Problem solving and diabetes self-management: investigation in a large, multiracial sample.
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.


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.
Glasgow
Russell E
RE
Clinical Research Unit, Kaiser Permanente Colorado, P.O. Box 378066, Denver, CO 80237-8066, USA. russg@ris.net
Fisher
Lawrence
L
Skaff
Marilyn
M
Mullan
Joe
J
Toobert
Deborah J
DJ
D000368:Aged; D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000523:psychology* / Q000534:rehabilitation*; D003927:Diet, Diabetic; D004522:Educational Status; D005006:Ethnicity; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D011340:Problem Solving; D044469:Racial Groups; D012044:Regression Analysis; D012648:Self Care; D011795:Surveys and Questionnaires
D006442:Glycated Hemoglobin