title: Is organizational justice associated with clinical performance in the care for patients with diabetes in primary care? Evidence from the improving Quality of care in Diabetes study.
abstract: BACKGROUND
  Type 2 diabetes is an increasingly prevalent illness, and there is considerable variation in the quality of care provided to patients with diabetes in primary care.
  
  
  OBJECTIVE
  The aim of this study was to explore whether organizational justice and organizational citizenship behaviour are associated with the behaviours of clinical staff when providing care for patients with diabetes.
  
  
  METHODS
  The data were from an ongoing prospective multicenter study, the 'improving Quality of care in Diabetes' (iQuaD) study. Participants (N = 467) were clinical staff in 99 primary care practices in the UK. The outcome measures were six self-reported clinical behaviours: prescribing for glycaemic control, prescribing for blood pressure control, foot examination, giving advice about weight management, providing general education about diabetes and giving advice about self-management. Organizational justice perceptions were collected using a self-administered questionnaire. The associations between organizational justice and behavioural outcomes were tested using linear multilevel regression modelling.
  
  
  RESULTS
  Higher scores on the procedural component of organizational justice were associated with more frequent weight management advice, self-management advice and provision of general education for patients with diabetes. The associations between justice and clinical behaviours were not explained by individual or practice characteristics, but evidence was found for the partial mediating role of organizational citizenship behaviour.
  
  
  CONCLUSIONS
  Quality improvement efforts aimed at increasing advice and education provision in diabetes management in primary care could target also perceptions of procedural justice.
authors.affiliation: National Institute for Health and Welfare (THL) Helsinki, Finland. marko.elovainio@thl.fi
authors.forename: Marko
authors.initials: M
authors.lastname: Elovainio
authors.forename: Nick
authors.initials: N
authors.lastname: Steen
authors.forename: Justin
authors.initials: J
authors.lastname: Presseau
authors.forename: Jill
authors.initials: J
authors.lastname: Francis
authors.forename: Susan
authors.initials: S
authors.lastname: Hrisos
authors.forename: Gillian
authors.initials: G
authors.lastname: Hawthorne
authors.forename: Marie
authors.initials: M
authors.lastname: Johnston
authors.forename: Elaine
authors.initials: E
authors.lastname: Stamp
authors.forename: Margaret
authors.initials: M
authors.lastname: Hunter
authors.forename: Jeremy M
authors.initials: JM
authors.lastname: Grimshaw
authors.forename: Martin P
authors.initials: MP
authors.lastname: Eccles
mesh_terms: D001291:Attitude of Health Personnel; D001835:Body Weight; D003657:Decision Making; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000628:therapy*; D017719:Diabetic Foot / Q000175:diagnosis / Q000517:prevention & control; D037001:Directive Counseling; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D008297:Male; D010353:Patient Education as Topic; D057184:Practice Patterns, Nurses'; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care / Q000458:organization & administration* / Q000592:standards*; D011787:Quality of Health Care; D012648:Self Care
chemical_list: D006442:Glycated Hemoglobin