Motivational techniques of dietitians counseling individuals with type II diabetes.

A survey was conducted to ascertain to what extent dietitians use techniques cited in the literature considered to affect adherence by patients with non-insulin dependent (Type II) diabetes. A survey instrument listing techniques related to changing behavior, the counseling process, and content of teaching was developed and mailed to 500 members of the ADA Diabetes Care and Education Practice Group. Responses were received from 39% of the sample. For a majority of techniques, data analysis showed statistical association between frequency of use, perceived importance, and adequacy of practitioner training. Dietitians regularly used only 40% of the cited techniques related to changing behavior and the counseling process, but they said most of the items were important. Only half of the items related to the content of teaching were rated as important, and dietitians felt prepared to use only 70% of them. Most dietitians did not teach concepts related to glucose utilization, energy metabolism, and the metabolic role of insulin in diabetes. Those findings suggest that dietitians do not regularly use many techniques considered effective in obtaining dietary adherence of patients with diabetes. Since other studies show compliance is directly influenced by skills of the provider, dietitians could improve cost-effective health care by developing further professional expertise in the area of counseling patients with diabetes.