Correlates of Patient Satisfaction with the Chronic Care Model and Self-Determination Principles versus Usual Care among Patients with Type 2 Diabetes Mellitus in North-Central Nigeria

Abstract

Background: This study assessed patient satisfaction with care delivered using the Chronic Care Model (CCM) integrated with Self-Determination Theory (SDT) principles compared with usual care among patients with type 2 diabetes mellitus (T2DM) in North-Central Nigeria. Patient satisfaction is a key indicator of quality of chronic illness care and adherence to long-term management. Methods: A single-blinded randomized controlled trial was conducted among 90 adults with T2DM attending the General Outpatient Clinic of the Federal University Teaching Hospital, Lafia. The study employed a mixed- methods approach, utilising both quantitative surveys to assess patient satisfaction scores and qualitative interviews to explore specific aspects influencing these scores within both care models. Participants were randomised to CCM-based care (n=45) or usual care (n=45). Patient satisfaction was measured using the Patient Assessment of Chronic Illness Care (PACIC) scale. Associations between SDT constructs (autonomy, competence, relatedness) and satisfaction were examined using Pearson’s correlation. Results: Patients in the CCM group reported significantly higher satisfaction scores across all PACIC domains than those in usual care (p < 0.001). Autonomy (r=0.62), competence (r=0.59), and relatedness (r=0.55) showed significant positive correlations with overall satisfaction (p<0.001). Socio-demographic factors such as age and educational status showed modest associations with satisfaction. Conclusion: The integration of Self-determination principles with the Chronic Care Model, significantly improves satisfaction among Nigerian patients with T2DM. Integration of SDT principles enhances motivation and engagement, supporting the adoption of CCM in resource-limited settings.