RESUMEN
PURPOSE: Diabetes self-management is essential for diabetes control, yet little is known about patient preferences for sources of health information or about the extent to which information is sought directly or received passively through various media sources. The aim of this qualitative study was to identify how individuals with diabetes seek and use health care information. METHODS: Using a health information model to guide our research, we conducted 9 focus groups with 46 adults with a diagnosis of diabetes and then analyzed the transcripts and notes from these focus groups. RESULTS: Five themes emerged: (1) passive receipt of health information about diabetes is an important aspect of health information behavior; (2) patients weave their own information web depending on their disease trajectory; (3) patients' personal relationships help them understand and use this information; (4) a relationship with a health care professional is needed to cope with complicated and sometimes conflicting information; and (5) health literacy makes a difference in patients' ability to understand and use information. CONCLUSIONS: Patients make decisions about diabetes self-management depending on their current needs, seeking and incorporating diverse information sources not traditionally viewed as providing health information. Based on our findings, we have developed a new health information model that reflects both the nonlinear nature of health information-seeking behavior and the interplay of both active information seeking and passive receipt of information.
Asunto(s)
Diabetes Mellitus/prevención & control , Manejo de la Enfermedad , Conducta en la Búsqueda de Información , Educación del Paciente como Asunto/estadística & datos numéricos , Satisfacción del Paciente/estadística & datos numéricos , Autocuidado/métodos , Anciano , Femenino , Grupos Focales , Educación en Salud , Conocimientos, Actitudes y Práctica en Salud , Alfabetización en Salud , Humanos , Masculino , Persona de Mediana Edad , Modelos Teóricos , Investigación Cualitativa , Autocuidado/estadística & datos numéricos , Encuestas y Cuestionarios , Estados Unidos , VirginiaRESUMEN
Pay for performance is a concept recently on the agenda of many health care providers, administrators, insurers, and payors in their search for methods to provide the best care at the most efficient price. At the same time it promises to promote quality care by paying financial incentives to providers who perform well clinically. As the fields continue to debate this approach, the following article explores how the pay-for-performance concept may be applied to one of the most prevalent chronic illnesses: diabetes. It identifies some of the issues and problems that may be faced with diseases such as diabetes, in which outcomes rely greatly on the role of the patient in self-management. Such considerations must be taken into account in the event of the refinement and implementation of pay for performance.