Purpose: Though many studies focus on patient perspectives of diabetes distress (DD), provider perceptions of DD require further investigation. Defined as diabetes-specific distress related to the emotional and behavioral burden of living with type 2 diabetes (T2DM), DD is a major psychological challenge to diabetes (DM) self-management. The purpose of this qualitative study was to explore how interdisciplinary interprofessional primary care team members identify factors that contribute to a DD future intervention.

Methods: A total of 18 providers from three rural nurse-managed clinics located in Northern Virginia participated in the study. Using purposive sampling, providers were interviewed for their perspectives on DD. Face-to-face interviews were conducted, digitally recorded, and transcribed. Two researchers coded the transcripts into themes. Data collection and analysis occurred sequentially using a constructivist grounded theory approach.

Results: Provider narratives identified a lack of awareness of DD in their experiences with T2DM-related psychological and emotional challenges in a low-income, immigrant, underserved patient populations. When asked about DD, most participants discussed biomedical aspects of DM management, such as diet, exercise, medications, and blood glucose management. The key facilitator identified by the few participants who recognized DD was the interdisciplinary team practice model. Perceived barriers included: (1) limited knowledge of DD by the healthcare team, (2) under recognition of DD in reported practice, (3) time constraints, and (4) limited clinical experience with treating or referring patients with DD to appropriate mental health services.

Conclusions: The American Diabetes Association (ADA) Standards of Medical Care in Diabetes recommends ongoing assessment and monitoring of DD to prevent and delay its progression. Therefore, the challenge is to enhance provider understanding of DD and promote strategies and activities that help reduce DD and improve diabetes outcomes.


A. John: None.

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