Exemplars' Experience of Self-Managing Type 2 Diabetes

1998 ◽  
Vol 24 (3) ◽  
pp. 325-330 ◽  
Author(s):  
Geraldine C. Ellison ◽  
Kathleen M. Rayman

The purpose of this qualitative study was to explore the experience of learning self-management among women with type 2 diabetes. The 17 study participants were nominated as exemplars of self-management by diabetes experts. Data were generated from four structured focus groups, clinic records of participants, and investigator field notes. Using the constant comparative method of analysis , data were examined for patterns and themes. Analysis revealed that participants moved through three distinct phases of learning to manage diabetes. Movement through phases was heralded by identifiable transitional events. The three phases — management-as-rules, management-as-work, and management-as-living — are described as a model by which healthcare practitioners and educators can better understand the socioclinical aspects in self-management of type 2 diabetes.

2017 ◽  
Author(s):  
Gerda Bernhard ◽  
Cornelia Mahler ◽  
Hanna Marita Seidling ◽  
Marion Stützle ◽  
Dominik Ose ◽  
...  

BACKGROUND Information technology tools such as shared patient-centered, Web-based medication platforms hold promise to support safe medication use by strengthening patient participation, enhancing patients’ knowledge, helping patients to improve self-management of their medications, and improving communication on medications among patients and health care professionals (HCPs). However, the uptake of such platforms remains a challenge also due to inadequate user involvement in the development process. Employing a user-centered design (UCD) approach is therefore critical to ensure that user’ adoption is optimal. OBJECTIVE The purpose of this study was to identify what patients with type 2 diabetes mellitus (T2DM) and their HCPs regard necessary requirements in terms of functionalities and usability of a shared patient-centered, Web-based medication platform for patients with T2DM. METHODS This qualitative study included focus groups with purposeful samples of patients with T2DM (n=25), general practitioners (n=13), and health care assistants (n=10) recruited from regional health care settings in southwestern Germany. In total, 8 semistructured focus groups were conducted. Sessions were audio- and video-recorded, transcribed verbatim, and subjected to a computer-aided qualitative content analysis. RESULTS Appropriate security and access methods, supported data entry, printing, and sending information electronically, and tracking medication history were perceived as the essential functionalities. Although patients wanted automatic interaction checks and safety alerts, HCPs on the contrary were concerned that unspecific alerts confuse patients and lead to nonadherence. Furthermore, HCPs were opposed to patients’ ability to withhold or restrict access to information in the platform. To optimize usability, there was consensus among participants to display information in a structured, chronological format, to provide information in lay language, to use visual aids and customize information content, and align the platform to users’ workflow. CONCLUSIONS By employing a UCD, this study provides insight into the desired functionalities and usability of patients and HCPs regarding a shared patient-centered, Web-based medication platform, thus increasing the likelihood to achieve a functional and useful system. Substantial and ongoing engagement by all intended user groups is necessary to reconcile differences in requirements of patients and HCPs, especially regarding medication safety alerts and access control. Moreover, effective training of patients and HCPs on medication self-management (support) and optimal use of the tool will be a prerequisite to unfold the platform’s full potential.


2015 ◽  
Vol 21 (2) ◽  
pp. 103-110 ◽  
Author(s):  
Liliana Laranjo ◽  
Ana L Neves ◽  
Alexandra Costa ◽  
Rogério T Ribeiro ◽  
Luciana Couto ◽  
...  

Hypertension ◽  
2012 ◽  
Vol 60 (suppl_1) ◽  
Author(s):  
Xiang Y Chen ◽  
Peng Yue ◽  
Yong L Wang ◽  
Shu Q Xiao ◽  
Xin W Feng ◽  
...  

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.


2017 ◽  
Vol 29 (2) ◽  
pp. 118 ◽  
Author(s):  
Temidayo Ogunrinu ◽  
Thelma Gamboa-Maldonado ◽  
R. Ndinda Ngewa ◽  
Jasmine Saunders ◽  
Jamie Crounse ◽  
...  

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e022163
Author(s):  
Kathleen Yin ◽  
Teresa Harms ◽  
Kenneth Ho ◽  
Frances Rapport ◽  
Sanjyot Vagholkar ◽  
...  

IntroductionSelf-management is widely promoted but less attention is focused on the work required from patients. To date, many individuals struggle to practise self-management. ‘Patient work’, a concept that examines the ‘work’ involved in self-management, is an approach to understanding the tasks, effort, time and context from patient perspective. The purpose of our study is to use a novel approach combining non-obstructive observations via digital devices with in-depth qualitative data about health behaviours and motivations, to capture the full range of patient work experienced by people with type 2 diabetes and chronic comorbidities. It aims to yield comprehensive insights about ‘what works’ in self-management, potentially extending to populations with other chronic health conditions.Methods and analysisThis mixed-methods observational study involves a (1) prestudy interview and questionnaires, (2) a 24-hour period during which participants wear a camera and complete a time-use diary, and a (3) poststudy interview and study feedback. Adult participants living with type 2 diabetes with at least one chronic comorbidity will be recruited using purposive sampling to obtain a balanced gender ratio and of participants using insulin and those using only oral medication. Interviews will be analysed using thematic analysis. Data captured by digital devices, diaries and questionnaires will be used to analyse the duration, time, context and patterns of health-related behaviours.Ethics and disseminationThe study was approved by the Macquarie University Human Research Ethics Committee for Medical Sciences (reference number 5201700718). Participants will carry a wallet-sized card that explains the purpose of the study to third parties, and can remove the camera at any stage. Before the poststudy interview begins, participants will view the camera images in private and can delete any images. Should any images be used in future publications or presentations, identifying features such as human faces and names will be obscured.


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