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Explanatory models of diabetes: Patient practitioner variation

Author

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  • Cohen, Marlene Zichi
  • Tripp-Reimer, Toni
  • Smith, Christopher
  • Sorofman, Bernard
  • Lively, Sonja

Abstract

Most cases of diabetes, a complex disorder that requires many lifestyle changes, can be controlled if persons adhere to their prescribed regimen. However, compliance is difficult to attain. Differences in explanatory models between client and practitioner have been suggested as one reason for non-compliance in several disorders. In this ethnographic investigation, individual explanatory models were elicited from persons with diabetes and from health professionals working with these patients. Professionals described models of diabetes in general and their model of a particular patient's diabetes. A composite professional model was constructed and compared with each of the patients' models. The models were most congruent regarding treatment. Etiology, pathophysiology, and severity had less congruence, and time and mode of symptom onset were least congruent. The Spearman correlation coefficient showed a positive but non-significant association of explanatory model congruence between professionals and patients with normal glycosylated hemoglobin levels. Patients and professionals seem to emphasize different domains; patients emphasized difficulties in the social domain and the impact of diabetes on their lives while staff saw diabetes primarily as a pathophysiological problem with impact on patients' physical bodies. This study's importance rests on its clear articulation of significant differences between patients' and staffs' models even when they are similar in demographic characteristics.

Suggested Citation

  • Cohen, Marlene Zichi & Tripp-Reimer, Toni & Smith, Christopher & Sorofman, Bernard & Lively, Sonja, 1994. "Explanatory models of diabetes: Patient practitioner variation," Social Science & Medicine, Elsevier, vol. 38(1), pages 59-66, January.
    • Handle: RePEc:eee:socmed:v:38:y:1994:i:1:p:59-66
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    Cited by:

    1. Weller, Susan C. & Baer, Roberta D. & Garcia de Alba Garcia, Javier & Salcedo Rocha, Ana L., 2012. "Explanatory models of diabetes in the U.S. and Mexico: The patient–provider gap and cultural competence," Social Science & Medicine, Elsevier, vol. 75(6), pages 1088-1096.
    2. Cynthia K. Russell & Therese Geraci & Anne Hooper & Linda Shull & David M. Gregory, 1998. "Patients' Explanatory Models for Heart Failure and COPD Exacerbations," Clinical Nursing Research, , vol. 7(2), pages 164-188, May.
    3. Naemiratch, Bhensri & Manderson, Lenore, 2006. "Control and adherence: Living with diabetes in Bangkok, Thailand," Social Science & Medicine, Elsevier, vol. 63(5), pages 1147-1157, September.
    4. Everett, Margaret, 2011. "They say it runs in the family: Diabetes and inheritance in Oaxaca, Mexico," Social Science & Medicine, Elsevier, vol. 72(11), pages 1776-1783, June.
    5. Lawton, Julia & Peel, Elizabeth & Parry, Odette & Araoz, Gonzalo & Douglas, Margaret, 2005. "Lay perceptions of type 2 diabetes in Scotland: bringing health services back in," Social Science & Medicine, Elsevier, vol. 60(7), pages 1423-1435, April.
    6. Olafsdottir, Sigrun & Pescosolido, Bernice A., 2011. "Constructing illness: How the public in eight Western nations respond to a clinical description of "schizophrenia"," Social Science & Medicine, Elsevier, vol. 73(6), pages 929-938, September.

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    Keywords

    explanatory models diabetes;

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