IDEAL (Improving Diabetes Education, Access to Care and Living). Measures of patient-centered outcomes of self-care were obtained from the Diabetes Quality Improvement Project (DQIP) Patient-Reported Measures set.
  
  
  RESULTS
  A substantial proportion of patients reported difficulty achieving standard self-care treatment goals. The study identified distinct patient characteristics associated with poor self-care outcomes. Increased understanding of self-care components and adherence to them were associated with increased perception of quality of care and, in turn, better general health perceptions in these patients (p < 0.01).
  
  
  CONCLUSIONS
  This study identified an unmet need for diabetes self-care knowledge and skills associated with patient outcomes in low-income patients. Routine monitoring of patient-centered self-care outcomes could help improve long-term outcomes of diabetes care in this population.
authors.affiliation: Department of Public Health Sciences, Wake Forest University School of Medicine, USA.
authors.forename: Roger T
authors.initials: RT
authors.lastname: Anderson
authors.forename: Rajesh
authors.initials: R
authors.lastname: Balkrishnan
authors.forename: Fabian
authors.initials: F
authors.lastname: Camacho
authors.forename: Ronny
authors.initials: R
authors.lastname: Bell
authors.forename: Vanessa
authors.initials: V
authors.lastname: Duren-Winfield
authors.forename: David
authors.initials: D
authors.lastname: Goff
mesh_terms: D003153:Community Health Services; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000208:ethnology / Q000628:therapy*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance / Q000208:ethnology; D010353:Patient Education as Topic; D017060:Patient Satisfaction / Q000208:ethnology; D018802:Patient-Centered Care / Q000592:standards; D011203:Poverty; D012648:Self Care / Q000592:standards*