Abstract

Type 2 diabetes mellitus (T2DM) presents challenges to both patients and healthcare providers. While researchers have begun to understand the patient-specific difficulties associated with diabetes management, less is known about how providers perceive and experience patients who are struggling to manage their T2DM, particularly in the context of training environments. The aim of the present study was to better understand the cognitions, emotions, and behavioral responses of medical trainees when presented with a clinical vignette of a patient with poor diabetes self-care. To this end, the research was guided by attribution-emotion models of helping and avoidance. It was hypothesized that perceiving the causes for poor diabetes self-care as uncontrollable would elicit greater positive/empathy-based interpersonal emotions on the part of the trainee, which would in turn predict increased helping behavior. On the other hand, it was hypothesized that attributing poorly T2DM self-care to more controllable causes would elicit greater negative/anger-based interpersonal emotions on the part of the trainee, which would in turn predict increased avoidance of helping. To test these hypotheses, 246 medical trainees responded to an online survey that included a clinical vignette detailing the account of a patient with poor T2DM self-care. Participants responded to instruments assessing controllability attributions, attribution-based interpersonal emotions, and behavioral responses associated with helping and avoidance. Structural equation modeling revealed that trainees who attributed the patient’s decreased self-care behavior to less controllable causes reported more positive/empathy-based emotion. These positive emotions subsequently predicted higher rates of reported helping behavior. Conversely, trainees who attributed changes in the patient’s behavior to causes that were more controllable were more likely to report higher levels of negative/anger-based emotion, which then subsequently predicted increased avoidance. Controllability did not directly predict behavior in either model, and instead had an indirect impact on helping and avoidance through the effects of emotions. Time in training impacted emotions and behaviors. More training was associated with decreases in aggravation, irritation, and feeling sorry for patients; time in training was also associated with decreased avoidance and increased helping. Findings support previous research on attributions, emotions, and behavior, and extend the use of attribution-emotion models to healthcare settings.

LLU Discipline

Clinical Psychology

Department

Clinical Psychology

School

School of Behavioral Health

First Advisor

Patricia Flynn

Second Advisor

Hector Betancourt

Third Advisor

Rishi Desai

Fourth Advisor

Tori Van Dyk

Degree Name

Doctor of Philosophy (PhD)

Degree Level

Ph.D.

Year Degree Awarded

2022

Date (Title Page)

12-2021

Language

English

Library of Congress/MESH Subject Headings

Empathy; Diabetes Mellitus, Type 2; Helping Behavior; Self Care; Patient-physician relationships

Type

Dissertation

Page Count

xi, 64 p.

Digital Format

PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses and Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

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