A study of patients' perceptions of diabetes care delivery and diabetes: propositional analysis in people with type 1 and 2 diabetes managed by group or usual care.
OBJECTIVE
We investigated the perceptions of diabetes care and diabetes in patients followed long-term by group or usual care.


METHODS
Three open questions were administered to 120 patients (43 with T1DM and 77 with T2DM) who had been randomized at least 2 years before to be followed by group care and 121 (41 T1DM and 80 T2DM) who had always been on usual care. The responses were analyzed by propositional analysis, by identifying the focal nuclei, i.e., the terms around which all sentences are organized, and then other predicates, according to their hierarchical relationship to the nuclear proposition. Specific communicative units were arbitrarily classified into three categories: attitudes, empowerment, and locus of control.


RESULTS
Patients on group care showed more positive attitudes, higher sense of empowerment, and more internal locus of control than those on usual care. In addition, they expressed a wider and more articulated range of concepts associated with the care received and made less use of medical terminology (P < 0.001, all). Higher HbA(1c) was associated with negative attitudes (P = 0.025) and negative empowerment (P = 0.055).


CONCLUSIONS
Group treatment reinforces communication and peer identification and may achieve its clinical results by promoting awareness, self-efficacy, positive attitudes toward diabetes and the setting of care, an internal locus of control, and, ultimately, empowerment in the patients.
Laboratory of Clinical Pedagogy, Department of Internal Medicine, University of Turin, Turin, Italy.
Marzia
M
Raballo
Martina
M
Trevisan
Anna Franca
AF
Trinetta
Lorena
L
Charrier
Franco
F
Cavallo
Massimo
M
Porta
Marina
M
Trento
D000328:Adult; D003695:Delivery of Health Care; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010465:Perception / Q000502:physiology; D011795:Surveys and Questionnaires