scholarly journals Understanding barriers to glycaemic control from the patient’s perspective

2013 ◽  
Vol 5 (2) ◽  
pp. 114 ◽  
Author(s):  
Ron Janes ◽  
Janet Titchener ◽  
Joseph Pere ◽  
Rose Pere ◽  
Joy Senior
Keyword(s):  
Glycaemic Control ◽  
Phenomenological Approach ◽  
Structured Interview ◽  
Emotional Reactions ◽  
Patient Centered ◽  
Centered Care ◽  
Interpretative Phenomenological Approach ◽  
Key Barrier ◽  
Patient Relationships

INTRODUCTION: To better understand barriers to glycaemic control from the patient’s perspective. METHODS: An interpretative phenomenological approach was used to study the experiences of 15 adults with Type 2 diabetes. Participants each gave a semi-structured interview of their experiences of living with diabetes. Interviews were transcribed, and themes extracted and organised using a patient-centred framework. FINDINGS: Participants’ stories confirmed many of the barriers in the literature, particularly those related to context, such as family, finances, work. Barriers also related to negative emotional reactions to diabetes: fear of new events (diagnosis, starting pills/insulin); guilt about getting diabetes and not controlling it; and shame about having diabetes. Barriers also related to unscientific beliefs and personal beliefs. There were additional barriers related to poor clinician–patient relationships. Overall, participants had a poor understanding of diabetes, and complained that their clinician simply ‘told them what to do’. CONCLUSION: Using a patient-centred approach, this study identified many barriers to glycaemic control. We suggest that a key barrier is clinician ignorance of their patients’ fears, beliefs, expectations, context; of what constitutes a positive therapeutic relationship; and of the limitations of a biomedical approach to patient non-adherence. Faced with both a worsening diabetes epidemic and increasing health care workforce shortages, clinicians urgently need to understand that it is they, not their patients, who must change their approach if diabetes care is to be improved. KEYWORDS: Communication barriers; diabetes mellitus, type 2; medication adherence; patient-centered care

scholarly journals Patient-Centered Care, Diabetes Empowerment, and Type 2 Diabetes Medication Adherence Among American Indian Patients

2017 ◽  
Vol 35 (5) ◽  
pp. 281-285 ◽  
Author(s):  
Nathan L. Ratner ◽  
Emily B. Davis ◽  
Laura L. Lhotka ◽  
Stephanie M. Wille ◽  
Melissa L. Walls
Keyword(s):  
Type 2 Diabetes ◽  
Medication Adherence ◽  
American Indian ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Diabetes Medication ◽  
Indian Patients ◽  
Centered Care ◽  
Diabetes Empowerment

scholarly journals An Interval Type-2 Fuzzy Similarity-Based MABAC Approach for Patient-Centered Care

Mathematics ◽  
2019 ◽  
Vol 7 (2) ◽  
pp. 140 ◽  
Author(s):  
Junhua Hu ◽  
Panpan Chen ◽  
Yan Yang
Keyword(s):  
Fuzzy Numbers ◽  
Patient Centered Care ◽  
Integrated Medicine ◽  
Patient Centered ◽  
Fuzzy Similarity ◽  
Nursing Services ◽  
Centered Care ◽  
Type 2 Diabetes Treatment ◽  
Interval Type

Patient-centered care is an essential part of the implementation of integrated medicine, integrating humanistic care into nursing services, enhancing communication between caregivers and patients, and providing personalized service to patients. Based on the similarity of interval type-2 fuzzy numbers (IT2FNs), a novel similarity-based methodology is presented for the selection of the most suitable medical treatment under a patient-centered environment. First, we propose a new similarity based on the geometric properties of interval type-2 fuzzy numbers and present a new property based on the center of gravity. Meanwhile, in order to better highlight the advantages of the proposed similarity, we selected 30 samples for comparative experiments. Second, considering the straightforward logic of the multi-attributive border approximation area comparison (MABAC) method, we extended it based on similarity to make the decision more accurate. Finally, a realistic patient-centered type-2 diabetes treatment selection problem is presented to verify the practicality and effectiveness of the proposed algorithm. A comparative analysis with existing methods is also described.

Clinician–patient relationships after two decades of a paradigm of patient-centered care

2020 ◽  
pp. 1-10 ◽  
Author(s):  
Riaz Akseer ◽  
Maureen Connolly ◽  
Jarold Cosby ◽  
Gail Frost ◽  
Rajwin Raja Kanagarajah ◽  
...  
Keyword(s):  
Patient Centered Care ◽  
Patient Centered ◽  
Centered Care ◽  
Patient Relationships

scholarly journals Patient-Centered Care, Glycemic Control, Diabetes Self-Care, and Quality of Life in Adults with Type 2 Diabetes

2016 ◽  
Vol 18 (10) ◽  
pp. 644-649 ◽  
Author(s):  
Joni S. Williams ◽  
Rebekah J. Walker ◽  
Brittany L. Smalls ◽  
Rachel Hill ◽  
Leonard E. Egede
Keyword(s):  
Quality Of Life ◽  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Self Care ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Centered Care ◽  
Control Diabetes

scholarly journals Effectiveness of Patient-centered Care for Diabetes Self-management to Improve Glycemic Control and Self-care Behaviors in Adults With Type 2 Diabetes: a Systematic Review

2021 ◽  
Author(s):  
Kainat Asmat ◽  
Khairunnisa Dhamani ◽  
Raisa Gul ◽  
Erika Sivarajan Froelicher
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Self Care ◽  
Self Management ◽  
Foot Care ◽  
Patient Centered ◽  
Management Interventions ◽  
Centered Care ◽  
Care Outcomes

Abstract Background: Patient-centered care in diabetes self-management might be a significant factor in improving self-care outcomes yet the supporting evidence is inadequate. This review is aimed to assess the effectiveness of patient-centered self-management care interventions on self-care outcomes such as glycemic control (HbA1c) and self-care behaviors in adults with type-2 diabetes compared with usual care. Methods: CINAHL, PubMed, Cochrane Library, Google Scholar and the HEC Pakistan digital library were searched for English language studies that assessed patient-centered self-management educational and/or behavioral interventions in adults aged 18 years or above with type 2 diabetes from 1991 to 2020. Interventional studies comprising randomized controlled trials (RCT) and quasi experimental studies (QES) with at least three months follow up and reporting on self-care outcomes with glycemic control (HbA1c) as primary outcome and self-care behaviors including diet control, physical activity, medication adherence and foot care as secondary outcomes were included. Results: Of the 168 identified records, 25 were found eligible comprising 21 RCTs and 4 QESs with total 4,443 participants. The meta-analysis involved 23 studies that provided enough information for a pooled estimate of HbA1c. Compared with the control group, patient-centered self-management interventions significantly lowered HbA1c −0.53 (95% CI −0.73, −0.32). Stratified analysis for HbA1c with respect to various aspects of intervention showed larger effects in interventions employing both educational and behavioral components −0.59 (95% CI −0.86, −0.32), spanned over shorter (<03 months) duration −0.56 (95% CI −0.86, −0.27), administered by nurses −0.80 (95% CI −1.44, −0.16) and delivered in community setting −0.65 (95% CI −1.00, −0.29). Moreover, patient-centered self-management interventions were found effective in improving diet control, physical activity and foot care. Conclusion: This systematic review provided the evidence supporting the effectiveness of patient-centered self-management care interventions in improving glycemic control and self-care behaviors in adults with type 2 diabetes and identified key features of intervention contributing towards success.

scholarly journals Clinician distress in seriously ill patient care: A dimensional analysis

2021 ◽  
pp. 096973302110032
Author(s):  
Anessa M. Foxwell ◽  
Salimah H. Meghani ◽  
Connie M. Ulrich
Keyword(s):  
Dimensional Analysis ◽  
Clinical Situation ◽  
The United States ◽  
Emotional Reactions ◽  
Ethical Review ◽  
Patient Centered ◽  
Serious Illness ◽  
Centered Care ◽  
Seriously Ill Patients ◽  
Seriously Ill

Background: Caring for patients with serious illness may severely strain clinicians causing distress and probable poor patient outcomes. Unfortunately, clinician distress and its impact historically has received little attention. Research purpose: The purpose of this article was to investigate the nature of clinician distress. Research design: Qualitative inductive dimensional analysis. Participants and research context: After review of 577 articles from health sciences databases, a total of 33 articles were eligible for analysis. Ethical considerations: This study did not require ethical review and the authors adhered to appropriate academic standards in their analysis. Findings: A narrative of clinician distress in the hospital clinician in the United States emerged from the analysis. This included clinicians’ perceptions and sense of should or the feeling that something is awry in the clinical situation. The explanatory matrix consequence of clinician distress occurred under conditions including: the recognition of conflict, the recognition of emotion, or the recognition of a mismatch; followed by a process of an inability to feel and act according to one’s values due to a precipitating event. Discussion: This study adds three unique contributions to the concept of clinician distress by (1) including the emotional aspects of caring for seriously ill patients, (2) providing a new framework for understanding clinician distress within the clinician’s own perceptions, and (3) looking at action outside of a purely moral lens by dimensionalizing data, thereby pulling apart what has been socially constructed. Conclusion: For clinicians, learning to recognize one’s perceptions and emotional reactions is the first step in mitigating distress. There is a critical need to understand the full scope of clinician distress and its impact on the quality of patient-centered care in serious illness.

Health Information Seeking and Implications for the Operative Dentist

2015 ◽  
Vol 40 (5) ◽  
pp. 451-457 ◽  
Author(s):  
K Walker
Keyword(s):  
Health Information ◽  
Information Seeking ◽  
Steady Increase ◽  
Health Information Seeking ◽  
Internet Communication ◽  
Patient Centered ◽  
Operative Dentistry ◽  
Centered Care ◽  
And Behavior ◽  
Patient Relationships

SUMMARYThe steady increase in online health information seeking by patients is ingrained in central notions of patient-centered care and shared decision-making models reflected in operative dentistry and the healthcare industry at large. More patients today seek health information prior to an appointment, communicate their findings with their providers, and expect two-way communication exchanges. This e-consumer trend has many implications for operative dentistry, for which surgery, by its very nature, lends to a confluence of questioning and informational needs. Operative dentists must acknowledge patient information and be prepared to address the breadth of information brought to them. The purpose of this literature review is threefold: 1) to provide the operative dentist with information about the demographics, psychology, and behavior of today's e-health patient; 2) to provide a review of the benefits and challenges of communicating with e-health patients; and 3) to provide recommendations for communicating with e-patients interpersonally and through Internet communication. In so doing, it is hoped that discussion can provide insight useful for improving provider/patient relationships in the progressive communication era.

scholarly journals Feelings of women after the diagnosis of type 2 diabetes

2008 ◽  
Vol 16 (1) ◽  
pp. 101-108 ◽  
Author(s):  
Denise Siqueira Péres ◽  
Laércio Joel Franco ◽  
Manoel Antônio dos Santos
Keyword(s):  
Treatment Adherence ◽  
Exploratory Study ◽  
Structured Interview ◽  
Emotional Reactions ◽  
Educational Process ◽  
Thematic Content Analysis ◽  
Health Team ◽  
Primary Health ◽  
Health Care Unit

Descriptive and exploratory study with the objective of knowing feelings and emotional reactions of women after the diagnosis of diabetes. Data were collected at a primary health care unit in Ribeirão Preto - SP, Brazil, through a semi-structured interview. Thematic content analysis was used for interpreting the data. The results showed that women's behavior after the diagnosis of diabetes was associated with feelings and emotional reactions that interfere with treatment adherence and which the health team needs to understand. In an educational process, it is not enough to offer information. Human behavior is extremely complex, going beyond the cognitive aspects, and is rooted in affective-emotional dispositions.

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