Analisi psicolinguistica nelle persone con diabete di tipo 1 e 2 seguite mediante educazione strutturata e visite tradizionali. La percezione di malattia e dei percorsi di cura

Objective. We investigated the perceptions of diabetes and its treatment in patients followed with long-term group or usual care. Study design and methods. Three open questions were ad ministered to 120 patients (43 with T1DM and 77 with T2DM) who had been randomised at least two years earlier to be followed by group care and 121 (41 T1DM and 80 T2DM) who had always been on usual care. The responses were analysed by propositional analysis, identifying the focal nuclei, i.e. the terms around which all sentences are organised, then other predicates, according to their hierarchical relationship to the nuclear proposition. Specific communicative units were arbitrarily classified into three categories: attitudes, empowerment and locus of control. Patients' main personal details and medical history were recorded. Results. Group care patients had more positive attitudes, a greater sense of empowerment and more internal locus of control than those on usual care. They also expressed a wider and more articulated range of concepts associated with the care received and used fewer medical terms (p < 0.001, all). Higher HbA1c was associated with negative attitudes (p = 0.025) and weaker empowerment (p = 0.055). Conclusions. Group treatment reinforces communication and peer identification and may achieve its clinical results by promoting awareness, self-efficacy, positive attitudes towards diabetes and the setting of care, an internal locus of control and, ultimately, empowerment in the patients.