Interpersonal Relationships in Diabetes: Views and Experience of People with Diabetes, Informal Carers, and Healthcare Professionals in Portugal (original) (raw)
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Diabetic Medicine, 2013
Objectives: DAWN2 assessed the psychosocial impact of diabetes on persons with diabetes (PWDs), family members and healthcare professionals (HCPs) across 17 countries. This article reports on the Canadian cohort of PWDs. Methods: PWDs completed online, validated self-report scales assessing quality of life (QOL), selfmanagement, beliefs, social support and priorities for improving diabetes care. Analyses used unweighted data. Results: Of 500 participants (80 type 1, 420 type 2) positive self-reported QOL was common (64.6%) and likely depression less common (12.8%). Diabetes distress, however, was identified by almost half of PWDs with type 1 diabetes, and one-quarter of PWDs with type 2 (47.5% vs. 25.7% type 2; p<0.001). Numerous life areas were negatively impacted, particularly finances, work and emotional well-being for those with type 1 diabetes (p<0.001 vs. type 2). Most PWDs reported support from family, friends and HCPs, but few reported being asked by HCPs how diabetes affected their lives. Most PWDs participated in (type 1, 90.0%; type 2, 85.7%) and valued (type 1, 84.7%; type 2, 78.1%) diabetes education. Few PWDs relied on community supports (type 1, 17.5%; type 2, 26.9%), and discrimination was not uncommon for those with type 1 (33.8% vs. 12.4% for type 2; p<0.001). Conclusions: PWDs experience psychological challenges that should be addressed within diabetes management services.
The multinational second Diabetes, Attitudes, Wishes and Needs study: results of the French survey
Patient Preference and Adherence, 2015
The second Diabetes, Attitudes, Wishes and Needs (DAWN2™) multinational cross-sectional study was aimed at generating insights to facilitate innovative efforts by people with diabetes (PWD), family members (FMs), and health care professionals (HCPs) to improve self-management and psychosocial support in diabetes. Here, the French data from the DAWN2™ study are described. Methods: In France, 500 PWD (80 with type 1 diabetes [T1] and 420 with type 2 diabetes [T2]), 120 FMs, and 288 HCPs were recruited. The questionnaires assessed the impact of diabetes on quality of life and mood, self-management, attitudes/beliefs, and care/support. Results: Diabetes negatively impacted the emotional well-being of 59% of people with T1 versus 45% of people with T2 (P0.05) and about half of FMs. A high level of distress was felt by about half of PWD and FMs. About half of HCPs reported assessing depression in their patients. Sixty-two percent of FMs considered managing diabetes to be a burden. Hypoglycemia was a source of concern for 64% of people with T1 and 73% of FMs of insulin users. About two-thirds of non-insulin-medicated people with T2 agreed to start insulin if prescribed, while half of HCPs preferred to delay insulin initiation. A discrepancy between HCPs' perceptions of their interactions with their patients and PWD's recollection of these interactions with regard to patients' personal needs and distress was also observed. Conclusion: While distress remains under-assessed by HCPs, the negative impact of diabetes on the lives of PWD and FMs clearly induces distress on both groups. These findings provide new understanding of barriers precluding optimal management of diabetes. Developing strategies to overcome these barriers is now warranted.
Journal of Public Health, 2011
Aims: To identify barriers and resources of an effective diabetes care management from the perspectives of patients with diabetes. Background: The current health care situation of patients with diabetes indicates that the German health care system is not sufficiently prepared for the increasing incidence rate. Methods: Qualitative design reflecting symbolic interactionism as a methodological background. Problem-centered interviews were used for data collection. A qualitative content analysis was applied for data analysis. Results: Findings suggest a need for individual-and resource-oriented concepts of care in home settings. Participants rate exercise, professional and social support as well as self-efficacy as important resources in diabetes management. Barriers such as lacking acceptance of the disease, problems in adjustment to a new diet as well as utilisation of diabetes education in the daily routine, cognitive impairment and impaired perception of physical changes such as neuropathy, were identified. Conclusions: Prevention orientated counselling and education concepts in diabetes management should systematically integrate the resources of patients with diabetes and tackle the barriers they perceive in order to support them in their specific care needs.
Diabetic Medicine, 2005
To examine patient- and provider-reported psychosocial problems and barriers to effective self-care and resources for dealing with those barriers. Cross-sectional study using face-to-face or telephone interviews with diabetic patients and health-care providers in 13 countries in Asia, Australia, Europe and North America. Participants were randomly selected adults (n = 5104) with Type 1 or Type 2 diabetes, and providers (n = 3827), including primary care physicians, diabetes specialist physicians and nurses. Regimen adherence was poor, especially for diet and exercise; provider estimates of patient self-care were lower than patient reports for all behaviours. Diabetes-related worries were common among patients, and providers generally recognized these worries. Many patients (41%) had poor psychological well-being. Providers reported that most patients had psychological problems that affected diabetes self-care, yet providers often reported they did not have the resources to manage these problems, and few patients (10%) reported receiving psychological treatment. Psychosocial problems appear to be common among diabetic patients worldwide. Addressing these problems may improve diabetes outcomes, but providers often lack critical resources for doing so, particularly skill, time and adequate referral sources.
Diabetes care, 2014
To identify the psychosocial experiences of diabetes, including negative accounts of diabetes and adaptive ways of coping from the perspective of the person with diabetes. Participants were 8,596 adults (1,368 with type 1 diabetes and 7,228 with type 2 diabetes) in the second Diabetes Attitudes, Wishes and Needs (DAWN2) study. Qualitative data were responses to open-ended survey questions about successes, challenges, and wishes for improvement in living with diabetes and about impactful experiences. Emergent coding developed with multinational collaborators identified thematic content about psychosocial aspects. The κ measure of interrater reliability was 0.72. Analysis identified two negative psychosocial themes: 1) anxiety/fear, worry about hypoglycemia and complications of diabetes, depression, and negative moods/hopelessness and 2) discrimination at work and public misunderstanding about diabetes. Two psychosocial themes demonstrated adaptive ways of coping with diabetes: 1) hav...
Family Support in Caring for Diabetes Mellitus Patient: Patient’s Perspective
Open Access Macedonian Journal of Medical Sciences
BACKGROUND: Perspectives of diabetes mellitus patients on family support received during the treatment of their disease at home has high complexity. The family’s intention to help patients to take care of themselves at home can lead to misperceptions or is not well accepted by diabetes mellitus patients. AIM: The aim of the study was to explore the support provided by families in the care of diabetes mellitus patients at home based on the patient’s perspective. METHODS: A phenomenological study using semi-structured questions was chosen as a design in this study. A total of 19 participants were recruited using criteria including being diagnosed with diabetes mellitus for at least 1 year, outpatient, and willing to participate in the study. Data analysis used seven steps of descriptive phenomenological analysis from Colaizzi including data recognition, identification of significant statements, formulating meanings, grouping themes, developing complete descriptions, producing fundamen...