Practitioners' actions inhibited patient participation in self care decision making

Practitioners communicated their distrust of participants' experiential knowledge by emphasising objective data (eg, laboratory results), quizzing participants about their diabetes knowledge if they suggested changes in regimens, disregarding data that contradicted textbook information (eg, unique bodily cues of hypoglycaemia), and by communicating expectations of compliance, either by blaming patients for high blood glucose concentrations or through excessive monitoring behaviour. Because of the costs associated with long waiting times for appointments (child care, parking), participants who waited for >1 hour to see their practitioner were often reluctant to take the time needed for participatory decision making.