Preferring to manage by myself: A qualitative study of the perspectives of hardly reached people with type 2 diabetes on social support for diabetes management

2019 ◽  
Vol 28 (9-10) ◽  
pp. 1889-1898
Author(s):  
Laura K. Bech ◽  
Camilla Borch Jacobsen ◽  
Anne Sophie Mathiesen ◽  
Thordis Thomsen
Keyword(s):  
Social Support ◽  
Type 2 Diabetes ◽  
Qualitative Study ◽  
Diabetes Management

scholarly journals Perceptions of Type 2 Diabetes Patients Towards Diabetes Management Visits at Public Primary Health Care Centers with Diverse Opinions Towards Nurse-led Clinics in Muscat, Oman: A Pilot Qualitative Study

2020 ◽  
Vol 35 (6) ◽  
pp. e196-e196
Author(s):  
Kamila Al-Alawi ◽  
Ahmed Al-Mandhari
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
Primary Health Care ◽  
Qualitative Study ◽  
Diabetes Management ◽  
Primary Health ◽  
Primary Health Care Centers ◽  
Health Care Centers ◽  
Diabetes Patients

Objectives: The literature has described several positive outcomes related to diabetes management via nurse-led clinics. This is especially true where a shortage of physicians is recorded within a team-based approach. We sought to explore the perceptions of patients with type 2 diabetes towards the current diabetes management visits at public primary health care centers in Muscat, Oman and their opinions towards nurse-led diabetes management clinics. Methods: This pilot qualitative study included seven semi-structured interviews with type 2 diabetes patients from four purposely selected public primary health care centers in Muscat. Qualitative thematic analysis was applied. Results: Patients with type 2 diabetes expressed their satisfaction with the present diabetes management visits at public primary health care. Their opinions towards nurse-led clinic were diverse and divided patients into three categories: those who totally refused the nurse-led clinics, those who accepted the clinics but with reservations, and patients that totally accepted the nurse-led clinics. The patients’ main concern was the nurses’ abilities to handle and understand the disease and its management. Conclusions: Our pilot study revealed type 2 diabetes patients’ satisfaction with the current diabetes management clinics. However, transformation to nurse-led clinics within team-based approach requires further studies with a bigger sample size. Further studies on requirements related to the Omani health care system and a better understanding of patients’ worries and their readiness to accept the concept of nurse-led clinics and their outcomes are also recommended.

Abstract 311: Facilitators and Barriers to Self-management of Patients with Type 2 Diabetes in Communities in China, a Qualitative Study

Hypertension ◽  
2012 ◽  
Vol 60 (suppl_1) ◽  
Author(s):  
Xiang Y Chen ◽  
Peng Yue ◽  
Yong L Wang ◽  
Shu Q Xiao ◽  
Xin W Feng ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Qualitative Study ◽  
Management Practices ◽  
Diabetes Management ◽  
Financial Burden ◽  
Chinese Patients ◽  
Self Management ◽  
Difficult Time ◽  
Facilitators And Barriers

Background: Self-management has become a key strategy for caring chronic patients in community. However, little is known about peoples’ self-management experiences and their perceived cues and barriers to engagement in self-management. Objective: To explore issues patients with type 2 diabetes experienced in their self-management practices,to understand cues and barriers to engagement in self-management. Design: Qualitative study (Semi-structured interviews) Setting: 11 communities in Beijing, China Participants: Type 2 diabetes patients in community, aged >18, no admission in past 90 days. Methods: 40 critical incident interviews were run during Apr to Sep in 2011 using purposive sampling (20 interviews with patients whose HbA1c well-controlled (<6.5%), while 20 badly-controlled (≥8%)).Themes from interviews were identified using content analysis, which revealed cues and barriers to self-modification for diabetes management. Results: Implications for self- management practice included objectively understanding on the severity and complications of diabetes. In addition to family support such as supervision in family and fully-use of family resource, desires/duties to be responsible for whole family life as a breadwinner was emerged as a key cue to engagement in self-control. Barriers to engagement in self-management stemmed from financial burden to monitor blood glucose daily, dissatisfaction of HbA1c level after efforts, and malignant life events. It is worth mentioning that starving experience of difficult time with natural disasters in1960s- 1970s in China was identified also as a key barrier to engagement in diet management. Discussion and Conclusion: There was a strong desire for Chinese patients to comply with Chinese cultural norms; particularly those relating to family value. It was the patients’ power to be involved in self-management that they could devote their healthy life to family duty. Everyone had his/her own history so experiences in past shaped patients’ behaviors now. The findings highlighted the importance of understanding the family value and the personal experiences as facilitators and barriers to self-management of Chinese patients with type 2 diabetes living in community.

scholarly journals To Tell or Not to Tell: Disclosure and Self-Management among Adults with Early-Onset Type 2 Diabetes: A Qualitative Study

2020 ◽  
Vol 10 (1) ◽  
pp. 11-19
Author(s):  
Maja Hykkelbjerg Nielsen ◽  
Annesofie Lunde Jensen ◽  
Anne Bo ◽  
Helle Terkildsen Maindal
Keyword(s):  
Type 2 Diabetes ◽  
Qualitative Study ◽  
Early Onset ◽  
Diabetes Management ◽  
Well Being ◽  
Self Management ◽  
Close Relative ◽  
High Risk Population ◽  
Onset Type

Background: Adults with early-onset Type 2 Diabetes Mellitus (T2DM) are an emerging high-risk population who may experience social challenges related to diabetes management. Objective: To explore the disclosure of T2DM and how disclosure affects diabetes self-management and the psychosocial adjustment to life with diabetes among adults with early-onset T2DM. Methods: A qualitative study was conducted using Systematic Text Condensation (STC). Data was derived from semi-structured interviews with 15 individuals with T2DM ≤ 46 years (10 women and 5 men) recruited from diverse settings using purposeful sampling. Results: Most informants disclosed their diabetes to a close relative shortly after receiving the diagnosis. This led to immediate emotional support and overall positive disclosure experiences. However, informants often hesitated to disclose their condition to others due to shame, fear of negative judgement or social exclusion. Over time, the majority of informants became more open about their condition, which often resulted in emotional and practical self-management support. Those most reluctant to disclosing their diabetes struggled with shame and negative diabetes-related emotions, which had negative effects on their diabetes self-management. Conclusion: Disclosure of T2DM seemed important for the social, emotional and practical management of diabetes among adults with early-onset T2DM. The disclosure was most often accompanied by feelings of shame and fear of condemnation. Professional guidance to support disclosure and interventions to address stigma may improve well-being and diabetes self-management in this population.

Dyadic appraisal and coping with illness among older Chinese adults with type 2 diabetes mellitus: a qualitative study

2020 ◽  
Author(s):  
Jiong Tu ◽  
Yuyang Liu ◽  
Xueji Wu ◽  
Dong Xu ◽  
Jing Liao
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Health Status ◽  
Qualitative Study ◽  
Diabetes Management ◽  
Living Environment ◽  
Older Couples ◽  
Older Chinese

Abstract Introduction Diabetes management permeates patients’ daily routines and interacts with their living context. Less is known about how older Chinese couples view their supportive roles and the allocation of the management responsibility between them. Objectives To explore dyadic appraisal, coping and the barriers to diabetes management shared by older Chinese couples. Methods A qualitative study of older couples where at least one partner had type 2 diabetes mellitus was implemented in four communities of Guangzhou, China. Four focus groups containing 11 couples, and ten in-depth interviews with individual couples were conducted sequentially. All of the data were coded with Nvivo 11 using thematic analysis. Results The majority of the older couples interviewed appraised diabetes as a shared problem, taking part in monitoring and altering each other’s health status and behaviour. Limited knowledge and a lack of accurate information about diabetes negatively impacted the patients’ self-management and their spouse’s ability to support them. A female dominated-care pattern was evident that female spouses, regardless of their health status, were actively involved in or fully responsible for managing their husband’s health. Older couples’ management practices were also shaped by family responsibilities and their living environment. Conclusions Our study provides first-hand evidence of older Chinese couples’ daily interactions and the main barriers to diabetes management. It is vital to provide health education directly to older couples to empower them to access adequate mutual support when managing chronic diseases.

scholarly journals Treatment and monitoring remain the purview of the doctor: Health literacy of people struggling with insufficiently controlled type 2 diabetes. A longitudinal qualitative study

2020 ◽  
Author(s):  
Xavier Debussche ◽  
Maryvette Balcou-Debussche ◽  
Delphine Ballet ◽  
Jessica Caroupin-Soupoutevin
Keyword(s):  
Social Support ◽  
Type 2 Diabetes ◽  
Health Literacy ◽  
Disease Management ◽  
Qualitative Study ◽  
Health Knowledge ◽  
Care Providers ◽  
Structured Care ◽  
Relation Type

Abstract Background Assessing complex health literacy needs is a key element to improve management of diabetes in vulnerable people. This study aimed to analyse health literacy and practices in insufficiently controlled type 2 diabetes. Methods Data are issued from the qualitative ERMIES-ethnosocio study nested in the ERMIES randomized controlled trial testing a 2 years structured care in type 2 diabetes. A total of 42 participants were seen at the beginning and after the completion of the trial. Interviews explored experiences and views on daily management of diabetes. Health literacy was assessed via the multidimensional Health Literacy Questionnaire. Results Eight themes grouped in 3 main poles could be individualized: health knowledge, disease management, expertise and social support. Participants exhibited a primarily one-way relationship to treatment and monitoring, leaving the health care providers (HCP) the initiatives. In contrast, relation to food practices and exercise were more interactive. After 2 years participants tended to engage a more interactive relation to treatment. Having sufficient, appraising, and feeling able to find good health information were at stake while social support for health and relation to HCP and services were important determinants for managing health. Conclusion This longitudinal qualitative study shows the inter-individual et intra-individual variations of health literacy related to disease management, with the importance of the relation type to HCP, as well as social context with complex and evolving interactions. Decision-making as a shared social task beside the resources for engaging with health services are key considerations in the co-design of relevant interventions in type 2 diabetes.

Correlation of Symptom Distress, Self-Efficacy, and Social Support With Problem-Solving and Glycemic Control Among Patients With Type 2 Diabetes

2021 ◽  
Vol 47 (1) ◽  
pp. 85-93
Author(s):  
Meihua Ji ◽  
Susan M. Sereika ◽  
Jacqueline Dunbar-Jacob ◽  
Judith A. Erlen
Keyword(s):  
Social Support ◽  
Type 2 Diabetes ◽  
Problem Solving ◽  
Glycemic Control ◽  
Self Efficacy ◽  
Diabetes Management ◽  
Symptom Distress ◽  
Personal Factors ◽  
Care Providers

Purpose The purpose of the study was to examine the associations of self-efficacy, social support, and symptom distress with perceived problem-solving and glycemic control among patients with type 2 diabetes. Method Using baseline data from a parent study, which examined the effect of a problem-solving-focused intervention on medication adherence among patients with type 2 diabetes, this secondary analysis examined the relationships among self-efficacy, social support, symptom distress, problem-solving, and A1C. Of 358 patients enrolled at baseline, 304 (mean age = 64.1 years, 57.2% female) were included in the current analysis. Multiple linear regression was used to identify potential correlates of problem-solving and A1C. Results The results showed that self-efficacy, social support, and symptom distress were independent predictors of problem-solving; they significantly improved the prediction of perceived problem-solving in diabetes management after controlling covariates. Adding problem-solving to the model did not improve the prediction for A1C. Conclusion The current study suggests that self-efficacy, social support, and symptom distress are essential factors associated with patients’ perceived problem-solving in diabetes management. Researchers and clinicians should consider both personal factors and psychosocial factors such as self-efficacy, social support, and symptom distress when examining patients perceived problem-solving and developing tailored interventions to improve diabetes management. In addition, health care providers should consider these important aspects when providing tailored care to this patient population.

Caregiver role development in chronic disease: A qualitative study of informal caregiving for veterans with diabetes

2020 ◽  
pp. 174239532094963 ◽  
Author(s):  
Beth Fields ◽  
Lena Makaroun ◽  
Keri L Rodriguez ◽  
Claire Robinson ◽  
Jane Forman ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Qualitative Study ◽  
Diabetes Management ◽  
Health Management ◽  
Chronic Health Condition ◽  
Health Condition ◽  
Direct Care ◽  
Care Experience ◽  
Aging Adults

Objective Support for chronic conditions such as diabetes from friends and family positively influences health management and outcomes, but limited data exist on how and why caregivers assume specific support roles for otherwise independent aging adults. We conducted a qualitative study to examine the nature of caregivers’ roles in supporting Veterans’ management of a chronic condition and caregivers’ reasons for assuming those roles, using Type 2 diabetes as an example. Methods Thirty-two interviews were conducted with Veterans with Type 2 diabetes (n = 20) and their caregivers (n = 12). Two coders independently analyzed interview transcripts using a thematic analysis approach. Results Three central roles of caregivers in diabetes management were described: direct care support, memory support/care organizer, and advocate. Three explanations for assuming caregiving roles emerged: changes in patient health, natural evolution of family roles, and caregivers’ health care experience or training. Discussion Understanding what roles caregivers fill and why is critical to designing services to support caregivers in helping improve chronic health condition management for aging adults.

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