Academic journal article Pakistan Journal of Psychological Research

Patient-Physician Trust, Emotional Distress, and Self-Care Activities of Adults with Type II Diabetes Mellitus

Academic journal article Pakistan Journal of Psychological Research

Patient-Physician Trust, Emotional Distress, and Self-Care Activities of Adults with Type II Diabetes Mellitus

Article excerpt

Diabetes Mellitus, a global epidemic, impacts millions of individuals globally and is identified as one of the most challenging and serious health concerns of the 21st century (International Diabetes Federation [IDF], 2006). It is listed as the 7th leading cause of death in 2007 and a contributing cause for many more deaths (Ogden, Carroll, Fryar, & Flegal, 2015). The prevalence of Diabetes Mellitus showed that approximately 7.1 million people are suffering from this disease in Pakistan, with maximum number of adult patients. If crucial steps are not taken to control Diabetes Mellitus, the figure could go up to 11.5 million by 2025 in Pakistan (IDF, 2006).

Type II Diabetes Mellitus is a chronic and self-managed ailment, which requires long-lasting self-monitoring and self-management by indulging in self-care activities such as quitting smoking, exercise, weight loss, and balanced diet (Lee, Ahn, & Kim, 2008). The treatment can be extended by the prescription of oral medication, lowering blood glucose to maintain or achieve adequate levels of blood glucose. When lifestyle and oral blood glucose lowering medications are not sufficient to maintain blood glucose levels, patients are recommended insulin therapy (Geyer et al., 2006; Sarfraz, Sajid, & Ashraf, 2016).To avoid insulin therapy, adhering to an appropriate regimen of diet and exercise are crucial, along with these, previously discussed (Pearson & Raeke, 2000) psychosocial factors such as trust in one's physician and emotional distress can influence diabetes related outcomes. Previous studies predominantly focusing on White-English-speaking adults with diabetes highlighted that increased trust in one's physician has been associated with better glycemic control (Alazri, Heywood, Neal & Leese, 2007; Wellenet al.,2010).

The successful management of Diabetes Mellitus through selfcare activities involves considerable interaction between the patients and their physicians. With high level of interaction between patients and physicians in the treatment of Diabetes Mellitus, the degree to which adherence to guidelines related to self-care activities can be successfully achieved by enhancing trust that patients have in their physician (Pearson & Raeke, 2000). Patient-physician trust has been defined as the optimistic acceptance of a vulnerable situation in which the patient believes that the physician will care for the patients' interests (Hall, Dugan, Zheng, & Mishra, 2001).

Health care is influenced by diabetes related emotional distress. A variety of emotional reactions and responses to life with Diabetes Mellitus effect health care, particularly, those that are related to treatment and challenges for self-care (Polonsky et al., 2005). Diabetes related emotional distress might create difficulty in the required self-management of the condition, and is likely to bind the person's management of self-care activities which is important to attain a particular level of glycemic control. Research has documented that diabetes related emotional distress often occurs in people with Diabetes Mellitus and is frequently related to problems in coping with the daily treatment and concerns about evolving complications latter on (Hupcey, Penrod, Morse & Mitcham, 2001). Concerns associated with emotional distress are metabolic lack of control (Weinger & Jacobson, 2001), low self-efficacy, and poor quality of life (Fisher et al., 2010), therefore, it can be hypothesized that diabetes related emotional distress is likely to hinder self-care activities.

Safran et al. (1998) explored that patients' trust in their physician was related to compliance with lifestyle changes and patients' satisfaction. Likewise, in a longitudinal study of patients in primary care clinics, researchers documented that high level of patients' trust in their physician was related with greater compliance to recommended medicines (Thom, Ribisl, Stewart, & Luke, 1999). …

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