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Associations between Perceived Chronic Care Quality, Perceived Patient Centeredness, and Illness Representations among Persons with Diabetes

Thomas, Joseph III; Iyer, Neeraj N.; Collins, William B.

The Journal for Healthcare Quality (JHQ): September-October 2014 - Volume 36 - Issue 5 - p 50–59
doi: 10.1111/jhq.12077
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Abstract: Patient beliefs about their illness can motivate behaviors consistent with good disease management. Perceived high-quality chronic care would be expected to increase likelihood of having such beliefs. Associations between perceived quality of chronic care and illness representations, and associations between patient centeredness and illness representations were assessed among persons with diabetes. A mail survey of diabetic patients visiting a multispecialty physician network serving urban and suburban populations in a large midwestern city was conducted. The Patient Assessment of Chronic Illness Care-5A questionnaire was used to assess perceived chronic care quality and patient centeredness. The Brief Illness Perception Questionnaire was used to assess illness representations. Of 500 mailed surveys, 89 completed surveys were returned. The sample consisted mostly of retirees (61%), Whites (81%), and women (60%). Higher perceived chronic care quality was associated with better disease understanding of diabetes (0.24, p = .05). Patients reporting higher patient centeredness (or lower patient-centeredness scores) indicated better disease understanding (−0.26, p = .04) and those reporting higher patient centeredness (or lower patient-centeredness scores) perceived less impact of illness (0.29, p = .02). Chronic care quality as defined in the Chronic Care Model and consistency of chronic care with patient expectations (patient centeredness) was associated with illness representations favorable for good self-care management.

For more information on this article, contact Joseph Thomas III at jt3@purdue.edu.

Joseph Thomas III, PhD, FAPhA, is a Professor in the Purdue University, College of Pharmacy, Department of Pharmacy Practice and Director of Center for Health Outcomes Research and Policy in the Purdue University Regenstrief Center for Healthcare Engineering. Professor Thomas' research interests are understanding how variations in treatment affect health outcomes and cost of treatment analysis.

Neeraj N. Iyer, PhD is a Manager, Health Economics and Outcomes Research at Novo Nordisk Inc. At the time of this study, he was a Doctoral Candidate and Research Assistant in the Purdue University College of Pharmacy, Department of Pharmacy Practice and Center for Health Outcomes Research and Policy in the Purdue University Regenstrief Center for Healthcare Engineering. His research interests include health economics and health outcomes research.

William B. Collins, PhD, is a Clinical Associate Professor in the Brian Lamb School of Communication and a faculty scholar in the Regenstrief Center for Healthcare Engineering in Purdue's Discovery Park. His research interests include patient–provider communication and the adoption of health communication technologies.

© 2014 National Association for Healthcare Quality
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