PATIENT SELF-CARE
The Applied Psychology Laboratory studied how people manage complex problems in everyday life. One domain of interest has been adherence to medication instructions and the management of complex chronic disorders. Billions of medications are dispensed each year and millions of Americans manage chronic illnesses. Patients must make complex decisions and engage in a bewildering array of self-care behaviors. Our research examines how patients cope with these challenges. We are describing mental models and coping strategies so that we can use human factors solutions to help patients achieve better self-care.
•Type 2 diabetes presents a formidable challenge to patients. In order to design interventions to support successful self-management we first need to know how people with type 2diabetes conceptualize their illness and make self-care decisions. We conduct interviews with people with diabetes in order to uncover the mental models patient adopt. The interviews also address patient decision making and strategies for coping with critical incidents. We have been identifying effective and ineffective models for self-care to provide insight into patient cognition.
•A related ongoing effort is focused on the design of training systems for diabetes self-management. Human factors and cognitive engineering both provide useful guidelines for the design of training systems now used in domains, such as power-plant management and aviation. We are using these same principals to design advanced diabetes training systems based on the use of simulations and training of mental models.
A few recent references:
Lippa, K. D. & Klein, H. A. (in press). Portraits of patient cognition: How patients understand diabetes self-care. Canadian Journal of Nursing Research.
Lippa, K. & Klein, H. A. (2008). Everyday expertise: Cognitive demands in diabetes self-management. Human Factors. 5, 01
Feufel, M. A., Lippa, K. L. & Klein, H. A. (in press). Calling 911: Emergency medical services in need of human factors. Ergonomics in Design.
Klein, H. A. & Lippa, K. D. (2008). Type 2 Diabetes self-management: Controlling a dynamic system. Journal of Cognitive Engineering and Decision Making.
Lippa, K. & Klein, H. A. (2006). The role of patient cognition in glycemic control. Journal of the American Diabetes Association Abstract Book 66th Scientific Session. Washington, DC: ADA.
Klein, H. A. & Meininger, A. (2004) Self-management of medication and diabetes. In IEEE Transactions Systems, Man, and Cybernetics-Part A. Special issue: Using Field Studies to Understand Healthcare Technical Work. Pg. 718 – 725.
Klein, H. A. & Isaacson, J. J. (2003). Making medication instructions usable. Ergonomics in Design. 11, 7 - 12.
Isaacson, J.J., Klein, H.A. & Makavey (2000). Prescription medication information sheets. Real world assessment. Proceedings of the 2000 Meeting of the Human Factors and Ergonomics Society.
Klein, H. A. (2000). Opportunities for healing; Opportunities for harm. Focus on Patient Safety. The Newsletter of the National Patient Safety Foundation. AMA.
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