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Challenges faced by physicians when discussing the Type 2 diabetes diagnosis with patients: insights from a cross‐national study (IntroDia ® )
Author(s) -
Capehorn M.,
Polonsky W. H.,
Edelman S.,
Belton A.,
Down S.,
Gamerman V.,
Nagel F.,
Lee J.,
Alzaid A.
Publication year - 2017
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.13357
Subject(s) - medicine , type 2 diabetes , diabetes mellitus , family medicine , type 1 diabetes , medline , intensive care medicine , endocrinology , political science , law
Aims To investigate physicians’ recalled experiences of their conversations with patients at diagnosis of Type 2 diabetes, because physician–patient communication at that time may influence the patient's subsequent self‐care and outcomes. Methods As part of a large cross‐national study of physician–patient communication during early treatment of Type 2 diabetes (IntroDia ® ), we conducted a cross‐sectional survey of physicians treating people with Type 2 diabetes in 26 countries across Africa, Asia, Europe, Latin America, the Middle East, North America and Oceania. The survey battery was designed to evaluate physician experiences during diagnosis conversations as well as physician empathy (measured using the Jefferson Scale of Physician Empathy). Results A total of 6753 of 9247 eligible physicians completed the IntroDia ® survey (response rate 73.0%). Most respondents (87.5%) agreed that the conversation at diagnosis of Type 2 diabetes impacts the patient's acceptance of the condition and self‐care. However, almost all physicians (98.9%) reported challenges during this conversation. Exploratory factor analysis revealed two related yet distinct types of challenges ( r = 0.64, P < 0.0001) associated with either patients (eight challenges, α = 0.87) or the situation itself at diagnosis (four challenges, α = 0.72). There was a significant inverse association between physician empathy and overall challenge burden, as well as between empathy and each of the two types of challenges (all P < 0.0001). Study limitations include reliance on accurate physician recall and inability to assign causality to observed associations. Conclusions Globally, most physicians indicated that conversations with patients at diagnosis of Type 2 diabetes strongly influence patient self‐care. Higher physician empathy was associated with fewer challenges during the diagnosis conversation.