WASHINGTON — A significant number of patients with diabetes say they need help coping with the disease, but too few have such psychological needs addressed during initial diabetes education sessions, Mark Peyrot, Ph.D., reported at the annual scientific sessions of the American Diabetes Association.
“Most of patients' basic care needs are addressed [in diabetes self-management training],” said Dr. Peyrot of the department of medicine at Johns Hopkins University, Baltimore. “But very little of their psychosocial needs are being addressed.”
Dr. Peyrot reported that 44% percent of 178 patients in this study, which was based at the University of Pittsburgh Medical Center, chose “healthy coping” as one of the areas in which they wanted help.
The patients were asked to review the American Association of Diabetes Educators' seven “self-care behaviors”—used in AADE's patient assessment and outcomes evaluation tools—and choose areas in which they wanted to set goals and learn skills. Patients could choose as many behaviors as they wished. The interest in “healthy coping” was unexpectedly similar to the interest expressed in “reducing risks” (49%), “being active” (46%), and “problem-solving” (41%).
Dr. Peyrot said that he expected interest in coping would be more modest. On the other hand, some areas—such as “monitoring” (chosen by 39%) and “taking medications” (chosen by 34%)—were rated “lower than what we'd expect,” he said.
Diabetes educators' responses to patients' needs varied widely. In 94% of initial visits, educators addressed monitoring issues, for instance, and in 88% and 87% of initial visits they addressed exercise and eating, respectively. Medications were addressed in 75% of visits, problem-solving in 44%, and risk reduction in 56%, said Dr. Peyrot, who is also director of the center for social and community research at Loyola College, Baltimore.
Although almost half of patients expressed psychological needs, coping was addressed in only 18% of patients' initial visits, he said. “To a large extent, there was a standardized package being delivered to patients.”
Patients in the study were seen at four University of Pittsburgh Medical Center diabetes self-management training programs.
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