Evaluation of the locus of control in patients with type 2 diabetes after long-term management by group care

To investigate the locus of control in patients with type 2 diabetes followed by systemic group education (Group Care) and traditional one-to-one care. In a post-hoc analysis, two questionnaires were administered to 56 patients who had been followed for 5-7 years by Group Care and 51 controls followed by individual care, similar by age, sex, diabetes duration, glycaemia, insulinaemia, weight and other clinical variables. Patients on Group Care had lower HbA 1c (7.40 ± 1.21%) than controls (7.99 ± 1.48%), P = 0.027. The Peyrot and Rubin questionnaire, specific for diabetes, and the Wallston and Wallston questionnaire, more generic for chronic diseases, were administered. Both questionnaires explore 3 areas: internal control of disease, and the role of chance or powerful other people, including health operators, in changing the disease. Both questionnaires showed lower scores for chance in patients followed by Group Care (P < 0.001), while scores for powerful others did not differ from those of patients followed by traditional care. The Peyrot and Rubin tool showed increased Internal Control (P < 0.001) in the patients followed by Group Care. Multi-variate analysis showed that the HOMA index of insulin resistance was inversely related to Internal Control (β = -0.144, P = 0.005) independently of BMI and HbA 1c. Fatalistic attitudes were lower and internal control higher in patients with type 2 diabetes followed by Group Care. These changes may be related to insulin resistance, above and beyond the effects of body weight and metabolic control. Évaluation du locus de contrôle de patients diabétiques de type 2 après une éducation de groupe prolongée Nous avons étudié de manière rétrospective le locus de contrôle de patients diabétiques pris en charge soit dans des sessions d'éducation thérapeutique (Group Care), soit en consultation traditionnelle individuelle. Nous avons étudié 56 patients qui ont suivi l'éducation de groupe durant 5 à 7 ans et 51 témoins appariés selon l'âge, la durée du diabète, la glycémie, le poids et l'insulinémie, qui avaient été suivis en consultation traditionnelle. Deux questionnaires furent utilisés : Peyrot et Rubin, spécifique du diabète, et Wallston et Wallston, spécifique des maladies chroniques. Les deux questionnaires évaluent 3 zones : le contrôle interne de la maladie, le rôle de la fatalité et la collaboration avec les soignants. Les patients pris en charge en éducation de groupe avaient une HbA 1c (7,40 ± 1,21) inférieure à