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Understanding care relationships in diabetes practice: A psychodynamic interview-based exploratory study.

Francesco Marchini1,2, Andrea Caputo1, Viviana Langher1

  • 1Department of Dynamic and Clinical Psychology, "Sapienza" University of Rome, Rome, Italy.

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Physicians in diabetes care experience complex emotions like ambivalence and devotion, impacting their professional well-being. Training in emotional labor is crucial for preventing burnout and improving patient adherence.

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Area of Science:

  • Psychology
  • Internal Medicine
  • Healthcare Management

Background:

  • Diabetes care presents unique emotional challenges for physicians.
  • Understanding physicians' subjective experiences is vital for their professional health and patient adherence management.

Purpose of the Study:

  • To explore physicians' emotional experiences in diabetes care relationships.
  • To identify factors influencing physician professional health and patient adherence.

Main Methods:

  • An interview-based exploratory study with 18 physicians in diabetes care.
  • Analysis of in-depth interviews using computer-based text analysis (Cluster and Correspondence Analysis).
  • Psychodynamic and constructivist lens applied to thematic and factor identification.

Main Results:

  • Six thematic domains emerged: Concern, Control, Ambivalence, Devotion, Guilt, and Strive for Achievement.
  • Three latent dimensions explained 69.20% of variance: Affect Repression, Tendency to Repair, and Anxiety Pattern.
  • Physicians' efforts to restore patients' psychological integrity in chronic conditions were a key finding.

Conclusions:

  • Diabetes care is inherently challenging, requiring significant emotional labor from physicians.
  • Emotional labor training is recommended to prevent physician burnout and enhance shared decision-making.
  • Findings are preliminary due to sample size and convenience sampling.