title: Are differences between patient and provider explanatory models of diabetes associated with patient self-management and glycemic control?
abstract: In this study we test whether differences between patient and provider explanatory models of diabetes affect self-management and glucose control in type 2 diabetes patients. Diabetic patients (n=60) and family practice physicians (n=39) in Guadalajara, Mexico, responded to a structured explanatory model interview (130 questions on causes, symptoms, and treatments). A cultural consensus analysis indicated a widely shared model among physicians and provided a single shared set of answers to the questions. Patient-provider congruence in beliefs was assessed by comparing each patient's responses with the physician answer set. Congruence in beliefs predicted self-management behaviors (r=0.27, p=.03), more than educational level (r=0.16, p=.23), but was not predictive of A1C (r=0.12, p=.40). Differences between patient and physician explanatory models can adversely affect patient-directed activities and may indirectly affect glycemic control by affecting self-management. These differences may be due to low patient educational level and resulting problems in understanding biomedical approaches to diabetes.
authors.forename: Susan C
authors.initials: SC
authors.lastname: Weller
authors.forename: Roberta D
authors.initials: RD
authors.lastname: Baer
authors.forename: Javier Garcia
authors.initials: JG
authors.lastname: de Alba Garcia
authors.forename: Ana L
authors.initials: AL
authors.lastname: Salcedo Rocha
mesh_terms: D001291:Attitude of Health Personnel; D054521:Cultural Competency; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008800:Mexico; D008875:Middle Aged; D010817:Physician-Patient Relations; D010821:Physicians, Family; D016601:RNA-Binding Proteins / Q000032:analysis; D012648:Self Care
chemical_list: C411647:A1CF protein, human; D016601:RNA-Binding Proteins