Understanding patients’ beliefs about their role communicating in medical visits is an important pre-requisite to encourage patients’ use of active participatory communication, and these beliefs may be particularly relevant for patients with diabetes. Focus groups were conducted to examine patients with diabetes view of their role communicating in medical encounters. Patients had type 2 diabetes, A1C ≥ 8% (64 mmol/mol), and were from an inner-city VA hospital. Guiding questions for the focus groups were based on theoretical models of patient-physician communication. Focus group transcripts were analyzed with the constant comparative method. Four focus groups were conducted with a total of 20 male Veterans. Participants mean age was 61 years, 65% self-identified as black or African-American, 80% completed high school or higher education, and mean A1C was 10.3% (89 mmol/mol). Eight themes were identified as to why patients might have difficulty communicating with physicians. These themes were grouped into three overarching categories explaining reasons why patients might avoid participatory communication and included patients’ view about their condition; about physician’s communication behaviors; and about external influences on patient-physician communication. For example, patients described how use of the EHR may deter patients’ use of active participatory communication. These results are important for understanding how patients’ use of active participatory communication is influenced by their beliefs and expectations, physicians’ behaviors, and structural factors. The results may be useful for educational efforts to increase patient, physician, and healthcare systems awareness of problems that patients perceive when communicating with physicians.

中文翻译：

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“他们从大不列颠百科全书开始说话”：糖尿病患者对与医生沟通障碍的看法。

理解患者对其在就诊中进行沟通的角色的信念是鼓励患者进行积极参与式沟通的重要前提，这些信念可能与糖尿病患者特别相关。进行了焦点小组检查，以了解糖尿病患者在交流中的沟通作用。患者患有2型糖尿病，A1C≥8％（64 mmol / mol），来自弗吉尼亚州内城医院。焦点小组的指导性问题是基于医患沟通的理论模型。用恒定比较法分析焦点小组的成绩单。与总共20位男性退伍军人进行了四个焦点小组讨论。参与者的平均年龄为61岁，有65％的人将自己标识为黑人或非裔美国人，有80％的人具有高中或高等教育程度，平均AlC为10.3％（89 mmol / mol）。确定了八个主题，说明患者为何难以与医生沟通。这些主题分为三大类，解释了为什么患者可以避免参与式交流的原因，并包括患者对病情的看法。关于医生的沟通行为；以及对医患沟通的外部影响。例如，患者描述了使用EHR如何阻止患者使用主动参与式交流。这些结果对于理解患者的积极参与式沟通如何受到他们的信念和期望，医生的行为以及结构因素的影响非常重要。结果对于增加患者，医师，