Related Experiment Video
Updated: Aug 11, 2026
Effects of Mindfulness Training Combined with Tai Chi in Patients with Diabetic Peripheral Neuropathy
Published on: July 14, 2023
Dimensions of patient-provider communication and diabetes self-care in an ethnically diverse population
John D Piette1, Dean Schillinger, Michael B Potter
1Center for Practice Management and Outcomes Research, VA Ann Arbor Health Care System, Ann Arbor, Mich 48113-0170, USA. jpiette@umich.edu
Background:
Patient-provider communication is essential for effective care of diabetes and other chronic illnesses. However, the relative impact of general versus disease-specific communication on self-management is poorly understood, as are the determinants of these 2 communication dimensions.
Design:
Cross-sectional survey.
Setting:
Three VA heath care systems, 1 county health care system, and 1 university-based health care system.
Patients:
Seven hundred fifty-two diabetes patients were enrolled. Fifty-two percent were nonwhite, 18% had less than a high-school education, and 8% were primarily Spanish-speaking.
Measurements And Main Results:
Patients' assessments of providers' general and diabetes-specific communication were measured using validated scales. Self-reported foot care; and adherence to hypoglycemic medications, dietary recommendations, and exercise were measured using standard items. General and diabetes-specific communication reports were only moderately correlated (r =.35) and had differing predictors. In multivariate probit analyses, both dimensions of communication were independently associated with self-care in each of the 4 areas examined. Sociodemographically vulnerable patients (racial and language minorities and those with less education) reported communication that was as good or better than that reported by other patients. Patients receiving most of their diabetes care from their primary provider and patients with a longer primary care relationship reported better general communication. VA and county clinic patients reported better diabetes-specific communication than did university clinic patients.
Conclusions:
General and diabetes-specific communication are related but unique facets of patient-provider interactions, and improving either one may improve self-management. Providers in these sites are communicating successfully with vulnerable patients. These findings reinforce the potential importance of continuity and differences among VA, county, and university health care systems as determinants of patient-provider communication.
Related Concept Videos
01:23Techniques of Therapeutic Communication II: Focusing, Paraphrasing, and Summarizing
This therapeutic technique can also be used when a patient brings up pertinent information during a health-related conversation. The...
01:25Role of Communication in the Nursing Process I: Assessment and Diagnosis
The nursing process considers the patient's emotional and physical well-being. The process can be repeated or stopped at any point if judged essential. Assessment is the first step in the nursing process.
01:25Role of Communication in the Nursing Process II: Planning and Implementation
01:14SBAR II: Application of SBAR
SBAR Report from a Nurse to a Health Care Provider
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...
01:21Barriers to Effective Communication II
Cultural barriers:
Differences in values, beliefs, religion, knowledge, and tradition can significantly impact communication. Awareness of nonverbal cues is critical, especially when conversing with a patient from a different culture. What appears appropriate in one culture may be inappropriate in another.
Semantic barriers:
As a result of their tendency to use...
01:15Diabetes: Management and Pharmacotherapy
Insulin remains the cornerstone of treatment for most patients with type 1 and many...