Health communication, self-care, and treatment satisfaction among low-income diabetes patients in a public health setting

作者：White Richard O^*; Eden Svetlana; Wallston Kenneth A; Kripalani Sunil; Barto Shari; Shintani Ayumi; Rothman Russell L

来源：Patient Education and Counseling, 2015, 98(2): 144-149.

DOI：10.1016/j.pec.2014.10.019

• Diabetes
• Health communication
• Public health
• Primary care
• Provider education

Objective: Diabetes patients with limited resources often experience suboptimal care. Less is known about the role of effective health communication (HC) in caring for low income diabetes patients.
Methods: Ten health department clinics in TN participated in a trial evaluating a literacy-sensitive communication intervention. We assessed the quality of baseline HC and measured associations with diabetes outcomes. Assessments included: demographics, measures of HC, health literacy, self-care behaviors, self-efficacy, medication non-adherence, treatment satisfaction, and A1C. Unadjusted and adjusted multivariable regression models were used to test associations.
Results: Participants (N = 411) were 49.7 +/- 9.5 years, 61% female, uninsured (96%), with A1C 9.6 +/- 2.1. In unadjusted analyses, better communication, was associated with lower medication non-adherence (OR 0.40-0.68, all p < 0.05), higher treatment satisfaction (OR 1.76-1.96, all p < 0.01), portion size reduction (OR 1.43, p < 0.05), diabetes self-efficacy (OR 1.41, p < 0.05), and lower A1C (beta = -0.06, p < 0.01). In adjusted analyses, communication quality remained associated with lower medication non-adherence (AOR 0.39-0.68, all p < 0.05), and higher treatment satisfaction (AOR 1.90-2.21, all p < 0.001).
Conclusions: Better communication between low-income patients and providers was independently associated with lower medication non-adherence and higher treatment satisfaction.

• 出版日期2015-2
• 单位河北医科大学