Using Photovoice to understand physical and social living environment influence on adherence to diabetes

2021 ◽  
pp. 136345932110200
Author(s):  
Alice Scavarda ◽  
Giuseppe Costa ◽  
Franca Beccaria
Keyword(s):  
Blood Sugar ◽  
Diabetes Management ◽  
Lifestyle Changes ◽  
Living Environment ◽  
Local Health ◽  
Bonding Social Capital ◽  
Physical Context ◽  
Individual Traits ◽  
Italian City ◽  
The Individual

Within the past several years, a considerable body of research on adherence to diabetes regimen has emerged in public health. However, the focus of the vast majority of these studies has been on the individual traits and attitudes affecting adherence. Still little is known on the role of the social and physical context in supporting or hindering diabetes self-management, particularly from a qualitative standpoint. To address these limitations, this paper presents the findings of a Photovoice study on a sample of 10 type 2 diabetic older adults living in a deprived neighbourhood of an Italian city. The findings reveal that the possibility to engage in diet, exercise and blood sugar monitoring seems to be more affected by physical and social elements of the respondents’ environment than by the interviewees’ beliefs and attitudes. Both environmental barriers and social isolation emerge as barriers to lifestyle changes and self-care activities related to blood sugar monitoring. The predominance of bonding social capital, the scant level of trust and the negative perception of local health services result in a low level of social cohesion, a limited circulation of health information on diabetes management and, consequently, in poor health outcomes.

scholarly journals Analysis of the factors that prevent adherence to treatment in patients with diabetes mellitus and the strategies that contribute to the improvement in adherence

2018 ◽  
Vol 21 (1) ◽  
pp. 5-14
Author(s):  
Natalia V. Likhodey ◽  
Marina F. Kalashnikova ◽  
Elena M. Likhodey ◽  
Valentin V. Fadeyev
Keyword(s):  
Diabetes Mellitus ◽  
Diabetes Management ◽  
Theoretical Models ◽  
Lifestyle Changes ◽  
World Health ◽  
Dietary Advice ◽  
Adherence To Treatment ◽  
Scientific Publications ◽  
Health Organization ◽  
The Individual

This review examined the current problem of low adherence to treatment in patients with chronic diseases, particularly type 2 diabetes mellitus. According to the definition of the World Health Organization, adherence to treatment is the degree to which a patients behaviour corresponds to the doctors recommendations with respect to medications and implementation of dietary advice and/or lifestyle changes. The current medical literature includes a large number of scientific publications devoted to the study of various factors that lead to low adherence to treatment. The term barriers is most often used to designate these factors. The first part of this work contains an analysis of the main factors that impede compliance to the doctors recommendations, such as socioeconomic and psychological (personal) barriers related to the disease itself, the peculiarities of its treatment and the organisation of medical care (the health care system). The second part of this review examines the different theoretical models of patient behaviour and strategies that improve adherence to treatment. Most researchers believe that there is an unsatisfactory (low) adherence to treatment and that none of the existing intervention strategies can improve adherence to treatment among all patients. The cornerstone of the entire diabetes management system is the training of patients within the framework of developed structured programmes. Conversely,, success depends on the individual approach, the course of the disease and the mandatory consideration of the individual psychological characteristics of each person. Establishment of a partnership built on trust between a doctor and a patient contributes to greater patient satisfaction with treatment and improved adherence, and this relationship ultimately affects the treatment efficacy and clinical outcomes.

Collective Efficacy and Organizational Commitment in an Italian City Hall

2009 ◽  
Vol 14 (4) ◽  
pp. 363-371 ◽  
Author(s):  
Laura Borgogni ◽  
Silvia Dello Russo ◽  
Laura Petitta ◽  
Gary P. Latham
Keyword(s):  
Organizational Commitment ◽  
Collective Efficacy ◽  
Structural Equation ◽  
Structural Equation Models ◽  
Practical Significance ◽  
City Hall ◽  
Italian City ◽  
Public Sector Managers ◽  
The Individual ◽  
Level Group

Employees (N = 170) of a City Hall in Italy were administered a questionnaire measuring collective efficacy (CE), perceptions of context (PoC), and organizational commitment (OC). Two facets of collective efficacy were identified, namely group and organizational. Structural equation models revealed that perceptions of top management display a stronger relationship with organizational collective efficacy, whereas employees’ perceptions of their colleagues and their direct superior are related to collective efficacy at the group level. Group collective efficacy had a stronger relationship with affective organizational commitment than did organizational collective efficacy. The theoretical significance of this study is in showing that CE is two-dimensional rather than unidimensional. The practical significance of this finding is that the PoC model provides a framework that public sector managers can use to increase the efficacy of the organization as a whole as well as the individual groups that compose it.

STUDI KUALITATIF : KEBUTUHAN IBU HAMIL DENGAN DIABETES MELITUS GESTASIONAL DI KABUPATEN KARANGANYAR JAWA TENGAH

2020 ◽  
pp. 17-26
Author(s):  
Arista Apriani ◽  
M Mufdlilah ◽  
Menik Sri Daryanti
Keyword(s):  
Social Support ◽  
Pregnant Women ◽  
Health Center ◽  
Blood Sugar ◽  
Interpretative Phenomenological Analysis ◽  
Health Workers ◽  
Phenomenological Analysis ◽  
Lifestyle Changes ◽  
Structured Interviews ◽  
Diabetes Melitus

ABSTRAK GDM dapat berpotensi menimbulkan komplikasi serius yang dapat mengakibatkan risiko kesehatan jangka pendek dan jangka panjang bagi ibu dan bayinya. diagnosis GDM menimbulkan efek emosional yang negatif. Persepsi ibu hamil tentang GDM dapat memengaruhi perubahan gaya hidup. Garis pertama penatalaksanaan DMG yaitu dengan perubahan gaya hidup. Tujuan menggali secara mendalam kebutuhan ibu dengan diagnosis diabetes melitus gestasional. Metode penelitian kualitatif dengan pendekatan  fenomenologi. Lokasi di Kabupaten Karanganyar yaitu Puskesmas Jaten I, Puskesmas Matesih dan RSUD Kabupaten Karanganyar, pada bulan Oktober 2019 - Januari 2020. Sampel secara criterion sampling Pengumpulan data dengan semistructure interview dengan one on one interview. Uji Keabsahan Data dengan Credibility pada penelitian ini menggunakan strategi validitas triangulasi, Tranferability, Dependability, Confirmability. Analisis data dengan Interpretative Phenomenological Analysis (IPA). Hasil penelitian kebutuhan ibu hamil dengan DMG teridentifikasi empat tema, yaitu dukungan keluarga dalam hal mengontrol pola makan, mengatarkan periksa ke tenaga kesehatan, dan mengingatkan untuk aktifitas olah raga. Dukungan sosial, yaitu cara mengontrol gula darah. Dukungan tenaga kesehatan, yaitu saran dan motivasi untuk mengontrol gula darah. Informasi mendapat saran atau perawatan DMG dalam kehamilan adalah dari tenaga kesehatan yaitu bidan, dokter, serta selain tenaga kesehatan dari teman dan internet. Kesimpulannya kebutuhan ibu hamil dengan DMG teridentifikasi empat tema, yaitu dukungan keluarga, dukungan sosial, dukungan tenaga kesehatan dan informasi.   Kata kunci: diabetes melitus gestasional, kehamilan, kebutuhan.   ABSTRACT GDM can overcome serious problems that can overcome short-term and long-term health problems for mother and baby. a diagnosis of GDM has a negative emotional effect. Pregnant women 's perception of GDM can affect lifestyle changes. The first line of management of DMG is lifestyle changes. Diagnosis of gestational diabetes mellitus. Qualitative research methods by studying phenomenology. Locations in Karanganyar Regency are Jaten I Health Center, Matesih Health Center and Karanganyar District Public Hospital, in October 2019 - January 2020. Sample sampling criteria Data collection by semi-structured interviews with one-on-one interviews. Data Validity Test with Credibility in this study using the triangulation validity strategy, Transparency, Dependability, Confirmability. Data analysis with Interpretative Phenomenological Analysis (IPA). The results of the study of the needs of pregnant women with DMG identified four themes, namely supporting the family in terms of controlling diet, sending check to health workers, and reminding for sports activities. Social support, which is a way to control blood sugar. Support of Health Workers, namely advice and motivation to control blood sugar. The information obtained from DMG advice or treatment in the assessment is from health workers, namely midwives, doctors, and also health workers from friends and the internet. In conclusion, the needs of pregnant women with DMG identified four themes, namely family support, social support, support of health workers and information.  

scholarly journals Care-seeking and managing diabetes in rural Bangladesh: a mixed methods study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hannah Maria Jennings ◽  
Joanna Morrison ◽  
Kohenour Akter ◽  
Hassan Haghparast-Bidgoli ◽  
Carina King ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Health Care Providers ◽  
Low Income ◽  
Diabetes Management ◽  
Local Health ◽  
Care Seeking ◽  
Care Providers ◽  
Structured Interviews ◽  
Rural Bangladesh

Abstract Background Type 2 diabetes mellitus poses a major health challenge worldwide and in low-income countries such as Bangladesh, however little is known about the care-seeking of people with diabetes. We sought to understand the factors that affect care-seeking and diabetes management in rural Bangladesh in order to make recommendations as to how care could be better delivered. Methods Survey data from a community-based random sample of 12,047 adults aged 30 years and above identified 292 individuals with a self-reported prior diagnosis of diabetes. Data on health seeking practices regarding testing, medical advice, medication and use of non-allopathic medicine were gathered from these 292 individuals. Qualitative semi-structured interviews and focus group discussions with people with diabetes and semi-structured interviews with health workers explored care-seeking behaviour, management of diabetes and perceptions on quality of care. We explore quality of care using the WHO model with the following domains: safe, effective, patient-centred, timely, equitable and efficient. Results People with diabetes who are aware of their diabetic status do seek care but access, particularly to specialist diabetes services, is hindered by costs, time, crowded conditions and distance. Locally available services, while more accessible, lack infrastructure and expertise. Women are less likely to be diagnosed with diabetes and attend specialist services. Furthermore costs of care and dissatisfaction with health care providers affect medication adherence. Conclusion People with diabetes often make a trade-off between seeking locally available accessible care and specialised care which is more difficult to access. It is vital that health services respond to the needs of patients by building the capacity of local health providers and consider practical ways of supporting diabetes care. Trial registration ISRCTN41083256. Registered on 30/03/2016.

scholarly journals Physical Activity in First Generation South Asian Women Living in Canada: Barriers and Facilitators to Participation

2016 ◽  
Vol 24 (2) ◽  
pp. 110-119 ◽  
Author(s):  
Kiruthika Rathanaswami ◽  
Enrique Garcia Bengoechea ◽  
Paula Louise Bush
Keyword(s):  
Physical Activity ◽  
Focus Group ◽  
South Asian ◽  
Living Environment ◽  
Barriers And Facilitators ◽  
Asian Women ◽  
South Asian Women ◽  
Family Responsibilities ◽  
Women Employees ◽  
The Individual

The aim of this study was to understand the physical activity (PA) experiences of South Asian women employees and their perceptions of new immigrant South Asian women in regards to barriers and facilitators to participation. This was examined using an interpretive description approach where similarities and differences between South Asian Women’s Centre employees and their perception of new South Asian immigrants were explored. Eight South Asian women employees (Mean age = 45.57 years) working at a South Asian Women’s Centre in Canada participated in this study. Five South Asian women employees participated in a focus group, three in an individual interview and one participant from the focus group took part in a follow-up interview to better understand their PA experiences. Barriers found included: family responsibilities, upbringing, feeling guilty, immediate living environment, clothing, cost, and location of activity. PA facilitators found included: help at home, cultural sports events, group support, female only programs, design of PA facilities, health and self-image benefits, providing PA for children at the same time as adults and collaborations. The main differences found between South Asian Women’s Centre employees and their clients concerned time, language and their partners. For this population of women, programs need to be affordable, close to home, female only and allow their own choice of clothing. The results suggest the importance for those working with South Asian women to take into consideration the many factors between the individual and the environment that may inhibit or facilitate PA behavior change in this population.

scholarly journals Self-esteem, social comparison, and Facebook use

2018 ◽  
Vol 14 (4) ◽  
pp. 831-845 ◽  
Author(s):  
Elisa Bergagna ◽  
Stefano Tartaglia
Keyword(s):  
Social Interaction ◽  
Social Comparison ◽  
Technology Use ◽  
Structural Equation ◽  
Structural Equation Models ◽  
Self Esteem ◽  
Self Report ◽  
Individual Traits ◽  
Facebook Use ◽  
The Individual

Facebook use is very popular among young people, but many open issues remain regarding the individual traits that are antecedents of different behaviours enacted online. This study aimed to investigate whether the relationship between self-esteem and the amount of time on Facebook could be mediated by a tendency towards social comparison. Moreover, three different modalities of Facebook use were distinguished, i.e., social interaction, simulation, and search for relations. Because of gender differences in technology use and social comparison, the mediation models were tested separately for males and females. Data were collected by means of a self-report questionnaire with a sample of 250 undergraduate and graduate Italian students (mean age: 22.18 years). The relations were examined empirically by means of four structural equation models. The results revealed the role of orientation to social comparison in mediating the relations between low self-esteem and some indicators of Facebook use, i.e., daily hours on Facebook and the use of Facebook for simulation. For females, the use of Facebook for social interaction was directly influenced by high self-esteem and indirectly influenced by low self-esteem. Globally, the dimension of social comparison on Facebook emerged as more important for females than for males.

scholarly journals Physical Context Detection using Wearable Wireless Sensor Networks

2008 ◽  
Vol 4 (3) ◽  
pp. 191 ◽  
Author(s):  
Muhannad Quwaider ◽  
Subir Biswas
Keyword(s):  
Markov Model ◽  
Hidden Markov Model ◽  
Hidden Markov ◽  
Human Subjects ◽  
Real Life ◽  
Sensor Data ◽  
Physical Context ◽  
Significant Extension ◽  
The Individual ◽  
Stochastic Identification

This paper presents the architecture of a wearable sensor network and a Hidden Markov Model (HMM) processingframework for stochastic identification of body postures andphysical contexts. The key idea is to collect multi-modal sensor data from strategically placed wireless sensors over a human subject’s body segments, and to process that using HMM in order to identify the subject’s instantaneous physical context. The key contribution of the proposed multi-modal approach is a significant extension of traditional uni-modal accelerometry in which only the individual body segment movements, without their relative proximities and orientation modalities, is used for physical context identification. Through real-life experiments with body mounted sensors it is demonstrated that while the unimodal accelerometry can be used for differentiating activityintensive postures such as walking and running, they are not effective for identification and differentiation between lowactivity postures such as sitting, standing, lying down, etc. In the proposed system, three sensor modalities namely acceleration, relative proximity and orientation are used for context identification through Hidden Markov Model (HMM) based stochastic processing. Controlled experiments using human subjects are carried out for evaluating the accuracy of the HMMidentified postures compared to a naïve threshold based mechanism over different human subjects.

scholarly journals Diabetes Management Experience and the State of Hypoglycemia: National Online Survey Study

JMIR Diabetes ◽  
10.2196/17890 ◽  
2020 ◽  
Vol 5 (2) ◽  
pp. e17890
Author(s):  
Karim Zahed ◽  
Farzan Sasangohar ◽  
Ranjana Mehta ◽  
Madhav Erraguntla ◽  
Khalid Qaraqe
Keyword(s):  
Blood Sugar ◽  
Online Survey ◽  
Diabetes Management ◽  
Nonparametric Tests ◽  
Mobile App ◽  
Survey Study ◽  
Management Tool ◽  
False Alarms ◽  
Diabetic Patients ◽  
Cross Sectional

Background Hypoglycemia, or low blood sugar levels, in people with diabetes can be a serious life-threatening condition, and serious outcomes can be avoided if low levels of blood sugar are proactively detected. Although technologies exist to detect the onset of hypoglycemia, they are invasive or costly or exhibit a high incidence of false alarms. Tremors are commonly reported symptoms of hypoglycemia and may be used to detect hypoglycemic events, yet their onset is not well researched or understood. Objective This study aimed to understand diabetic patients’ perceptions of hypoglycemic tremors, as well as their user experiences with technology to manage diabetes, and expectations from a self-management tool to ultimately inform the design of a noninvasive and cost-effective technology that detects tremors associated with hypoglycemia. Methods A cross-sectional internet panel survey was administered to adult patients with type 1 diabetes using the Qualtrics platform in May 2019. The questions focused on 3 main constructs: (1) perceived experiences of hypoglycemia, (2) experiences and expectations about a diabetes management device and mobile app, and (3) beliefs and attitudes regarding intention to use a diabetes management device. The analysis in this paper focuses on the first two constructs. Nonparametric tests were used to analyze the Likert scale data, with a Mann-Whitney U test, Kruskal-Wallis test, and Games-Howell post hoc test as applicable, for subgroup comparisons to highlight differences in perceived frequency, severity, and noticeability of hypoglycemic tremors across age, gender, years living with diabetes, and physical activity. Results Data from 212 respondents (129 [60.8%] females) revealed statistically significant differences in perceived noticeability of tremors by gender, whereby males noticed their tremors more (P<.001), and age, with the older population reporting lower noticeability than the young and middle age groups (P<.001). Individuals living longer with diabetes noticed their tremors significantly less than those with diabetes for ≤1 year but not in terms of frequency or severity. Additionally, the majority of our participants (150/212, 70.7%) reported experience with diabetes-monitoring devices. Conclusions Our findings support the need for cost-efficient and noninvasive continuous monitoring technologies. Although hypoglycemic tremors were perceived to occur frequently, such tremors were not found to be severe compared with other symptoms such as sweating, which was the highest rated symptom in our study. Using a combination of tremor and galvanic skin response sensors may show promise in detecting the onset of hypoglycemic events.

scholarly journals Health Care Professionalism Without Doctors

2018 ◽  
Vol 5 (2) ◽  
pp. 72-94 ◽  
Author(s):  
Marie Østergaard Møller
Keyword(s):  
Health Professionals ◽  
Qualitative Data ◽  
Nationwide Survey ◽  
Relational Theory ◽  
Local Health ◽  
Medical Field ◽  
Data Set ◽  
The Individual ◽  
The Relationship ◽  
Larger Sample

The article uses the organization of health houses in Denmark as a case to study the relationship between spatial surroundings and professionalization. The question is whether these new local health houses comprise an alternative to the medical view on health or ––even in the absence of the hospital–– script the professionals to identify themselves as agents from the medical field? In this article, macro-structural theory is combined with micro-relational theory in order to identify how macro structures such as professionalization nest the way social interaction takes place in concrete spatial situations and surroundings. The argument put forward is that we need to identity this process at the level of the individual in order to qualify and anchor our understanding of professionalization as a macro phenomenon. The empirical basis is two dissimilar locations (health houses), selected from a larger qualitative data set of interviews with health professionals and citizens and observations of health houses, originally selected from a nationwide survey. The presented analysis zooms in on selected places and situations and relates analyses to the overall picture of differences and similarities identified in the larger sample. The analysis shows how entrances, receptions, information screens and coffee tables not only design houses, but also script styles of interaction between health professionals and citizens as well as they work as signs creating expectations about professional roles and how to reflect and act as a professional in a given physical and social setting. The main finding is that spatial surroundings facilitate processes of identification and counter-identification crucial to a new kind of health professionals such as the ones under study here.

scholarly journals Individual and Community Social Determinants of Health Associated With Diabetes Management in a Mexican American Population

2021 ◽  
Vol 8 ◽  
Author(s):  
Kehe Zhang ◽  
Belinda Reininger ◽  
Miryoung Lee ◽  
Qian Xiao ◽  
Cici Bauer
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Mexican American ◽  
Diabetes Management ◽  
Spatial Models ◽  
Neighborhood Context ◽  
Community Level ◽  
Border Region ◽  
Determinants Of Health ◽  
The Individual

Background: Diabetes is a major health burden in Mexican American populations, especially among those in the Lower Rio Grande Valley (LRGV) in the border region of Texas. Understanding the roles that social determinants of health (SDOH) play in diabetes management programs, both at the individual and community level, may inform future intervention strategies.Methods: This study performed a secondary data analysis on 1,568 individuals who participated in Salud y Vida (SyV), a local diabetes and chronic disease management program, between October 2013 and September 2018 recruited from a local clinic. The primary outcome was the reduction of hemoglobin A1C (HbA1C) at the last follow-up visit compared to the baseline. In addition to age, gender, insurance status, education level and marital status, we also investigated 15 community (census tract) SDOH using the American Community Survey. Because of the high correlation in the community SDOH, we developed the community-level indices representing different domains. Using Bayesian multilevel spatial models that account for the geographic dependency, we were able to simultaneously investigate the individual- and community-level SDOH that may impact HbA1C reduction.Results: After accounting for the diabetes self-management education classes taken by the participants and their length of stay in the program, we found that older age at baseline, being married (compared to being widowed or divorced) and English speaking (compared to Spanish) were significantly associated with greater HbA1C reduction. Moreover, we found that the community level SDOH were also highly associated with HbA1C reduction. With every percentile rank decrease in the socioeconomic advantage index, we estimated an additional 0.018% reduction in HbA1C [95% CI (−0.028, −0.007)]. Besides the socioeconomic advantage index, urban core opportunity and immigrant's cohesion and accessibility indices were also statistically associated with HbA1C reduction.Conclusion: To our knowledge, our study is the first to utilize Bayesian multilevel spatial models and simultaneously investigate both individual- and community-level SDOH in the context of diabetes management. Our findings suggest that community SDOH play an important role in diabetes control and management, and the need to consider community and neighborhood context in future interventions programs to maximize their overall effectiveness.

Sign in / Sign up

Export Citation Format

Share Document