The relationship between patient perception of healthcare provision by professionals and the self-care activity of patients with diabetes: Japanese subgroup analysis of the second Diabetes Attitudes, Wishes, and Needs (DAWN2) study

Data for a subgroup of Japanese diabetes patients from the second Diabetes Attitudes, Wishes, and Needs (DAWN2) study were analyzed to investigate possible relationships between patient-perceived healthcare provision by healthcare professionals, patient self-care, and glycemic control, by focusing on the patient’s perception. Patients answered a questionnaire that was originally developed and validated for the DAWN2 study. Questions on their perception of healthcare provision, duration of self-care activity during the past 7 days, and their last HbA_1c level were analyzed. Self-care activity for more than 5 days was regarded as good adherence. This analysis included 508 patients (81 type 1 and 427 type 2). Of the self-care activity, “taking physical activity” for both types of diabetes and “checking feet” for type 2 patients were implemented for longer among patients with the perception of equivalent care provision than among those without. Patients with perception of “examining feet” as healthcare provision also reported longer implementation of “following healthy diet”, “taking physical activity”, “testing blood sugar”, and “taking diabetes medications exactly” than those who did not; however, this trend was not observed for “testing blood sugar” among type 1 patients. HbA_1c level was significantly lower among type 2 patients with good adherence to “following healthy diet” and “taking physical activity”. Association may exist between patients’ perceptions of diabetes care and improvement in self-care activity, and between more engagement in self-care activity and better HbA_1c achievement as a treatment outcome. For better management, it is essential for healthcare professionals to provide care that patients can perceive.