A guide for assessing a patient's level of personal responsibility for diabetes management.

This paper presents a guide for assessing a diabetic patient's level of personal responsibility. In the general population, high levels of personal responsibility have been shown to be related to psychological well-being and are especially appropriate for chronic disease such as diabetes. With diabetes, patients are required to deliver virtually all of the daily self-care. Successful adaptation to this role is enhanced when patients are able to accept personal responsibility for having and treating their diabetes. The paper describes five levels of personal responsibility starting with the lowest level in which patients feel overwhelmed, hopeless, and helpless and ending with the highest level in which patients accept diabetes as a fact of their lives and fully accept responsibility for it. A discussion of assessing the patient's level of personal responsibility and responding appropriately to patients at different levels is included.