title: Communicating with older diabetes patients: self-management and social comparison.
abstract: OBJECTIVE
  The health status and life experiences of older diabetes patients may be highly heterogeneous, thus making their perspectives particularly relevant for developing individualized self-management plans for this population. Our earlier research showed older diabetes patients' healthcare goals and self-management behaviors are frequently shaped through social comparisons with peers/family members. The present paper explores this role of social comparison in their self-management practices and develops a conceptual model depicting the process.
  
  
  METHODS
  Data were collected using open-ended, semi-structured interviews to elicit 28 older, type 2 diabetes patients' healthcare goals and self-management practices. Qualitative techniques were used to extract salient themes.
  
  
  RESULTS
  Social comparison plays a salient role in routinizing older patients' self-management practices. Almost all patients assess their self-management by making "downward" comparisons with individuals doing worse than them; "upward" comparisons are rarely invoked. Occasionally patients' social comparisons lead them to adopt "normalizing" behaviors resulting in deviations from medically recommended self-care.
  
  
  CONCLUSIONS
  The findings formed the basis for developing a conceptual model delineating the role of social comparison in self-management that can be beneficial for providers in tailoring educational interventions for self-management.
  
  
  CONCLUSIONS
  Fostering these comparisons can help providers enhance communication on initiating and sustaining self-management practices.
authors.affiliation: The University of Chicago, Department of Medicine, Chicago, IL 60637, USA. rbhat@medicine.bsd.uchicago.edu
authors.forename: Rita
authors.initials: R
authors.lastname: Gorawara-Bhat
authors.forename: Elbert S
authors.initials: ES
authors.lastname: Huang
authors.forename: Marshall H
authors.initials: MH
authors.lastname: Chin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002641:Chicago; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology / Q000628:therapy*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008960:Models, Psychological; D009042:Motivation; D010379:Peer Group; D012648:Self Care / Q000523:psychology*; D012919:Social Behavior; D012933:Social Identification