Using the common sense model of illness selfregulation to understand diabetes-related distress: The importance of being able to 'make sense' of diabetes

This study examines the relationships between illness perceptions and illness-related distress among adults with type 2 diabetes. Research participants (N = 615) were randomly selected from a primary care database in New Zealand. Data were collected through a mailed questionnaire survey and review of medical records. The primary outcome was diabetes-related psychological distress measured using the Problem Areas in Diabetes (PAID) scale. Multiple regression analyses controlling for age, clinical characteristics, and mental health showed that illness perceptions accounted for 15% of differences in distress about diabetes (F change (4,462) = 35.37, p < .001). Poor mental health and illness severity alone do not explain differences in diabetes-related emotional adjustment. Results suggest that ‘making sense’ of diabetes may be central to successfully managing the emotional consequences of diabetes.FALSEPublishe

Drivers of overall satisfaction with primary care: Evidence from the English General Practice Patient Survey

This is the final version. Available from Wiley via the DOI in this record.Background/objectives: To determine which aspects of primary care matter most to patients, we aim to identify those aspects of patient experience that show the strongest relationship with overall satisfaction and examine the extent to which these relationships vary by socio-demographic and health characteristics. Design/setting: Data from the 2009/10 English General Practice Patient Survey including 2 169 718 respondents registered with 8362 primary care practices. Measures/analyses: Linear mixed-effects regression models (fixed effects adjusting for age, gender, ethnicity, deprivation, self-reported health, self-reported mental health condition and random practice effect) predicting overall satisfaction from six items covering four domains of care: access, helpfulness of receptionists, doctor communication and nurse communication. Additional models using interactions tested whether associations between patient experience and satisfaction varied by socio-demographic group. Results: Doctor communication showed the strongest relationship with overall satisfaction (standardized coefficient 0.48, 95% CI = 0.48, 0.48), followed by the helpfulness of reception staff (standardized coefficient 0.22, 95% CI = 0.22, 0.22). Among six measures of patient experience, obtaining appointments in advance showed the weakest relationship with overall satisfaction (standardized coefficient 0.06, 95% CI = 0.05, 0.06). Interactions showed statistically significant but small variation in the importance of drivers across different patient groups. Conclusions: For all patient groups, communication with the doctor is the most important driver of overall satisfaction with primary care in England, along with the helpfulness of receptionists. In contrast, and despite being a policy priority for government, measures of access, including the ability to obtain appointments, were poorly related to overall satisfaction.UK Department of HealthNational Institute for Health Research (NIHR