Abstract
Treatment failure is usually understood as a problem of patient compliance. This paper suggests another approach: to see this problem as resulting from a difference in the goals of the two parties involved, the doctor and the patient. Comparison was made between the goals of doctors and those of parents in treating children with diabetes. Significant differences emerged between the goals. Parents' goals of treatment were governed more by avoidance of the short-term threat of diabetes (hypoglycemia); doctors' goals more by the long-term threat of diabetes (diabetic complications). The outcome of treatment (diabetic control) was more closely related to parents' than doctors' goals of control. These results indicate that doctors and patients do not always share the same goals in treatment. It is suggested that a more effective clinical alliance would result if the goals of the clinical team were at least made explicit, even if they were not always shared.
Similar content being viewed by others
References
Becker, M. H., Nathanson, C. A., Drachman, R. H., and Kirscht, J. P. (1977). Mother's health belief and children's clinic visits. A prospective study.J. Comm. Health 3: 125–135.
Becker, M. H., Maiman, L. A., Kirscht, J. P., Haefner, D. P., Drachman, R. H., and Taylor, D. W. (1979). Patient perceptions and compliance: Recent studies of the Health Belief Model. In Haynes, R. B., Taylor, D. W., and Sackett, D. L. (eds.),Compliance in Health Care, Johns Hopkins University Press, Baltimore and London.
Deckert, T., Poulsen, J. E., and Larsen, M. (1978). Prognosis of diabetics with diabetes onset before the age of thirty-one. 1. Survival, causes of death and complications.Diabetologia 14: 363–370.
Fishbein, M., and Ajzen, I. (1975).Belief, Attitude, Intention and Behavior: An Introduction to Theory and Research, Addison-Wesley, Reading, Mass.
Gambrill, E. D. (1977).Behaviour Modification: Handbook of Assessment, Intervention and Evaluation, Jossey-Bass, San Francisco.
Haynes, R. B., Taylor, D. W., and Sackett, D. L. (eds.) (1979).Compliance in Health Care, Johns Hopkins University Press, Baltimore and London.
Johnson, S. B. (1980). Psychosocial factors in juvenile diabetes. A review.J. Behav. Med. 3: 95–116.
Ley, P. (1982). Satisfaction, compliance and communication.Br. J. Clin. Psychol. 21: 241–254.
Mann, N. P., and Johnston, D. I. (1982). Total glycosylated haemoglobin (HbA1) levels in diabetic children.Arch. Dis. Child. 57: 434–437.
Marteau, T. M., and Baum, J. D. (1984). Doctors' views on diabetes.Arch. Dis. Child. 59: 566–570.
Schafer, L. C., Glasgow, R. E., and McCaul, K. D. (1982). Increasing the adherence of diabetic adolescents.J. Behav. Med. 5: 353–362.
Tchobroutsky, G. (1978). Relation of diabetic control to development of microvascular complications.Diabetologia 15: 143–152.
Tunbridge, W. M. G. (1980). Factors contributing to deaths of diabetics under fifty years of age.Lancet 2: 569–572.
Tversky, A., and Kahneman, D. (1974). Judgment under uncertainty: Heuristics and biases.Science 185: 1124–1131.
Author information
Authors and Affiliations
Additional information
The authors wish to thank the British Diabetic Association and the Oxford Regional Health Authority Locally Organised Research scheme for financial support of this research.
Rights and permissions
About this article
Cite this article
Marteau, T.M., Johnston, M., Baum, J.D. et al. Goals of treatment in diabetes: A comparison of doctors and parents of children with diabetes. J Behav Med 10, 33–48 (1987). https://doi.org/10.1007/BF00845126
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00845126