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In part 6 of this Exclusive Interview, Kathryn Kreider talks with Diabetes in Control Publisher Steve Freed about when to look for diabetes distress in a newly diagnosed patient and further along in the patient’s experience.
Kathryn Kreider is an Assistant Professor at Duke University School of Nursing in Durham, NC.
Transcript of this video segment:
Freed: Timing– as far as showing a patient is under distress, they first get diagnosed with diabetes. Just the word alone brings shivers, plus they associate losing a limb. It’s just that’s way diabetes is with patients. So, before you see distress because they’re not distressed the first day although they’re emotionally — it’s an issue, because you’re telling them all these new things that they have to do; monitor their blood sugars, take medications, et cetera, et cetera. At what point do you usually find distress or when should you be looking to find distress with the patient? Is it three months down the road or six months down the road, every visit?
Kreider: We recommend in the standards of care, actually from the ADA, recommends that you screen patients regularly, routinely. So, that is — that could mean as often as every time as you see them and it should at least be on your radar that this could be a possibility, because we know that the incidence of diabetes distress over 18 months is over 45%. It’s very high. I think it’s about 48% — up to 48%. So, it really should be something we’re thinking about at diagnosis as well as at different intervals including when new complications arise, when there’s issues about quality of life, anything that could mean a change for the patient or present a barrier.
Freed: So, what recommendations would you give to a medical professional? Not an expert, just a medical professional, family practitioner. When it comes to distress, what advice would you give them as far as what they should do for their patients?
Kreider: Yes. So, kind of back to what we talked about. The first thing again would be assess them using reliable valid tools. I already mentioned the DDS or the PAID scale. And then secondly, start talking to them about what specifically they are concerned about and what presents the biggest challenge for them as a patient, and how can we as providers help them to reduce the barriers and reduce the anxiety related to diabetes. There’s a few things that come up often such as the idea of regimen distress. Patients feel very overwhelmed with what they have to do for medication, for diet, for activity. So, really helping them with concrete goals and doing step-wise goals that are one goal at a time and meeting that goal, and then moving on can be a very useful tool for motivational interviewing.