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Implementation of a Structured Diabetes Consultation Model to Facilitate a Person-Centered Approach:Results From a Nationwide Dutch Study

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  • معلومة اضافية
    • الموضوع:
      2018
    • Collection:
      KNAW: Research Explorer (Koninklijke Nederlandse Akademie van Wetenschappen / Royal Netherlands Academy of Arts and Sciences)
    • نبذة مختصرة :
      OBJECTIVE: We assessed both from a patient and provider perspective the usefulness and added value of a consultation model that facilitates person-centered diabetes care. RESEARCH DESIGN AND METHODS: The model consists of 1) inventory of disease and patient-related factors; 2) setting personal goals; 3) choosing treatment; and 4) determination of required care. It was implemented in 47 general practices and 6 hospital outpatient clinics. Providers were trained, and patients were recommended to prepare their visit. All filled out a questionnaire after every consultation. Differences between primary and secondary care practices and between physician-led and nurse-led consultations were analyzed. RESULTS: Seventy-four physicians and thirty-one nurses participated, reporting on 1,366 consultations with type 2 diabetes patients. According to providers, the model was applicable in 72.4% (nurses 79.3% vs. physicians 68.5%, P < 0.001). Physicians more often had a consultation time <25 min (80.4% vs. 56.9%, P < 0.001). According to providers, two of three patients spoke more than half of the consultation time (outpatient clinics 75.2% vs. general practices 66.6%, P = 0.002; nurses 73.2% vs. physicians 64.4%, P = 0.001). Providers stated that person-related factors often determined treatment goals. Almost all patients (94.4%) reported that they made shared decisions; they felt more involved than before (with physicians 45.1% vs. with nurses 33.6%, P < 0.001) and rated the consultation 8.6 of 10. After physician-led consultations, 52.5% reported that the consultation was better than before (nurse visit 33.7%, P < 0.001). CONCLUSIONS: A consultation model to facilitate person-centered care seems well applicable and results in more patient involvement, including shared decision making, and is appreciated by a substantial number of patients.
    • Relation:
      https://pure.knaw.nl/portal/en/publications/2415178d-ddcc-449d-8aa0-80625fbb22c3
    • الرقم المعرف:
      10.2337/dc17-1194
    • Rights:
      info:eu-repo/semantics/openAccess
    • الرقم المعرف:
      edsbas.1CBF9E78