Objective:
Emerging adults (EA; individuals aged 18–29 years) with Type 1 Diabetes (T1D) are at risk for diabetes-related distress (DD), in part because of unique challenges associated with this developmental stage. Symmetry, or match between patient preferences and physician behavior during the medical encounter, is associated with better patient outcomes in adults with diabetes. Yet, the relationships between symmetry and patient outcomes are understudied among EA with T1D. This study examined whether DD differed as a function of patterns of patient–physician symmetry across three domains: information sharing (providing sufficient explanations), behavioral involvement (encouraging patient to take an active role in diabetes care), and socioemotional support (supporting well-being).
Method:
In total, 114 EA were recruited through a midwestern academic medical center or via social media. Participants self-reported demographic and disease information, DD, preferences for their endocrinologist’s behavior, and perceptions of their endocrinologist’s behavior via an online survey. Analyses of covariances examined whether DD differed across four symmetry groups (symmetrical high preference/high behavior, symmetrical low preference/low behavior, asymmetrical high preference/low behavior, and asymmetrical low preference/high behavior).
Results:
Asymmetry in behavioral involvement was related to higher DD in several domains. DD was highest among participants with a high preference for physician behavioral involvement but demonstrated low behavioral involvement. DD did not differ across symmetry groups for information sharing or socioemotional support.
Conclusion:
Future research should replicate these findings via larger, more diverse samples. Clinicians should consider matching patients to physicians based on preference for behavioral involvement.
Implications for Impact Statement
This study suggests that a mismatch between patient preferences and physician behaviors that encourage patient involvement in their care (i.e., behavioral involvement) is associated with patient diabetes-related distress in select domains among emerging adults with Type 1 Diabetes. To reduce patient distress, health care teams should assess patients’ preferences for physician’s behavioral involvement and match patients who prefer physician high behavioral involvement with physicians high in this domain. In situations where matching is not feasible, behavioral health providers are well positioned to help patients cope with unmet expectations and explore other sources of support for their diabetes management.
