‘Working with the team’: an exploratory study of improved type 2 diabetes management in a new model of integrated primary/secondary care

2013 ◽  
Vol 19 (3) ◽  
pp. 207 ◽  
Author(s):  
Julie Hepworth ◽  
Deborah Askew ◽  
Claire Jackson ◽  
Anthony Russell
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
Health Care Providers ◽  
Secondary Care ◽  
Diabetes Management ◽  
Care Providers ◽  
Positive Health ◽  
New Model ◽  
Patient Centred Care

This study aimed to explore how a new model of integrated primary/secondary care for type 2 diabetes management, the Brisbane South Complex Diabetes Service (BSCDS), related to improved diabetes management in a selected group of patients. We used a qualitative research design to obtain detailed accounts from the BSCDS via semi-structured interviews with 10 patients. The interviews were fully transcribed and systematically coded using a form of thematic analysis. Participants’ responses were grouped in relation to: (1) Patient-centred care; (2) Effective multiprofessional teamwork; and (3) Empowering patients. The key features of this integrated primary/secondary care model were accessibility and its delivery within a positive health care environment, clear and supportive interpersonal communication between patients and health care providers, and patients seeing themselves as being part of the team-based care. The BSCDS delivered patient-centred care and achieved patient engagement in ways that may have contributed to improved type 2 diabetes management in these participants.

scholarly journals Health Care Providers’ Perceptions of Responsibilities and Resources to Reduce Type 2 Diabetes Risk After Gestational Diabetes Mellitus

2018 ◽  
Vol 36 (2) ◽  
pp. 160-167
Author(s):  
Sumali S. Hewage ◽  
Shweta R. Singh ◽  
Claudia Chi ◽  
Jerry K.Y. Chan ◽  
Tong Wei Yew ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Health Care ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Health Care Providers ◽  
Diabetes Risk ◽  
Care Providers

scholarly journals Case Report: Type 2 Diabetes Mellitus

2018 ◽  
Vol 1 (2) ◽  
pp. 45
Author(s):  
Shofi Hesfianto
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Health Care ◽  
Chronic Disease ◽  
Health Care Providers ◽  
The Other ◽  
Shared Understanding ◽  
Care Providers ◽  
Patient’S Expectation

.......A patient who was first diagnosed with a chronic disease often does not fully understand the meaning or significanceof the chronic disease with which his/ her body suffers, against the risk of future complications if the disease is not well-controlled. On the other hand, in this reported case, the patient’s expectation was that her chronic disease, the T2DM, can be cured. Therefore, a shared understanding between health care providers and patient is likely the key to commencing the course of managing any chronic disease in a patient effectively.......

scholarly journals Needs and resources of people with type 2 diabetes in peri-urban Cochabamba, Bolivia: A people-centred perspective.

2021 ◽  
Author(s):  
Christine Leyns ◽  
Niek Couvreur ◽  
Sara Willems ◽  
Ann Van Hecke
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
Health System ◽  
Health Care Providers ◽  
Treatment Plan ◽  
Public Healthcare ◽  
Care Providers ◽  
Low Literacy ◽  
Traditional Use

Abstract Background: The rising prevalence of type 2 diabetes results in a worldwide public healthcare crisis, especially in low- and middle-income countries (LMICs) with unprepared and overburdened health systems mainly focused on infectious diseases and maternal and child health. Studies regarding type 2 diabetes in LMICs describe specific interventions ignoring a comprehensive analysis of the local factors people see influential to their health. This study aims to meet this research gap by exploring what people with type 2 diabetes in Bolivia need to maintain or improve their health, how important they perceive those identified needs and to what extent these needs are met.Methods: From March until May 2019, 33 persons with type 2 diabetes from three periurban municipalities of the department of Cochabamba participated in this study. The concept mapping methodology by Trochim, a highly structured qualitative brainstorming method, was used to generate and structure a broad range of perspectives on what the participants considered instrumental for their health.Results: The brainstorming resulted in 156 original statements condensed into 72 conceptually different needs and resources, structured under nine conceptual clusters and four action domains. These domains illustrated with vital needs were: (1) self-management with use of plants and the possibility to measure sugar levels periodically; (2) healthcare providers with the need to trust and receive a uniform diagnosis and treatment plan; (3) health system with opportune access to care and (4) community with community participation in health and safety, including removal of stray dogs.Conclusions: This study identifies mostly contextual factors like low literacy levels, linguistic problems in care, the need to articulate people's worldview including traditional use of natural remedies with the Bolivian health system and the lack of expertise on type 2 diabetes by primary health care providers. Understanding the needs and structuring them in different areas wherein action is required serves as a foundation for the planning and evaluation of an integrated people centred care program for people with type 2 diabetes. This participative method serves as a tool to implement the often theoretical concept of integrated people centred health care in health policy and program development.

A qualitative thematic analysis of online UK diabetes health forums to assess experiences and perspectives of insulin therapy in Type 2 Diabetes (Preprint)

2021 ◽  
Author(s):  
Maya Allen-Taylor ◽  
Laura Ryan ◽  
Rebecca Upsher ◽  
Kirsty Winkley-Bryant
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
Insulin Therapy ◽  
Health Care Providers ◽  
Thematic Analysis ◽  
Self Management ◽  
Search Term ◽  
Care Providers ◽  
Study Results

BACKGROUND Despite the advent of newer therapeutic agents, many individuals with T2D will require insulin treatment. Insulin refusal and cessation of treatment in this group is common and their needs under explored. OBJECTIVE To understand the experiences and perspectives of individuals with type 2 diabetes who have been recommended or prescribed insulin therapy, expressed on online health forums. METHODS Setting: Retrospective archived forum threads from the two largest, freely and publicly accessible diabetes health forums in the UK were screened over a 12-month period (August 2019-20). Design: Within the Diabetes UK forum, the search term ‘insulin (title only)’ was employed to identify relevant threads. Within Diabetes.co.uk, threads were screened within an existing ‘Type 2 with insulin’ message board. Three independent researchers coded the forum threads and posts. Pertinent themes and subthemes were identified and have been illustrated by paraphrasing of members quotes, to ensure anonymity. Participants: n=299 posts from 29 threads from Diabetes UK and n=295 posts from 28 threads from Diabetes.co.uk, were analysed over the study period. Fifty-seven threads in total met the inclusion criteria and were included in the thematic analysis. RESULTS Four overarching themes with subthemes were generated to illustrate the unmet needs that had prompted members to seek information, advice and support outside of their usual care provision, via the forums: (1) unmet practical needs and self-management support; including insulin injection technique, titration, travel, driving with insulin and utilising new technology, (2) psychological and peer support; advice, encouragement and empathy, which was readily offered and well received, (3) seeking and providing extended lifestyle advice; discussions around alternative diet strategies, types of activity and their effects on glycaemia and body weight, and (4) relationships with health care professionals (HCPs); including recounting of problematic experiences such as paternalism, lack of HCP knowledge and inadequate provision of effective insulin focused diabetes self-management education. CONCLUSIONS This is the first study to utilise data from online health forums, to characterise the experiences and perspectives of people with T2D who are recommended or prescribed insulin therapy. The observed naturalistic conversations have generated useful insights. Our findings suggest there are additional needs that are not being currently met by health care providers. They also suggest that problematic relationships with HCPs remain a barrier to effective insulin therapy. The study results will help to directly inform insulin focused diabetes self-management and support strategies, in order to enable individuals to achieve their best outcomes.

scholarly journals Contextually Appropriate Tools and Solutions to Facilitate Healthy Eating Identified by People with Type 2 Diabetes

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2301
Author(s):  
M. Carolina Archundia Herrera ◽  
Denise L. Campbell-Scherer ◽  
Rhonda C. Bell ◽  
Catherine B. Chan
Keyword(s):  
Type 2 Diabetes ◽  
Health Care Providers ◽  
Healthy Eating ◽  
Eating Behaviors ◽  
Diabetes Management ◽  
Relevant Information ◽  
Care Providers ◽  
Foot Care ◽  
The Individual

Type 2 diabetes (T2D) is a complex, multifaceted disease and its treatment involves lifestyle intervention (LI) programs that participants may find difficult to adopt and maintain. The objective of this study is to understand the lived experiences of participants with T2D regarding healthy eating behavior change, in order to identify and incorporate relevant information, skills, and educational approaches into LI programs. An explorative qualitative study was undertaken. Purposeful sampling was used to recruit 15 participants. One-on-one, semi-structured, open-ended, and in-depth interviews were conducted. An essentialist paradigm was adopted to accurately report the experiences, meaning, and reality of participants. An inductive approach was used to analyze the data. Participants reported that being diagnosed and living with T2D could be overwhelming, and their ability to manage was influenced by health care providers (HCP), family, and individual context. Many experienced a loop of “good–bad” eating behaviors. Participants expressed desires for future diabetes management that would include program content (nutrition, physical activity, mental health, foot care, and consequences of T2D), program features (understand context, explicit information, individualized, hands-on learning, applicable, realistic, incremental, and practical), program components (access to multidisciplinary team, set goals, track progress and be held accountable, one-on-one sessions, group support, maintenance/follow-up), and policy change. In conclusion, the results of this study indicate that T2D management requires more extensive, comprehensive, and ongoing support, guided by the individual participant.

scholarly journals Needs and resources of people with type 2 diabetes in peri-urban Cochabamba, Bolivia: a people-centred perspective

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Christine Cécile Leyns ◽  
Niek Couvreur ◽  
Sara Willems ◽  
Ann Van Hecke
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
Health System ◽  
Health Care Providers ◽  
Treatment Plan ◽  
Public Healthcare ◽  
Care Providers ◽  
Low Literacy ◽  
Traditional Use

Abstract Background The rising prevalence of type 2 diabetes results in a worldwide public healthcare crisis, especially in low- and middle-income countries (LMICs) with unprepared and overburdened health systems mainly focused on infectious diseases and maternal and child health. Studies regarding type 2 diabetes in LMICs describe specific interventions ignoring a comprehensive analysis of the local factors people see influential to their health. This study aims to meet this research gap by exploring what people with type 2 diabetes in Bolivia need to maintain or improve their health, how important they perceive those identified needs and to what extent these needs are met. Methods From March until May 2019, 33 persons with type 2 diabetes from three periurban municipalities of the department of Cochabamba participated in this study. The concept mapping methodology by Trochim, a highly structured qualitative brainstorming method, was used to generate and structure a broad range of perspectives on what the participants considered instrumental for their health. Results The brainstorming resulted in 156 original statements condensed into 72 conceptually different needs and resources, structured under nine conceptual clusters and four action domains. These domains illustrated with vital needs were: (1) self-management with use of plants and the possibility to measure sugar levels periodically; (2) healthcare providers with the need to trust and receive a uniform diagnosis and treatment plan; (3) health system with opportune access to care and (4) community with community participation in health and safety, including removal of stray dogs. Conclusions This study identifies mostly contextual factors like low literacy levels, linguistic problems in care, the need to articulate people’s worldview including traditional use of natural remedies with the Bolivian health system and the lack of expertise on type 2 diabetes by primary health care providers. Understanding the needs and structuring them in different areas wherein action is required serves as a foundation for the planning and evaluation of an integrated people centred care program for people with type 2 diabetes. This participative method serves as a tool to implement the often theoretical concept of integrated people centred health care in health policy and program development.

scholarly journals Serious Complications for Patients, Care Providers and Policy Makers: Tackling the Structural Violence of First Nations People Living with Diabetes in Canada

2011 ◽  
Vol 2 (1) ◽  
Author(s):  
Marion A Maar ◽  
Darrel Manitowabi ◽  
Danusia Gzik ◽  
Lorrilee McGregor ◽  
Cheri Corbiere
Keyword(s):  
Type 2 Diabetes ◽  
First Nations ◽  
Health Care Providers ◽  
Diabetes Management ◽  
Aboriginal People ◽  
Structural Violence ◽  
Treatment Strategies ◽  
Care Providers ◽  
First Nations People

Type 2 diabetes mellitus is a progressive metabolic disorder that affects Aboriginal people disproportionately around the world. Evidence shows that diabetes treatment strategies can effectively reduce complications related to the disease; in contrast many Aboriginal people develop these rapidly and at a young age. We conducted qualitative research on the barriers to evidence-based self-management behaviours and education from the perspectives of Aboriginal people living with type 2 diabetes and their health care providers on Manitoulin Island in Ontario, Canada. Applying the concept of structural violence, we analyzed the social and political arrangements that can put Aboriginal people with diabetes “in harm’s way” by interfering with diabetes management. Lastly, we provide recommendations for structural interventions.

scholarly journals Economic Burden of Type 2 Diabetes Mellitus among the Patients Attending Combined Military Hospital, Dhaka

2014 ◽  
Vol 9 (1) ◽  
pp. 8-13
Author(s):  
MZ Rahman ◽  
MZ Islam ◽  
MJ Alam ◽  
S Sajjad ◽  
R Ara ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Health Care ◽  
Type 2 Diabetes Mellitus ◽  
Health Care Providers ◽  
Economic Burden ◽  
Treatment Cost ◽  
Military Hospital ◽  
Care Providers

Introduction: Diabetes Mellitus (DM) is a major concern for the developed as well as developing countries. It poses with enormous disabilities and economic burden to the victims. The treatment cost of diabetes is increasing day by day. Aim: To ascertain how type 2 diabetes mellitus is incurring economic burden to the patients. Materials and Methods: This descriptive cross sectional study was conducted during the period from January to June 2010 on 110 type 2 diabetes mellitus patients attending Combined Military Hospital, Dhaka. The patients were selected conveniently and data were collected by face to face interview with the help of a semi-structured questionnaire. For estimation of economic burden, both direct and indirect treatment costs were calculated. Results: The study revealed that majority (36.4%) of the patients were in the age group of 46-55 years with the mean age of 53.65 (+10.44) years. Majority (60.0%) of them had lower monthly family income (Tk.5, 000-Tk.10, 000) and 36.4% of them lived in urban area. Most of the patients (90.9%) were under treatment with drug, diet control and physical exercise. Regarding sources of fund for treatment, 31.8% patients used their savings while 27.3% took loan, 20% got help from relatives and the remaining 20.9% got donation and sold wealth. Average treatment cost incurred by the patients was estimated to Tk. 5543.35 (+1273.29). Average direct treatment cost was estimated to Tk.2656.88 (+1367.23) of which average drug cost was Tk.653.36 (+476.36), investigation cost was Tk.596.73 (+375.56), travel cost Tk.530.31 (+795.46), attendant cost Tk.865.87 (+734.22) and consultation fee was Tk.244.48 (+167.22). Average indirect cost was calculated to Tk.3081.27 (+1275.91) which was only due to loss of income due to illness. Conclusion: The study findings will enable the health policy makers and health care providers at different levels to provide need based cost-effective health care services to reduce the economic burden of diabetes mellitus patients. DOI: http://dx.doi.org/10.3329/jafmc.v9i1.18718 Journal of Armed Forces Medical College Bangladesh Vol.9(1) 2013: 8-13

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