title: A better model of diabetes self-management? Interactions between GP communication and patient self-efficacy in self-monitoring of blood glucose.
abstract: OBJECTIVE
  The aim of this exploratory study was to investigate the interaction between patient self-efficacy and GP communication in explaining diabetes self-management in a disadvantaged region of Sydney, Australia.
  
  
  METHODS
  This study was undertaken in South West Sydney with the Fairfield Division of General Practice. We used a cross-sectional survey design to assess patients' self-reported beliefs and behaviours about diabetes self-management. We used hierarchical multiple linear regression to test for interaction effects in diabetes self-management, following tests for clustering using multilevel modeling.
  
  
  RESULTS
  Of those eligible for survey, 105 patients completed the telephone survey (72%). There was a significant interaction between diabetes self-efficacy and GP communication in blood glucose testing; high-ratings of GP communication enhanced self-monitoring of blood glucose when patient self-efficacy was high but impeded self-monitoring of blood glucose when self-efficacy was low. There were no significant interaction effects for the general diet or exercise scales.
  
  
  CONCLUSIONS
  This exploratory study suggests a complex relationship between patient self-efficacy and GP communication in self-monitoring of blood glucose. It is likely optimal diabetes self-management behaviours are produced by a fit between high patient self-efficacy and high quality GP communication.
  
  
  CONCLUSIONS
  There is a risk that GPs who are sensitive to their patients' low self-efficacy in self-monitoring of blood glucose may step in and take over the monitoring role and inadvertently reduce self-management.
authors.affiliation: School of Biomedical & Health Sciences, College of Health & Science, University of Western Sydney, Penrith South DC, NSW, Australia. v.rose@uws.edu.au
authors.forename: Vanessa
authors.initials: V
authors.lastname: Rose
authors.forename: Mark
authors.initials: M
authors.lastname: Harris
authors.forename: Maria Theresa
authors.initials: MT
authors.lastname: Ho
authors.forename: Upali W
authors.initials: UW
authors.lastname: Jayasinghe
mesh_terms: D001786:Blood Glucose / Q000032:analysis*; D003142:Communication; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D010349:Patient Compliance; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D012648:Self Care; D020377:Self Efficacy; D011795:Surveys and Questionnaires
chemical_list: D001786:Blood Glucose