Objective: To assess the relationship between decision making and successful diabetes self-management. Background: Patients with type II diabetes make routine but critical self-management decisions. Method: We conducted cognitive task analysis interviews with 18 patients to examine problem detection, functional relationships, problem-solving strategies, and types of knowledge used to make self-management decisions. We expected that these decision processes would be related to behavioral adherence and glycemic control. Results: Verbal reports displaying problem detection skills, knowledge of functional relationships, and effective problem-solving strategies were all related to better adherence. Problem detection skill was linked to greater glycemic control. Participants differed in declarative and applied knowledge. Conclusion: Diabetes self-management draws on the same cognitive skills found in experts from diverse professional domains. Considering diabetes self-management as a form of expertise may support adherence. Application: Human factors approaches that support professional expertise may be useful for the decision making of patients with diabetes and other chronic diseases.
Anderson, R.N., & Smith, B.L. (2002) Deaths: Leading causes for 2002. National Vital Stat Report, 53(17), 1-92.
3.
Becker, G.E. (2001). The first year: Type II diabetes. New York: Marlowe.
4.
Bohm, A. (2004). Theoretical coding: Text analysis in grounded theory. In U. Flick, E. von Kardorff, & I. Steinke (Eds.), A companion to qualitative research (pp. 270-275). London: Sage.
5.
Chi, M.T.H. (1997). Quantifying qualitative analyses of verbal data: A practical guide. Journal of the Learning Sciences, 6, 271-315.
6.
Chi, M.T.H. (2000). Self-explaining: The dual processes of generating inference and repairing mental models. In R. Glaser (Ed.), Advances in instructional psychology: Educational design and cognitive science (Vol. 5, pp. 161-238). Mahwah, NJ: Erlbaum.
7.
Chi, M.T.H., Feltovich, P.J., & Glaser, R. (1981). Categorization and representation of physics problems by experts and novices. Cognitive Science, 5, 121-152.
8.
Chi, M.T.H., Glaser, R., & Farr, M.J. (1988). The nature of expertise. Hillsdale, NJ: Erlbaum.
9.
Crandall, B., & Getchell-Reiter, K. (1993). Critical decision method: A technique for eliciting concrete assessment indicators from the intuition of NICU nurses. Advances in Nursing Science, 16, 42-51.
10.
Devine, E.C., & Reifschneider, E. (1995). Ameta-analysis of the effect of psychoeducational care in adults with hypertension. Nursing Research, 44, 237-245.
11.
Diabetes Control and Complications Trial Research Group. (1993). The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. New England Journal of Medicine, 329, 977-986.
12.
Dreyfus, H.L. (1972). What computers can't do: A critique of artificial reason. New York: Harper and Row .
13.
Dreyfus, H.L., & Dreyfus, S.E. (1986). Mind over machine: The power of human intuition and expertise in the era of the computer. New York: Free Press.
14.
Ellis, S.E., Speroff, T., Dittus, R.S., Brown, A., Pichert, J.W., & Elasy, T.A. (2004). Diabetes patient education: Ameta-analysis and meta-regression. Patient Education and Counseling, 52, 97-105.
15.
Ericsson, K.A., & Charness, N. (1994). Expert performance: Its structure and acquisition . American Psychologist, 49, 725-747.
16.
Ericsson, K.A., Krampe, R.T., & Tescher-Römer, C. (1993). The role of deliberate practice in the acquisition of expert performance. Psychological Review, 100, 363-406.
17.
Flick, U. (1998). An introduction to qualitative research. London: Sage. Glanz, K., Lewis, F.M., & Rimer, B.K. (1997). The scope of health promotion and health education. In K. Glanz, F. M. Lewis , & B. K. Rimer (Eds.), Health behavior and health education (pp. 3-18). San Francisco : Jossey-Bass.
18.
Glasgow, R.E., McCaul, K.D., & Schafer, L.C. (1987). Self-care behaviors and glycemic control in type I diabetes. Journal of Chronic Diseases, 40, 399-412.
19.
Gordon, S.E., & Gill, R.T. (1997). Cognitive task analysis. In C. E. Zambok & G. Klein (Eds.), Naturalistic decision making (pp. 131-140). Mahwah, NJ: Erlbaum.
20.
Hampson, S.E., Glasgow, R.E., & Toobert, D.J. (1990). Personal models of diabetes and their relations to self-care activities. Health Psychology, 9, 632-646.
21.
Hmelo-Silver, C.E., & Pfeffer, M.G. (2004). Comparing expert and novice understanding of a complex system from the perspective of structures, behaviors, and functions . Cognitive Science, 28, 127-138.
22.
Hoffman, R.R. (1996). How can expertise be defined? Implications of research from cognitive psychology . In R. Williams, W. Faulkner, & J. Fleck (Eds.), Exploring expertise (pp. 81-100). Edinburgh, Scotland: University of Edinburgh Press .
23.
Klein, H.A., & Lippa, K. (in press). Type II diabetes self-management: Controlling a dynamic system. Journal of Cognitive Engineering and Decision Making .
24.
Klein, G. (1999). Sources of power: How people make decisions. London: MIT Press.
25.
Kolb, D.A., Boyatzis, R.E., & Mainemelis, C. (2000). Experiential learning theory: Previous research and new directions. In R. J. Sternberg & L. F. Zhang (Eds.), Perspectives on thinking, learning, and cognitive styles (pp. 227-248). Mahwah, NJ: Erlbaum.
26.
Kowal, S., & O'Connell, D.C. (2004). The transcription of conversations . In U. Flick, E. von Kardorff, & I. Steinke (Eds.), A companion to qualitative research (pp. 248-252). London: Sage.
27.
Lehmann, E.D. (1997). Interactive educational simulators for diabetes care. Medical Informatics, 22, 47-76.
28.
Manos, D. (2004). Majority of diabetics do not follow guidelines for maintaining health, despite a decade of warning, study shows. Medical Guidelines and Outcomes Research, 15, 1-6.
29.
National Institute of Diabetes and Digestive and Kidney Diseases. (n.d.a).Introduction to diabetes. Retrieved November 27, 2005, from http://diabetes.niddk.nih.gov/intro/index.htm
30.
National Institute of Diabetes and Digestive and Kidney Diseases. (n.d.b).Treatments for diabetes. Retrieved March 31, 2006, from http://diabetes.niddk.nih.gov/treatments/index.htm
31.
Nokes, T.J., & Ohlsson, S. (2005). Comparing multiple paths to mastery: What is learned ? Cognitive Science, 29, 769-796.
32.
O'Bryne, K., Clark, R.E., & Malakuti, R. (1997). Expert and novice performance: Implications for clinical training. Educational Psychology Review, 9, 321-332.
33.
Quesada, J., Kintsch, W., & Gomez, E. (2005). Complex problem-solving: A field in search of definition. Theoretical Issues in Ergonomic Science, 6, 5-33.
Rubin, A.L. (2004). Diabetes for dummies. Hoboken, NJ: Wiley.
36.
Salas, E., & Klein, G. (Eds.). (2001). Linking expertise and naturalistic decision making. Mahwah, NJ: Erlbaum .
37.
Shalin, V.L., & Verdile, C.L. (2003). The identification of knowledge content and function in manual labour. Ergonomics, 46, 695-713.
38.
Smith, P.J., Glades, D., Fraser, J., Miller, T., Smith, J.W., Svirbely, J.R., et al. (1991). Coping with the complexities of multiple-solution problems: A case study. International Journal of Man-Machine Studies, 35, 429-453.
39.
Spirito, A., Ruggiero, L., Duckworth, M., Low, K.G., Coustan, D.R., McGarvey, S.T., et al. (1993). The relationship of diabetes knowledge to regimen compliance and metabolic control during pregnancy. Psychology and Health, 8, 345-354.
40.
Swezey, R.W., & Andrews, D.H. (2001). Readings in training and simulation: A 30-year perspective. Santa Monica, CA: Human Factors and Ergonomics Society.
41.
Zoffman, V., & Kirkevold, M. (2005). Life versus disease in difficult diabetes care: Conflicting perspectives disempower patients and professionals in problem solving. Qualitative Health Research, 15, 750-765.
