Resources for and barriers to effective diabetes care management—experiences and perspectives of people with type 2 diabetes (original) (raw)
Related papers
O Diabético Numa Perspectiva Da Promoção De Saúde
2013
Objective: To identify the overall health and living conditions of diabetes patients, the main risk factors for the disease as well as the complications, difficulties, expectations and problems relating to health service monitoring, from the perspective of "Health Field" model. Methods: Descriptive, cross-sectional study conducted with 187 diabetes patients of both sexes, living in the urban area and enrolled at five Primary Healthcare Units of a municipality of Minas Gerais. Data was collected during home visits, applying an interview form created for diabetes patients, based on data from human biology, environment, lifestyle and health services' organization, elements of the adopted model. Data was analyzed descriptively and presented as frequencies, averages and percentages. Results: Type 2 diabetes mellitus, female gender, age above 60, married status, incomplete elementary school education, and monthly income of less than three minimum wages were prevalent. Of the participants, 71 (41.5%) had abnormal glucose levels, 94 (55.1%) had blood pressure higher than recommendations and 131 (70.1%) were using oral hypoglycemic agents. Also, 138 (73.8%) did not exercise on a regular basis and 133 (71.1%) were overweight or obese. Living with family was reported by 141 (75.4%) participants and 100 (53.5%) reported participating in meetings. The family was the main source of support for 96 (65.8%) of them. Conclusions: The results raised discussions on the clinical conditions, expectations and difficulties experienced by the participants, and highlighted the challenge to be faced by healthcare professionals in order to maintain the compliance of healthcare users with the long-term treatment, typical of chronic conditions such as diabetes.
BMJ open, 2016
There is a growing emphasis on the perspective of individuals living with diabetes and the need for a more person-centred diabetes care. At present, the Swedish National Diabetes Register (NDR) lacks patient-reported outcome measures (PROMs) based on the perspective of the patient. As a basis for a new PROM, the aim of this study was to describe important aspects in life for adult individuals with diabetes. Semistructured qualitative interviews analysed using content analysis. Hospital-based outpatient clinics and primary healthcare clinics in Sweden. 29 adults with type 1 diabetes mellitus (DM) (n=15) and type 2 DM (n=14). Swedish adults (≥ 18 years) living with type 1 DM or type 2 DM (duration ≥ 5 years) able to describe their situation in Swedish. Purposive sampling generated heterogeneous characteristics. To live a good life with diabetes is demanding for the individual, but experienced barriers can be eased by support from others in the personal sphere, and by professional supp...
Experience of adult individuals with Type 2 diabetes about diabetes: A qualitative study
International Diabetes Nursing, 2016
This study was carried out in a qualitative manner in order to identify the emotions and life experience of the patients with Type 2 diabetes with regard to their disease in the Endocrinology Clinic of Bayındır Hospital Kavaklıdere between December 2014 and April 2015. Twenty-one individuals, who were being monitored in the related department and whose consent forms were obtained, were recruited. The ethics committee approval was obtained for the study and statistical data were employed in respect of demographic features. The data were collected by using interview forms and in-depth interviews. Microsoft Word 2007 word processing software was used to analyse the data. A face-to-face interview technique was utilized by raising predetermined unbiased and non-directing questions to the individuals. A voice recording was used in the interviews which lasted at least 20 minutes, and written minutes of the data were issued within 24 hours after the interview. The content analysis was used in analysing the qualitative data so that the theming of the concepts and considerations pertaining to the subject addressed is determined through repetitive reading of the text on which the interview was analysed and classification and coding of the study as per sub-objectives. Consequently, there were 14 themes in total, namely lack of information, shock, fear, sadness, denial, feeling of guilt, anger, unacceptance, change of habits, adaptation difficulty, professional hardship, social challenges and environmental factors and feeling better. It is suggested that the process of acceptance of diabetes and adaption to the treatment should be facilitated, planning trainings on diabetes per individual requirements through sympathetic approach.
Living with diabetes: quality of care and quality of life
Patient Preference and Adherence, 2011
The aim of this research was to characterize the experience of living with diabetes mellitus (DM) and identify patients' opinions of the quality of care received and the results of interventions. Methods: A descriptive, exploratory evaluation study using qualitative methodology was performed. Participants consisted of 40 adult patients diagnosed with DM and followed up in a public hospital in Barcelona, Spain. A semistructured interview and a focus group were used and a thematic content analysis was performed. Results: Patients described DM as a disease that is difficult to control and that provokes lifestyle changes requiring effort and sacrifice. Insulin treatment increased the perception of disease severity. The most frequent and dreaded complication was hypoglycemia. The main problems perceived by patients affecting the quality of care were related to a disease-centered medical approach, lack of information, limited participation in decision-making, and the administrative and bureaucratic problems of the health care system. Conclusion: The bureaucratic circuits of the health care system impair patients' quality of life and perceived quality of care. Health professionals should foster patient participation in decision-making. However, this requires not only training and appropriate attitudes, but also adequate staffing and materials.
Lived Experiences of People Living with Type II Diabetes: A qualitative study
Journal of Advanced Academic Research
Introduction: Nepal is experiencing a double disease burden: Communicable diseases as well as rising incidence of non-communicable diseases. It is believed to be due to unhealthy life style and faulty food habit. Among the NCD Diabetes Mellitus (DM) is considered to be a major health problem. Methods: This study has adapted Phenomenological approach in which the researcher has tried to explore the perceptions and beliefs of people living with type 2 diabetes. In this study two instruments were used; in-depth interview were taken in 21 respondents who are attending different hospitals of Kathmandu. The interview was guided by using open ended questions. All interviews were analyzed manually and qualitative content analysis was done to identify the codes, categorizes, sub categorizes concepts data and to find out the main theme. Results: Most of the respondents believed that unhealthy diet(high carbohydrate, high fat, low rough phage food), sedentary life style, stressful life and consumption of the food with higher concentration of pesticides (eg: Metacid). Conclusions: People perceived that unhealthy life style is the main cause of diabetes and to reduce the number awareness program should be initiated by the government mainly in the public places and should be kept in the school level curriculum also.
The Patient’s Attitude Toward Type 2 Diabetes Mellitus, a Qualitative Study
Diabetes is an important health problem through the world. In comprehensive diabetes care, therapists must understand not just the observable behavior but the underlying attitudes which drive that behavior. Health, then sickness, has many aspects, and one of the famous descriptions is guided by WHO. This study aimed to explore dimensions of attitudes in diabetic patients about their disease, attending two medical centers in Tehran (capital of Iran). We conducted the open semi-structured face-to-face interviews with 27 patients. We used new methods for collecting data, reliability, validity, analyzing and ethical approval. We identified eighteen themes in four aspects of attitude: physical, mental, social and spiritual. Based on health promotion idea, we can divide themes in two broad categories: progressive attitude toward the higher level of health care and inhibitors attitude for this. The result of this research can be used in evidence-based education and management programs in comprehensive care of type 2 diabetes mellitus.
Towards Patient-Oriented Diabetes Care: Results from Two KORA Surveys in Southern Germany
Journal of Diabetes Research, 2015
Objective. This study aims to examine the relationship of diabetes care processes and patient outcomes with an expanded set of indicators regarding patient-oriented care delivery, such as treatment satisfaction, the quality of patient-physician relationship, and a wider range of patient outcomes such as self-management, health behaviour, disease-related burden, and health-related quality of life (HRQL).Methods. The study population consisted of 486 participants with type 2 diabetes in two population-based follow-up surveys, conducted in 2003 to 2005 and 2006 to 2008 in Southern Germany. Data were self-reported and questionnaire-based, including the SF-12 for HRQL. Multiple regression models were used to identify associations between care processes and outcomes with adjustment for confounders.Results. Frequent medical examinations increased the likelihood of self-monitoring activities, such as foot care. A positive patient experienced relationship with their physician is associated w...
Barriers to effective management of type 2 diabetes in primary care: qualitative systematic review
British Journal of General Practice, 2016
INTRODUCTION Diabetes mellitus is a global health problem affecting both developed and resource-limited countries. 1,2 The World Health Organization (WHO) estimates that 347 million people worldwide have diabetes, with deaths from diabetes projected to double between 2005 and 2030. 3 Diabetes also causes considerable morbidity related to macro-and microvascular damage, and to psychosocial sequelae, 4-6 and incurs significant and growing healthcare costs. 7 Despite the availability of evidence-based guidance, 8-10 and encouraging trends in the delivery of care, many patients with diabetes do not achieve the recommended glycaemic, cholesterol, and blood pressure levels. 2,11 Most routine diabetes management, particularly of type 2 diabetes, is undertaken in primary care, drawing on features of the chronic care model such as dedicated review clinics, 12 and shared care with specialists. 13 Interventions to improve diabetes care generally have modest effects. 14 Understanding influences on clinical behaviour is critical in guiding the selection and enhancement of interventions to improve practice. 15,16 Patient-reported influences on the receipt and outcome of diabetes care are well documented. 17-21 However, much variation in delivery and outcomes is not readily explained by patient characteristics, and is likely to be attributable to clinician and organisational behaviour. 22 Qualitative studies were reviewed that examined primary care clinicians' perceived barriers to and enablers of recommended practice for type 2 diabetes. METHOD Search strategy Search strategies were combined for papers on clinicians' perceptions and type 2 diabetes from the Cochrane Metabolic and Endocrine Disorders Group together with qualitative methodological filters (the full search strategy is available from the authors on request). 23 MEDLINE, Embase, CINAHL, PsycInfo, and ASSIA were searched from 1980, the year the WHO report recommended integrating diabetes care within community-based healthcare systems, 24 until the first week in March 2014, and reference lists of included studies were hand searched. Study selection Qualitative studies were included that described primary care physicians' or nurses' perceptions of type 2 diabetes management. Papers were included that either focused on specific treatment goals (such as glycaemic control) 8,11,25 or more general aspects of care. Papers were excluded that examined other specific care processes (for example, management of concurrent depression) and quantitative surveys. Paired reviewers independently screened titles and abstracts of all identified references. Inconsistencies were examined in decisions after 100 and 500 references, and inclusion criteria were refined. Paired