Paula Trief Part 1, Partners And Patients In Diabetes

In part 1 of this Exclusive Interview, Paula Trief talks with Diabetes in Control Publisher Steve Freed about ways the partners of people with diabetes can be of help.

Paula Trief, PhD is a Patrick A. Lehan Professor of Physiology and Biophysics and Chairman of the Department of Medicine Department at University of Mississippi.

Transcript of this video segment:

Steve Freed: This Steve Freed and we’re here at the American Diabetes Association 78th Scientific Sessions. And we have a very special guest: it’s Paula Trief, PhD. And tell us a little bit about your practice, a little bit about what you do.

Paula Trief: So I’m a clinical health psychologist. I’m at SUNY Upstate Medical University which is in Syracuse New York. And I primarily at this point — I have had a pretty extensive practice, with all kinds of patients but also a little specialty of working with diabetes patients — but primarily at this point I do behavioral diabetes research, so looking at psychological factors that affect how patients with diabetes manage their diabetes and cope with their outcomes, and also developing interventions to help patients with diabetes do better.

Steve Freed: I know you presented here at ADA. How was the turnout for your presentation?

Paula Trief: It was really good. It was the Richard Rubin award which is a really prestigious award in the psychosocial world here. And it was given to Dr. Tim Wysocki who is amazing so, they gave him the award, he gave a really good talk and then there were four panelists all talking very practically about ways to intervene with patients with diabetes, kind of quickly or effectively, but it was a very practical presentation not so much research focused.

Steve Freed: So, as far as the practical points that you wanted, people tended to take away — which is a good sign of presenters, that people use your information rather than write it down and forget about it — what would you like them to walk away with?

Paula Trief:  Well first I’d talk just about the importance of recognizing that, my focus has been partners and patients in diabetes, so couples, the important role they play and they’re going to play whether we work with them or not; the partner relationship is really unique. It’s emotionally intense, it’s intimate relationship, you can kind of let down your defenses and be yourself, it persists over time. It’s committed and patients and partners have talked about it, and other people coined this phrase, “shared social realities,” meaning that they have their attitudes, their beliefs their expectations about their disease and about the health care system. And they’re going to probably have some of that be very similar because people seek out people like themselves, but they’re living there; the effect of one is going to have the effect on the other essentially so we know that’s true. And that really led to the work that I did which is a partner intervention, couples interventions. So I want them to recognize that, I guess that was the main, one main thing.

I kind of tried to summarize the literature but basically said, these are some things that partners really should do we think, and these are some things partners really probably should avoid doing. But we also recognize that it’s a very very fine line. And it’s a tough road to walk for a partner. So the things that they should do are the obvious things to be supportive in some way, like help in terms of supporting the patient making behavior changes, so buying healthy foods or exercising together or reminding the person about taking their medications. Being emotionally supportive, so thinking about recognizing that it’s really difficult to have diabetes and it’s an ongoing burden, You never get a break and there is a high level of what we call diabetes distress. So for partners to recognize that this is going to affect their patient emotionally, and also pay attention to how it affects them emotionally, because we know too that partners have their own issues; they’re very often scared, they’re worried about hypoglycemia, they’re worried about future complications, they’re worried that their partner may die early or die younger. So they have their own issues that they’re dealing with. So having them kind of recognize that. There’s some evidence that when one person changes another person changes: so if I start exercising maybe my partner will start to exercise, so they can support each other by modeling good behavior.

So there’s lots of things partners can do and we think kind of overall they need to recognize that the disease is the patient’s disease and support the patients. It’s called autonomy support: support the patient’s sense of look, this is your disease, not mine; I’m here to help you, I’m here to try to make things better and make things easier, but it’s yours. You make the decisions, you do what you can; and that’s hard. It’s hard when you’re worried that the person is not going to take care of themselves.

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