Clinical and life quality differences between Mexican American diabetic patients at a free clinic and a hospital-affiliated clinic in Texas

Abstract

Objective: This paper explores the contribution of personal, cultural, and disease characteristics, diabetes knowledge, number of symptoms, and 2 specific clinics to the explained variance in glycosylated hemoglobin (A1c) and quality of life among Mexican Americans with type 2 diabetes.

Design: This descriptive correlational study used hierarchical multiple regression analysis.

Sample: 87 Mexican American patients with type 2 diabetes were recruited from 2 clinics, 1 hospital-affiliated and 1 free clinic, that served a primarily minority and indigent population.

Measurements: A language-based acculturation scale, the Diabetes Knowledge Questionnaire-24, Diabetes Symptom Self-Care Inventory, and Self-Anchoring Striving Scale were administered in one-on-one interviews. Medical records were reviewed for recent A1c and health history.

Results: The participants' clinic explained an additional 13% of the variance in A1c and 6% of the variance in quality of life after controlling for gender, acculturation, time since diagnosis, number of diabetes medications, diabetes knowledge, and number of symptoms. Clinics differed in patient characteristics, beyond the variables entered in the regression model, and in their care delivery.

Conclusions: Clinic characteristics and their influence on diabetes outcomes should be explored to maximize patients' abilities to steer the course of their diabetes away from complications.