Determinants of attrition from diabetes self-management education programs
By: by Enza Gucciardi.
Published: 2006
Language: eng
Number of pages: 192
ISBN-13: 9780494158753
Description: The phenomenon of attrition from diabetes self-management education (DSME) has received little attention in the literature. Findings about factors associated with patient attrition from diabetes health services have been often contradictory and largely inconclusive. A series of four studies were conducted to investigate determinants of attrition from DSME. We recruited patients attending their first visit at diabetes education centres who were diagnosed with type 2 diabetes. We defined attrition as three or fewer patient-provider contacts at a diabetes education centre over a one-year period and classified patients as users or nonusers of ongoing DSME. Logistic regression was used to analyze potential predictors of program attrition. Conventional content analysis was used to code and generate themes from text gathered from an open-ended question. Psychometric analyses were conducted to assess the new scales we developed. We observed an attrition rate between 43% and 50% across studies. Being over 65 or younger than 50 years of age, primarily speaking English, working full or part-time, having a regular primary care physician, fewer diabetes symptoms, low self-efficacy in overcoming barriers to use services, low intentions to use services, and the centre patients attended were important predictors of program attrition. The most common reasons cited by patients for attrition were conflict between patients' work schedule and the centre's hours of operation, patients' confidence with the amount of diabetes knowledge obtained, confidence in managing their diabetes, apathy towards diabetes education, distance to the centre, forgetfulness, seeing a physician regularly, low perceived seriousness of the disease, and lack of familiarity with the centre and its services. The new scales have good comprehension and psychometric properties. Individuals with diabetes need the necessary information and support to become an effective self-manager of their diabetes. This would entail primary care providers to inform patients of DSME and to encourage full participation of these services. We need to improve delivery of DSME that facilitate the ongoing monitoring, support and routine care that a chronic illness such as diabetes requires. Restructuring the delivery of DSME should lead to programs offering a broader range of intervention approaches with greater access, convenience and choice.
Notes: Source: Dissertation Abstracts International, Volume: 67-07, Section: B, page: 3736.

Thesis (Ph.D.)--University of Toronto, 2006.

Includes bibliographic references.

Electronic version licensed for access by U. of T. users.