Rate of minor injuries patients’ attendance at surgical emergency departments, Ain Shams University Hospitals (original) (raw)
Related papers
Health and Quality of Life Outcomes, 2007
Background Although insulin therapy is well-accepted by symptomatic diabetic patients, it is still often delayed in less severe patients, in whom injectable insulin remains under-used. A better understanding of patients' perception of insulin would eventually help physicians to adopt the most appropriate dialogue when having to motivate patients to initiate or to intensify insulin injection. Methods The 'Studying the Hurdles of Insulin Prescription' (SHIP) questionnaire was developed based on a list of concepts derived from three diabetic patients' focus groups, and was included into two cross-sectional studies with similar design: SHIP Oral study and SHIP Premix study. Diabetic patients treated with oral hypoglycaemic agents (OHA; n = 1,494) and patients already treated with insulin (n = 1,150) completed the questionnaire at baseline, 6- and 12 months. Psychometric properties were assessed: 1) structure analysis by Principal Component Analysis (PCA) with Varimax rotation, 2) internal consistency reliability (Cronbach's alpha), and 3) concurrent validity (Spearman correlation coefficients with the Fear of Self-Injecting (FSI) score of the Diabetes Fear of Injecting and Self-testing Questionnaire. Reluctance/motivation towards insulin was assessed. Scores' ability to predict patients' insulin injection reluctance/motivation and initiation/intensification was evaluated with the Area Under the Receiver Operating Characteristic (ROC) Curve (AUC). Results PCA analysis confirmed the structure of the 14 items grouped into 3 dimensions: 'acceptance and motivation', 'fear and constraints', and 'restraints and barriers' towards insulin injection. Internal consistency reliability was excellent (Cronbach's alpha > 0.70); concurrent validity was good. The three scores were significantly predictive of patients' reluctance/motivation towards insulin injection initiation, as they were of patients' actual switch, except for the 'restraints and barriers' dimension. 'Acceptance and motivation' and 'fears and constraints' dimensions were also significantly predictive of patients' reluctance/motivation towards insulin intensification. By the end of the 12-month study, 179 of the initially OHA-treated patients had started insulin injections; 186 of the patients already treated with insulin had increased their injections. Conclusion The SHIP questionnaire provides reliable and valid assessment of diabetic patients' attitude towards insulin and injections. The predictive power of scores for patients' reluctance/motivation and actual treatment decisions demonstrates encouraging potential for further application in clinical practice.
Resistance to Insulin Therapy Among Patients and Providers
Diabetes Care, 2005
OBJECTIVE—To examine the correlates of patient and provider attitudes toward insulin therapy. RESEARCH DESIGN AND METHODS—Data are from surveys of patients with type 2 diabetes not taking insulin (n = 2,061) and diabetes care providers (nurses = 1,109; physicians = 2,681) in 13 countries in Asia, Australia, Europe, and North America. Multiple regression analysis is used to identify correlates of attitudes toward insulin therapy among patients, physicians, and nurses. RESULTS—Patient and provider attitudes differ significantly across countries, controlling for individual characteristics. Patients rate the clinical efficacy of insulin as low and would blame themselves if they had to start insulin therapy. Self-blame is significantly lower among those who have better diet and exercise adherence and less diabetes-related distress. Patients who are not managing their diabetes well (poor perceived control, more complications, and diabetes-related distress) are significantly more likely to...
Attitude towards insulin therapy among patients with type 2 diabetes in Tripoli, Libya
Ibnosina Journal of Medicine and Biomedical Sciences, 2015
Background: In patients with type 2 diabetes mellitus (T2DM), failure to control of blood glucose with lifestyle modifications and oral hypoglycemic agents (OHA) leads to insulin therapy. Objectives: We aimed to 1) find out the prevalence of psychological insulin resistance among patients with T2DM and 2) explore the factors affecting and reasons behind their attitude towards insulin use. Patients and methods: In a cross sectional study, 1703 Libyan patients with T2DM on oral hypoglycemic agents (OHA) were studied. They were recruited from outpatient clinics of two hospitals and 5 primary health care centers in Tripoli, Libya over a period of six months. They were asked to complete a self-administered questionnaire. Results: From the total number of 1703 participants, 1611 (94.6%) reported unwillingness to accept insulin therapy should it be prescribed to them. Hesitant patients reported more concerns about possible side effects that may develop from errors in insulin dose than acce...
Attitude and Compliance with the Onset of Insulin Therapy in Patients with Type 2 Diabetes
Shiraz E-Medical Journal, 2020
Background: Insulin therapy refusal among type 2 diabetic patients is most challenging for healthcare providers. Objectives: This study aimed to evaluate the type 2 diabetic patients’ attitude and compliance with the initiation of insulin therapy. Methods: A cross-sectional study was conducted on 100 type 2 diabetic patients at the Endocrinology Clinic of Loghman Hakim Hospital, Tehran, Iran. A questionnaire was prepared to assess the attitudes toward the onset of insulin therapy. Positive and negative attitudes toward insulin injection were compared between the two groups of accepting and rejecting insulin therapy. Results: In this study, 62% of patients with type 2 diabetes tended to start insulin therapy. There was a statistical difference between the total positive and negative attitude items toward insulin therapy (agree/disagree) and acceptance of insulin therapy (P < 0.05). The most agreements related to a positive attitude in the two groups of accepting and rejecting insu...
Reluctance of Patients with Diabetes Mellitus to Insulin Therapy; Psychological Insulin Resistance
2021
Objective: To evaluate factors resulting in reluctance of initiation of insulin therapy in patients with type 2 diabetes mellitus. Study Design: Cross sectional study. Place and Duration of Study: Medical OPD of a private tertiary care multi-specialty hospital in Islamabad, from Apr to Jul 2019. Methodology: Patients with diabetes mellitus between age of 30-70 years, who had poor glycaemic control on two oral antidiabetic drugs having HbA1c>9% and were insulin naive, were included in this study. A validated questionnaire was developed which had two sections; first including the demographic data of the study populations and second having closedended dichotomous questions which were asked from patients by the treating physicians Results: A total of 180 patients with diabetes mellitus eligible for insulin therapy were included in the study, among them 52 (28.9%) were agreed to initiate the insulin. Negative attitude and beliefs include painful way of administration 85 (66.4%), diffi...
Primary care diabetes, 2014
p r i m a r y c a r e d i a b e t e s 8 ( 2 0 1 4 ) 49-55 Type 2 diabetes Insulin therapy initiation a b s t r a c t Aims: To explore how health care professionals (HCPs) assess patients when initiating insulin therapy in type 2 diabetes. Methods: Focus group discussions and in-depth interviews were conducted with 41 health care professionals in Malaysia in 2010-2011. A semi-structured topic guide was used for the interview. The interviews were transcribed verbatim and analysed using the Nvivo9 software based on a thematic approach.
The perceived barriers to insulin therapy among type 2 diabetic patients
African Health Sciences, 2019
Background: Problems may arise with insulin treatment, due to patients' perspective towards it leading to refusal. Objectives: To evaluate diabetic patients' refusal towards insulin therapy, and to assess patients' perception and perceived barriers towards insulin. Methods: A cross-sectionalstudy, where type 2 diabetics participated in the study during a period, February through March 2017. They were interviewed in person by a questionnaire including three sections; socio-demography, medical history and a health belief model, comprising barriers to use insulin. Five points Likert scale was used to measure patients' perception and barriers towards insulin therapy. Results: One fourth (24.4%) of the diabetic patients refused insulin. Among the controlled group, 34.4% refused insulin, while 21% refused insulin among the uncontrolled group. The study showed different barriers towards insulin therapy, including fear of injection, pain, insulin injection needs help from others, fear of hypoglycaemia and embarrassment. Conclusion: Diabetics showed a negative attitude towards insulin therapy due to social and psychological factors. The results necessitate the development of a strategy to address problems related with a reluctance to initiate insulin and put a strategy to implement education and better interaction with diabetic team to the stigma from phobia from insulin use.
The Professional Medical Journal, 2017
Background: The increasing morbidity of diabetes mellitus in Pakistan, andinsulin refusal is one of the main challenges in managing diabetic patients who have suboptimalcontrol. Objectives: The aim of present study was to determine the trend of insulin therapyrefusal among diabetes mellitus type 2 patients in Pakistan from the healthcare provider’sperspective and to find out the reasons behind this refusal. Design: Quantitative research study.Place and duration of study: The clinics of general practitioner & consultants from differentlocations of Karachi to cover all socio-economic groups of society to avoid any biasness inselection. The duration of study is from August 2013 to February 2014. Methods: Four hundredand fifty healthcare providers were approached with convenient random sampling fromclinics and hospital located in Karachi. The pre-tested and validated questionnaire was usedto collect data. Data were authorized following double entry as given the code number of allfilled ...
What are disease perceptions and subjective treatment goals of insulin treated diabetic patients?
Swiss medical weekly, 2005
Despite increasing importance of patient self-management, little is known about their own perceptions and treatment goals. The aim of this explorative study was to examine what diabetic patients perceive as most concerning and what their own treatment goals are. A 23-item anonymous questionnaire was distributed among type 1 diabetic patients treated with and without an insulin pump and insulin treated type 2 diabetic patients in the outpatient clinic of a University Hospital. 86% of the questionnaires were returned (n = 124). In open-ended questions, patients in all three groups together felt mostly restricted by their loss of freedom (24%), the dietary restrictions (17%) and the need to measure blood glucose (17%). Patients treated with an insulin pump worried more about hypoglycaemia and less about dietary restrictions. In closed-ended questions, patients were mostly concerned about hypoglycaemia and developing complications. However, the main treatment goal of both groups togethe...