Implementing person-centered communication in diabetes care: a new tool for diabetes care professionals

摘要

Purpose: This study tested the clinical implementation of the CoMac Communication System, an empirically validated tool for individualized Diabetes Self-Management Education and Support (DSMES). This system provides immediate feedback and guidance to health care providers (HCPs) to facilitate speaking with persons with type 2 diabetes mellitus in language reflecting patients’ own worldviews and health beliefs. Patients and methods: This 6-month implementation science study at an accredited diabetes care clinic in a Midwestern US hospital was conducted in two phases. Phase I consisted of CoMac implementation, qualitative interviews with HCPs, and evaluation of clinic flow among the diabetes education team. Seventy-two participants received CoMac’s linguistically tailored patient-centric communication; a control group of 48 did not receive this intervention. In Phase II, glycosylated hemoglobin A1c (HbA1c) levels from the first visit to the follow-up visit for each group were compared. Results: Interviews conducted during Phase I suggested that the system can be successfully implemented into DSMES practice. Knowing individual psychosocial profiles and participants’ language use allowed for more effective patient counseling. In Phase II, multiple regression analysis with HbA1c change as the dependent variable showed that the key variable of interest, treated with the CoMac intervention, had a one-tailed t -value of ?1.81, with a statistically significant probability value of 0.037. Conclusion: Findings suggest that use of the CoMac System by diabetes care professionals has the potential for improved patient health outcomes. Patients receiving the CoMac intervention showed significantly improved HbA1c levels, suggesting that this approach has great promise for effective DSMES management.