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DAWN2 study results highlight diabetes impact on patients, families
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ORLANDO — Results from the recently released DAWN2 study showed that diabetes-related distress is a harmful by-product of the disease for not only patients but also their families, a speaker said at the American Association of Diabetes Educators Annual Meeting.
Psychosocial problems and perceptions of health care professionals and the health care system revealed in the second Diabetes Attitudes Wishes and Needs (DAWN) study demonstrated the need for a new model, Martha Funnell, MS, RN, CDE, of the University of Michigan, said in her presentation.
“We need to truly focus on patient-centered care,” Funnell said. “We need to surround the patient with their family and friends, their health care team and finally their communities, their workplaces and the larger society if they’re going to be successful in their self-management.”
Results from the DAWN2 study, Funnell explained, showed themes: emotional and physical well-being, perspective on family burden and support, involvement and support for active self-management, educational and information resources, access to quality diabetes care and community resources and social attitudes.
But Funnell noted the aspects of diabetes — clinical content, medicine, diet, behavior, psychosocial and more — cannot always be delineated clearly, because that is not how patients perceive the condition.
“Patients experience this big thing called diabetes, and we need to address it as this big thing, not divided into little categories,” Funnell said. “Whether our patients are at work, or at home, or in the clinic, or driving their kids to school or rushing off to be at soccer practice, diabetes is there. And that’s where diabetes care happens. It’s all one thing.”
Diabetes negatively impacted a wide range of life domains, according to Funnell’s presentation, not only in reduced physical health and emotional well-being but finances, leisure activities, work, studies and relationships. Further, family members reported all of the same impacts on life domains.
“Almost half of the patients you see are experiencing some level of distress — anger, fear, frustration, sadness, guilt,” Funnell said. “Those are the feelings and the biggest influencers on self-management.”
Diabetes-related distress impacts HbA1c, diet and exercise behaviors and quality of life more than depression, Funnel said. “We have to address diabetes-related distress if want our patients to make changes and improve their outcomes,” she said.
Globally, less than half of patients participated in diabetes educational programs or activities to help them manage their condition, and less than a quarter of family members did, according to the presentation. In the US, 64% or patients and 35% of family members reported receiving education, Funnell told Endocrine Today.
Approximately 52% of health professionals said they had asked their patients how diabetes impacts their lives, but only 24% of patients thought they were asked that, Funnell said.
“Either we’re not asking the question as often as we think, or we’re not asking it in a way that patients know they were asked,” Funnell said. She added that is the optimal question to pose, as it would reveal almost everything a health care professional would need to know.
In summarizing the findings, Funnell pointed out that most patients reported wanting to improve their self-management and called for the community to look beyond the non-compliance.
“Self-management behaviors are not problems,” Funnell explained. “Self-management behaviors are symptoms of problems. We know from health care, you don’t treat symptoms, you treat the problem.” — by Allegra Tiver
For More Information:
Funnell M. GS02. Presented at: The American Association of Diabetes Educators Annual Meeting 2014; August 6-9, 2014; Orlando, Fla.
Disclosure: Funnell reported no relevant financial disclosures.