scholarly journals Exploring the barriers and facilitators of dietary self-care for type 2 diabetes: a qualitative study in Ghana

2019 ◽  
Vol 9 (3) ◽  
pp. 223-232 ◽  
Author(s):  
Martin Hushie
Keyword(s):  
Type 2 Diabetes ◽  
Family Members ◽  
Self Care ◽  
Adult Patients ◽  
Barriers And Facilitators ◽  
Future Research ◽  
Health Providers ◽  
Diabetes Clinic ◽  
Management Interventions

Background: There is an increasing prevalence of type 2 diabetes (T2D) globally and countries in Sub Sahara Africa, such as Ghana are contending with the epidemic. The main objective of this study was to explore the barriers and facilitators of T2D self-care as perceived by patients and health providers (HPs) in Ghana. Methods: A maximum variation sample of 33 adult patients with a range of demographic features, diabetic conditions and self-care regimens and 3 providers were purposely selected from the specialist diabetes clinic of a private hospital in Accra, Ghana. Data were collected using indepth interviews, which were recorded and transcribed; and non-participant observational field notes-that were analyzed thematically through directed content analysis. Results: The findings reveal that T2D adult patients face many inter-related challenges to diabetes self-care, than enabling factors that fell into four major domains:1) the counselling process and context (patients missing follow-up appointments, unacceptance of diagnosis); 2) recommended food and diet regimens (changing habitual diets, dislike and confusion about recommended diets); 3) social aspects (social functions interfering with dietary regimens, family members diverting patient from dietary goals) and 4) fears (non-disclosure to family member/ pretense of being well). Conclusion: Integrated self-management interventions are needed to address these barriers, including tailoring dietary education to patients’ specific needs, guiding patients on how to manage diet during social occasions and among family members; and as well, providing mental health support. Future research should focus on T2D self-care behaviours and practices outside the clinic, including home, work and shopping environments.

The effects of a supportive-educational intervention on women with type 2 diabetes and diabetic peripheral neuropathy: a randomized controlled trial

2020 ◽  
Vol 34 (6) ◽  
pp. 794-802
Author(s):  
Zohre Ahrary ◽  
Shahla Khosravan ◽  
Ali Alami ◽  
Mahdi Najafi Nesheli
Keyword(s):  
Type 2 Diabetes ◽  
Peripheral Neuropathy ◽  
Educational Intervention ◽  
Diabetic Peripheral Neuropathy ◽  
Glycosylated Hemoglobin ◽  
Self Care ◽  
Control Group ◽  
Trial Group ◽  
Diabetes Clinic

Purpose: To determine the effect of a supportive educational intervention based on the Orem self-care model on women with type 2 diabetes and diabetic peripheral neuropathy. Design: A randomized controlled trial. Setting: Hospital outpatient diabetes clinic. Subjects: Adult women with type 2 diabetes and mild-to-moderate diabetic peripheral neuropathy. Out of 410 patients, 120 diabetic patients were recruited and randomly assigned to trial group ( N = 60) and control group ( N = 60). Intervention: The trial group received a designed intervention consist of one-month supportive educational program with three months of follow-up (totally four months), based on self-care requisites according to the Orem self-care regarding diabetic peripheral neuropathy. The control group only received a routine care program in the diabetes clinic. Main measurements: The main outcomes were symptoms and severity of diabetic neuropathy. Further outcomes were fasting blood sugar and glycosylated hemoglobin. Results: By the end of the intervention, the number of participants reduced from 60 to 58 in the trial group and to 57 in the control group (totally 115). The intervention significantly decreased mean score of diabetic neuropathy symptoms (trial group: 3.26 vs. control group: 9.57, P = 0.001), severity (trial group: 5.86 vs. control group: 9.02, P = 0.001), fasting blood sugar (trial group: 151 vs. control group: 204, P = 0.001), and glycosylated hemoglobin (trial group: 7.85 vs. control group: 8.62, P = 0.004). Conclusion: Delivering a supportive-educational intervention based on the Orem self-care model on outpatient diabetes clinic can decrease the symptoms and severity of diabetic peripheral neuropathy. Trial registration: It was registered in the Iranian Registry of Clinical Trials (IRCT2015021521095N1).

scholarly journals The Design, Usability, and Feasibility of a Family-Focused Diabetes Self-Care Support mHealth Intervention for Diverse, Low-Income Adults with Type 2 Diabetes

2016 ◽  
Vol 2016 ◽  
pp. 1-13 ◽  
Author(s):  
Lindsay Satterwhite Mayberry ◽  
Cynthia A. Berg ◽  
Kryseana J. Harper ◽  
Chandra Y. Osborn
Keyword(s):  
Type 2 Diabetes ◽  
Low Socioeconomic Status ◽  
Low Income ◽  
Family Members ◽  
Self Care ◽  
Text Messages ◽  
User Engagement ◽  
Mhealth Intervention ◽  
Care Support

Family members’ helpful and harmful actions affect adherence to self-care and glycemic control among adults with type 2 diabetes (T2D) and low socioeconomic status. Few family interventions for adults with T2D address harmful actions or use text messages to reach family members. Through user-centered design and iterative usability/feasibility testing, we developed a mHealth intervention for disadvantaged adults with T2D called FAMS. FAMS delivers phone coaching to set self-care goals and improve patient participant’s (PP) ability to identify and address family actions that support/impede self-care. PPs receive text message support and can choose to invite a support person (SP) to receive text messages. We recruited 19 adults with T2D from three Federally Qualified Health Centers to use FAMS for two weeks and complete a feedback interview. Coach-reported data captured coaching success, technical data captured user engagement, and PP/SP interviews captured the FAMS experience. PPs were predominantly African American, 83% had incomes <$35,000, and 26% were married. Most SPs (n=7) were spouses/partners or adult children. PPs reported FAMS increased self-care and both PPs and SPs reported FAMS improved support for and communication about diabetes. FAMS is usable and feasible and appears to help patients manage self-care support, although some PPs may not have a SP.

scholarly journals Barriers and facilitators to self-care communication during medical appointments in the United States for adults with type 2 diabetes

2014 ◽  
Vol 10 (4) ◽  
pp. 303-313 ◽  
Author(s):  
Marilyn D Ritholz ◽  
Elizabeth A Beverly ◽  
Kelly M Brooks ◽  
Martin J Abrahamson ◽  
Katie Weinger
Keyword(s):  
Type 2 Diabetes ◽  
Self Care ◽  
The United States ◽  
Barriers And Facilitators ◽  
Provider Communication ◽  
Semistructured Interview ◽  
Interview Guide ◽  
Clinical Benefits ◽  
Patient Provider Communication

Objective Diabetes self-care is challenging and requires effective patient–provider communication to achieve optimal treatment outcomes. This study explored perceptions of barriers and facilitators to diabetes self-care communication during medical appointments. Design Qualitative study using in-depth interviews with a semistructured interview guide. Participants Thirty-four patients with type 2 diabetes and 19 physicians who treat type 2 diabetes. Results Physicians described some patients as reluctant to discuss their self-care behaviors primarily because of fear of being judged, guilt, and shame. Similarly, patients described reluctant communication resulting from fear of being judged and shame, particularly shame surrounding food intake and weight. Physicians and patients recommended trust, nonjudgmental acceptance, open/honest communication, and providing patients hope for living with diabetes as important factors for improving self-care communication. Further, patients stressed the clinical benefits of physicians directly addressing poor self-care behaviors while physicians described having few strategies to address these difficulties. Conclusions Physician–patient self-care communication barriers included patients’ reluctance to discuss self-care behaviors and physicians’ perceptions of few options to address this reluctance. Treatment recommendations stressed the importance of establishing trusting, nonjudgmental and open patient–provider communication for optimal diabetes treatment. Medical education is needed to improve physicians’ strategies for addressing self-care communication during medical appointments.

Improving Foot Self-Care Knowledge, Self-Efficacy, and Behaviors in Patients With type 2 Diabetes at Low Risk for Foot Ulceration

2013 ◽  
Vol 23 (6) ◽  
pp. 627-643 ◽  
Author(s):  
Lifeng Fan ◽  
Souraya Sidani ◽  
Angela Cooper-Brathwaite ◽  
Kelly Metcalfe
Keyword(s):  
Type 2 Diabetes ◽  
Pilot Study ◽  
Educational Intervention ◽  
Self Efficacy ◽  
Self Care ◽  
Low Risk ◽  
Adult Patients ◽  
Foot Ulceration ◽  
And Behaviors

The pilot study aimed to explore the effects of an educational intervention on patients’ foot self-care knowledge, self-efficacy, and behaviors in adult patients with type 2 diabetes at low risk for foot ulceration. The intervention consisted of three sessions and was given over a 3-week period. A total of 70 eligible consenting participants were recruited for this pilot study. Fifty-six participants completed the study. The outcomes were assessed at pretest, following the first two sessions, and 3-month follow-up. The findings indicated that the foot self-care educational intervention was effective in improving foot self-care knowledge, self-efficacy and behaviors in adult patients with type 2 diabetes at low risk for foot ulceration. The findings support the effects of the intervention. Future research should evaluate its efficacy using a randomized clinical trial design, and a large sample of patients with type 2 diabetes at low risk for foot ulcerations.

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.

Abstract 13213: Correlates of Dietary Self-care Behaviors in Adults With Type 2 Diabetes and Comorbid Heart Failure

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Fekadu Aga ◽  
Sandra B Dunbar ◽  
Tedla Kebede ◽  
Melinda K Higgins ◽  
Rebecca A Gary
Keyword(s):  
Heart Failure ◽  
Type 2 Diabetes ◽  
Self Efficacy ◽  
Self Care ◽  
Future Research ◽  
Cardiac Device ◽  
Diet Score ◽  
Implanted Device ◽  
Specific Diet

Introduction: Multi-morbidity is increasingly recognized to negatively influence self-care behaviors such as dietary adherence in persons living with serious or life-threatening chronic conditions such as type 2 diabetes (T2D) and heart failure (HF). Aim: The aim of this study was to describe demographic, clinical, and psychosocialcorrelates of dietary self-care behaviors in adult patients with T2D and comorbid HF. Methods: The parent study for this secondary analysis was a randomized trial that tested a 6-month integrated self-care intervention for 180 participants with comorbid HF and T2D. Cross-sectional, baseline data was used for the predictive model which included demographic (age, sex, marital status, and education) psychosocial (depression [PhQ-9], self-efficacy [PDSMS], and diabetes knowledge [MDKT]); and clinical variables (years diagnosed with T2D and HF, New York Heart Association (NYHA) functional classification, Charlson comorbidity index (CCI), and implanted cardiac device). The general and specific diet components of the Summary of Diabetes Self-Care Activities (SDSCA) were used to measure dietary self-care behaviors. Correlational bivariate and stepwise linear regression analyses were performed to examine correlates of dietary self-care behaviors. Results: Participants mean age was 58 ±11 years and the majority were male (n = 118, 66%) and African American (n = 119, 66%). Charlson comorbidity >2 ( p <0.05) and implanted device ( p <0.05) predicted lower SDSCA general diet score. Diabetes self-efficacy ( p <0.01) predicted higher SDSCA specific diet score while implanted cardiac device ( p <0.05) predicted lower score, collectively explaining 18.2% of the variance in diabetes-specific dietary self-care behavior. Conclusion: Findings suggest that multimorbidity may increase risk for lower diabetes dietary self-care behaviors, particularly those with more advanced HF requiring an implanted device. Future research should focus on how to promote effective self-care behaviors in persons living with multimorbidity as a strategy to improve clinical outcomes and enhance quality of life.

scholarly journals The The Barriers and Facilitators of Physical Activity Participation Among People Living with Type 2 Diabetes

2020 ◽  
Vol 3 ◽  
pp. 1-16
Author(s):  
Ozge Olbeci ◽  
Aycan Celik ◽  
Russell Jone
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Science Studies ◽  
Meta Analysis ◽  
Barriers And Facilitators ◽  
Primary Data ◽  
Future Research ◽  
Quantitative Studies ◽  
Facilitators And Barriers

Background: Type 2 diabetes mellitus (T2DM) is among the leading causes of serious mortality and health burden globally. Exercise is one of the commonly suggested preventions/ interventions for T2DM. However, many adults with T2DM are not achieving the recommended levels of physical activity. The objective of this systematic review is to investigate the barriers and facilitators to physical activity among people living with type 2 diabetes. Methods/Design: This review will be undertaken using the Preferred Reporting Items and Meta-analysis (PRISMA). The database search will be performed in MEDLINE, CINAHL, PubMed, and Web of Science. Studies included will report primary data (qualitative and quantitative) on people with T2DM (18 and over years of age). The review will be limited in English published between 2009 and 2020. A study design describing reasons for barriers, facilitators or both of physical activity among people with T2DM will be included. The risk of bias will be evaluated with Mixed-Methods Appraisal Tool (MMAT). Data synthesis will be conducted with narrative synthesis for quantitative studies, and thematic synthesis for qualitative studies followed by a mix-method synthesis to combine the previous synthesis. Discussion: This review will provide evidence for better understanding the facilitators and barriers to physical activity among people with T2DM. This information will also guide future research and support the development of the intervention to expand and increase facilitator factors determined by people with T2DM.    

scholarly journals Self-Care and Family Support among People with Type 2 Diabetes

2020 ◽  
Author(s):  
Shashi Kandel ◽  
Wit Wichaidit
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Factor Analysis ◽  
Family Support ◽  
Exploratory Factor Analysis ◽  
Family Members ◽  
Self Care ◽  
Daily Physical Activity ◽  
Care Practices

Objective: To assess the prevalence of self-care practices, and family support among people with type 2 diabetes. Material and Methods: We conducted a cross-sectional study among outpatients for people with type 2 diabetes, at a teaching hospital in Kathmandu, Nepal. We modified the Summary of Diabetes Self-Care Activities, and Diabetes Family Behavior Checklist scales; to measure self-care practices and perceived family support, respectively, so as to better suit the Nepali context. We performed an exploratory factor analysis to identify independent, latent dimensions of family support. Results: We recruited 411 patients (56.9% females), aged between 25 and 92. From these, we found high levels of adherence to daily intakes of the oral hypoglycemic agent (98.2%) and insulin (100.0%), daily physical activity (86.4%) and daily vegetable consumption (78.3%). Respondents commonly reported that they, and their family members ate meals together (98.1%). Family members also suggested things to help them take their medications on time (89.5%) and additionally helped them to decide on changes based on their glucose test results (84.2%). Exploratory factor analysis uncovered three behavior dimensions: nagging and arguing (“authoritarian”), praise and encouragement (“supportive”) and plan-making (“planning”). Conclusion: We presented data on self-care as well as family support among people with type 2 diabetes, tailored to the local context. From the data a high level of medication adherence and daily physical activity was observed. “Eating together” was the most reported family support behavior. We identified three dimensions of family support behaviors, which are potentially helpful for future health promotion programs, and provides a methodological basis for future studies in other low and middle-income countries.

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