type 2 diabetes patients’ perceptions of and satisfaction with healthcare in rural areas
DESCRIPTION
Type 2 diabetes patients’ perceptions of and satisfaction with healthcare in rural areas. ERWIN DE BLIEK REIN POSTHUMA SUPERVISOR: M. GLASSER, PHD SCIENTIFIC ELECTIVE 05-26-2008 - 09-26-2008. Introduction. Scientific elective Part of our 6th year as medical students 18 weeks - PowerPoint PPT PresentationTRANSCRIPT
ERWIN DE BLIEKREIN POSTHUMA
SUPERVISOR: M. GLASSER, PHDSCIENTIFIC ELECTIVE
05-26-2008 - 09-26-2008
Type 2 diabetes patients’ perceptions of and satisfaction with healthcare in rural areas
Introduction
Scientific elective Part of our 6th year as medical students 18 weeks Student is able to choose the project Collaboration between University of Maastricht and
UIC:J. Metsemakers and M. Glasser
Context
Diabetes is a serious health care problem 17.9 million diabetes patients Life-long monitoring Considerable costs
American Diabetes Association (ADA) guidelines Focuses mainly on what the physician should do
according to research and the evidence base
Patient’s view receives little attention
Context
Diabetes care is a challenge in rural areas Limited resources Few diabetes programs Lack of accessibility to speciality centers Lack of availability Lack of healthcare providers
Rural diabetes care is suboptimal when compared to more urban areas1
Aim of the study
Assess patients’ perspectives about diabetes care Satisfaction Expectation
Examine attitudes in relation to: gender and educational status
Determine physician perspectives of diabetes care they provide to patients
Understand perceived barriers to diabetes care
Methods
Participants Rural patients with type 2 diabetes Health care providers, family physicians, nurse
practioners4 Health clinics in Northern IllinoisPatients recruited through WHO-codes
Considered to be active if visited clinic in past three yearsExclusion
< 21 years Unable to understand English
Rurality was determined by the Rural Urban Commuting codes (RUCA) RUCA ≥4 is considered as rural
Methods
In total 1078 eligible patients
Questionnaires were mailed to participants with postage paid return envelope
Non-respondents received a reminder after three weeks
Clinic visits to leave surveys at front desk
Methods
Patient Questionnaire:1. General health questions2. Diabetes Treatment
Satisfaction Scale2
3. Diabetes Attitude Scale3
4. HbA1c knowledge5. Check-ups related to
ADA6. Delgado Expectation
Scale7. Barrier list8. Characteristics of
patient
Physician Questionnaire1. Diabetes control of
their patients2. Satisfaction about
given diabetes care3. Check-ups related to
ADA4. Delgado expectation
scale 5. Barrier list
Discussion
Useful to know patients’ views of their diabetes care Care should also be focused on patients needs and
expectations Diabetes needs an interdisciplinary approach Low response rate (16.6%) to-date?
The elderly patient Indirect approach
References
1. Andrus MR, Kelley KW, Murphey LM, Herndon KC. A comparison of diabetes care in rural and urban medical clinics in Alabama. J Community Health. 2004 Feb;29(1):29-44.
2. Bradley C, Plowright R, Stewart J, Valentine J, Witthaus E. The Diabetes Treatment Satisfaction Questionnaire change version (DTSQc) evaluated in insulin glargine trials shows greater responsiveness to improvements than the original DTSQ. Health Qual Life Outcomes. 2007;5:57.
3. Anderson RM, Fitzgerald JT, Funnell MM, Gruppen LD. The third version of the Diabetes Attitude Scale. Diabetes Care. 1998 Sep;21(9):1403-7.
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