scholarly journals Assessment of Rwandan diabetic patients’ needs and expectations to develop their first diabetes self-management smartphone application (Kir’App)

2019 ◽  
Vol 10 ◽  
pp. 204201881984531 ◽  
Author(s):  
Claudine B. Kabeza ◽  
Lorenz Harst ◽  
Peter E. H. Schwarz ◽  
Patrick Timpel
Keyword(s):  
Qualitative Content Analysis ◽  
Diabetes Education ◽  
Information Provision ◽  
Smartphone Application ◽  
Self Management ◽  
Diabetic Patients ◽  
Face To Face ◽  
And Coping ◽  
Study Participants

Background: Knowledge of and coping with diabetes is still poor in some communities in Rwanda. While smartphone applications (or apps) have demonstrated improving diabetes self-care, there is no current study on the use of smartphones in the self-management of diabetes in Rwanda. Methods: The main objective of this study was to assess the needs and expectations of Rwandan diabetic patients for mobile-health-supported diabetes self-management in order to develop a patient-centred smartphone application (Kir’App). Results: Convenience sampling was used to recruit study participants at the Rwanda Diabetes Association. Twenty-one patients participated in semi-structured, in-depth, face-to-face interviews. Thematic analysis was performed using Mayring’s method of qualitative content analysis. Conclusions: The study included 21 participants with either type 1 (female = 5, male = 6) or type 2 (female = 6, male = 4) diabetes. Participants’ age ranged from 18 to 69 years with a mean age of 35 and 29 years, respectively. Eight main themes were identified. These were (a) diabetes education and desired information provision; (b) lack of diabetes knowledge and awareness; (c) need for information in crisis situations; (d) required monitoring and reminder functions; (e) information on nutrition and alcohol consumption; (f) information on physical activity; (g) coping with burden of disease, through social support and network; (h) app features. This study provides recommendations that will be used to design the features of the first Rwandan diabetes self-management smartphone application (Kir’App). The future impact of the application on the Rwandan diabetic patients’ self-management capacity and quality of life will be evaluated afterwards.

scholarly journals A qualitative study of users’ experiences after 3 months: the first Rwandan diabetes self-management Smartphone application “Kir’App”

2020 ◽  
Vol 11 ◽  
pp. 204201882091451
Author(s):  
Claudine B. Kabeza ◽  
Lorenz Harst ◽  
Peter E.H. Schwarz ◽  
Patrick Timpel
Keyword(s):  
Qualitative Content Analysis ◽  
Diabetes Education ◽  
Information Provision ◽  
Smartphone Application ◽  
Self Management ◽  
Diabetes Knowledge ◽  
Face To Face ◽  
Management Application

Background: Owing to the increasing popularity of smartphones in Rwanda, almost 75% of the entire population currently has access to the internet. Although it has been shown that smartphone applications can support diabetes self-management, there was no diabetes self-management application available in Rwanda until April 2019. Based on the findings of a prior study assessing the needs and expectations of potential users, ‘Kir’App’ was developed to fill that void. The aim of this study was to evaluate users’ experiences after 3 months of use of the first Kir’App prototype. Methods: The participants of the previous study were recruited to take part in the current study. Semi-structured, in-depth, face-to-face interviews were conducted. Findings were analysed thematically using Mayring’s method of qualitative content analysis. Both deductive and inductive approaches were used to analyse transcripts according to the original categories and subcategories of the previous study. Results: A total of 14 people with either type 1 or type 2 diabetes participated in the study. Age of participants ranged from 19 to 70 years, with a mean age of 34.4 years. Seven of the eight original themes and one additional theme were subjoined: diabetes education and desired information provision; increased diabetes knowledge and awareness; monitoring and reminder functions; nutrition; physical activity; coping with burden of disease; app features; use behaviour and usability. Overall, participants stated that the app increased their diabetes knowledge and assisted them with their diabetes self-management. Conclusions: We found that the first prototype of Kir’App meets the overall needs and expectations of participating Rwandan diabetics. Having followed a strict user-centred design process, their qualitative insights will help to further improve the app.

scholarly journals Evaluating the Effect of Knowledge, Attitude, and Practice on Self-Management in Type 2 Diabetic Patients on Dialysis

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Shima Ghannadi ◽  
Atieh Amouzegar ◽  
Parisa Amiri ◽  
Ronak Karbalaeifar ◽  
Zhale Tahmasebinejad ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Microvascular Complications ◽  
Glycosylated Hemoglobin ◽  
Self Care ◽  
Self Management ◽  
Diabetic Patients ◽  
Attitude And Practice ◽  
Knowledge Attitude And Practice

Background.Type 2 diabetes is an increasingly common condition with several preventable microvascular complications such as kidney damage. Nephropathy is expensive to manage, especially as hospital dialysis treatment. Improving patients’ knowledge, attitude, and practice (KAP) toward their condition can achieve better control, delay complications, and improve their quality of life. This study evaluated the KAP and self-care behaviors of diabetic patients on dialysis and variables that affect it.Methods.This cross-sectional study was conducted at Shahid Beheshti academic hospitals of Tehran, Iran. Face-to-face interviews were held to fill five validated questionnaires: three evaluating KAP, one evaluating self-management, and one evaluating quality of life.Result.117 diabetic patients on hemodialysis (42 females) with mean (SD) age of68.70±9.26years were enrolled in the survey. The scores for patient’s KAP, self-care, and quality of life were59.90±11.23,44.27±8.35,45.06±12.87,46.21±10.23, and26.85±13.23, respectively. There was significant negative correlation between patients’ knowledge and attitude with their glycosylated hemoglobin level and their fasting blood sugar. There was significant correlation between patients’ knowledge and practice with their self-care activities.Conclusion.The present study suggests that patients’ KAP scores have a practical effect upon self-care behavior. This highlights the needs for effective diabetes education programs in developing countries like Iran.

scholarly journals Proactive Health Support: Exploring Face-to-Face Start-Up Sessions Between Participants and Registered Nurses at the Onset of Telephone-Based Self-Management Support

2020 ◽  
Vol 7 ◽  
pp. 233339362093002
Author(s):  
Susanne Winther ◽  
Mia Fredens ◽  
Marie Brund Hansen ◽  
Kirstine Skov Benthien ◽  
Camilla Palmhøj Nielsen ◽  
...  
Keyword(s):  
Registered Nurses ◽  
Large Scale ◽  
Self Management ◽  
Management Support ◽  
Continuous Contact ◽  
Face To Face ◽  
Start Up ◽  
Health Support ◽  
The Relationship

Proactive Health Support (PaHS) is a large-scale intervention in Denmark carried out by registered nurses (RNs) who provide self-management support to people at risk of hospital admission to enhance their health, coping, and quality of life. PaHS is initiated with a face-to-face session followed by telephone conversations. We aimed to explore the start-up sessions, including if and how the relationship between participants and RNs developed at the onset of PaHS. We used an ethnographic design including observations and informal interviews. Data were analyzed using a phenomenological–hermeneutical approach. The study showed that contexts such as hospitals and RNs legitimized the intervention. Face-to-face communication contributed to credibility, just as the same RN throughout the intervention ensured continuity. We conclude that start-up sessions before telephone-based self-management support enable a trust-based relationship between participants and RNs. Continuous contact with the same RNs throughout the session promoted participation in the intervention.

scholarly journals Pharmacist-Led Interventions on Improving Outcomes in Patients with Diabetes Mellitus: Evidence from the Literature

2020 ◽  
Vol 10 (4) ◽  
pp. 49-58
Author(s):  
Sini T Inasu ◽  
MV Kumudavalli
Keyword(s):  
Diabetes Mellitus ◽  
Self Management ◽  
Diabetic Patients ◽  
Health Related Quality ◽  
Randomized Controlled ◽  
Chd Risk ◽  
Patients With Diabetes ◽  
Related Quality ◽  
Health Related

Diabetes mellitus is a rapidly growing major health problem world-wide. The management of type 2 diabetes mellitus is complex, requiring continuous medical care by health care professionals and considerable self-care efforts by patients. A collaborative and integrated team approach in which pharmacists can play a pivotal role should be sought when managing patients with diabetes. Pharmacist-led care programs have been shown to help patients with diabetes succeed in achieving treatment goals and improving outcomes. Hence, the aim of this narrative review is to address and summarize the effectiveness of pharmacist interventions in the management of diabetic patients. A comprehensive literature search was conducted in PubMed/Medline, Scopus, web of Science and the Cochrane Library were searched from the date of database inception to June 2019. All randomized controlled trials evaluating the effectiveness of pharmacist-based interventions on diabetic patients in comparison with usual care were included in study. Outcomes of interest included short-term and long-term measures such as glycated haemoglobin (HbA1c), and secondary outcomes were blood glucose level, blood pressure (BP), lipid profile, body mass index (BMI), 10-year coronary heart disease (CHD) risk, medication adherence, health related quality of life (HRQoL), and economic outcomes. Twenty-five studies were included in this systematic study. They were heterogeneous in terms of interventions, participants, settings and outcomes. Pharmacist-led self-management interventions included education on diabetes and its complications, medication adherence, lifestyle and education of self-management skills. Few studies even focussed on patients need through a tailored intervention. We found that those who received the pharmacist care had a statistically significant improvement in HbA1C, blood pressure, lipid profile, health-related quality of life, and CHD risk. These results underline the added value of pharmacists in patient-related care.  Hence this review supports the involvement of pharmacists as a member of health- care teams in managing diabetic patients at diverse settings worldwide. Keywords: diabetes, self-management, HbA1C, pharmaceutical care, randomized controlled trial

scholarly journals Using Mobile Health Tools to Engage Rural Underserved Individuals in a Diabetes Education Program in South Texas: Feasibility Study (Preprint)

2019 ◽  
Author(s):  
Zenong Yin ◽  
Janna Lesser ◽  
Kristi A Paiva ◽  
Jose Zapata Jr ◽  
Andrea Moreno-Vasquez ◽  
...  
Keyword(s):  
Rural Communities ◽  
Feasibility Study ◽  
Mobile Health ◽  
Education Program ◽  
Financial Incentives ◽  
Diabetes Education ◽  
South Texas ◽  
Self Management ◽  
Study Participants

BACKGROUND Access to diabetes education and resources for diabetes self-management is limited in rural communities, despite higher rates of diabetes in rural populations compared with urban populations. Technology and mobile health (mHealth) interventions can reduce barriers and improve access to diabetes education in rural communities. Screening, Brief Intervention, and Referral to Treatment (SBIRT) and financial incentives can be used with mHealth interventions to increase the uptake of diabetes education; however, studies have not examined their combined use for diabetes self-management in rural settings. OBJECTIVE This two-phase Stage 1 feasibility study aimed to use a mixed methods design to examine the feasibility and acceptability of an mHealth diabetes education program combining SBIRT and financial incentives to engage rural individuals. METHODS In Phase 1, we aimed to develop, adapt, and refine the intervention protocol. In Phase 2, a 3-month quasi-experimental study was conducted with individuals from 2 rural communities in South Texas. Study participants were individuals who attended free diabetes screening events in their community. Those with low or medium risk received health education material, whereas those with high risk or those with a previous diagnosis of diabetes participated in motivational interviewing and enrolled in the 6-week mHealth Diabetes Self-Management Education Program under either an unconditional or aversion incentive contract. The participants returned for a 3-month follow-up. Feasibility and acceptability of the intervention were determined by the rate of participant recruitment and retention, the fidelity of program delivery and compliance, and the participant’s satisfaction with the intervention program. RESULTS Of the 98 screened rural community members in South Texas, 72 individuals met the study eligibility and 62 individuals agreed to enroll in the study. The sample was predominately female and Hispanic, with an average age of 52.6 years. The feedback from study participants indicated high levels of satisfaction with the mHealth diabetes education program. In the poststudy survey, the participants reported high levels of confidence to continue lifestyle modifications, that is, weight loss, physical activity, and diet. The retention rate was 50% at the 3-month follow-up. Participation in the intervention was high at the beginning and dissipated in the later weeks regardless of the incentive contract type. Positive changes were observed in weight (mean -2.64, SD 6.01; <i>P</i>&lt;.05) and glycemic control index (-.30; <i>P</i>&lt;.05) in all participants from baseline to follow-up. CONCLUSIONS The finding showed strong feasibility and acceptability of study recruitment and enrollment. The participants’ participation and retention were reasonable given the unforeseen events that impacted the study communities during the study period. Combining mHealth with SBIRT has the potential to reach individuals with need to participate in diabetes education in rural communities.

scholarly journals From the experience of planning a life with diabetes to the mechanisms of the management of illness

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M M Mathilde ◽  
W A André ◽  
K N P Paul
Keyword(s):  
Quality Of Life ◽  
Improve Patient Care ◽  
Lessons Learned ◽  
The Body ◽  
Therapeutic Education ◽  
Self Management ◽  
Diabetic Patients ◽  
Sources Of Information ◽  
Forms Of Knowledge

Abstract Background In the context of chronic diseases, it is now recognized that experiences of planning a new life with diabetes are very informative, and are a source of knowledge that can be used to improve patient care and quality of life. However, the professionals in health and the patients’ therapeutic education are still struggling to translate this knowledge into their practices or to make use of it, as long as its forms remain largely unknown and it is not known how to identify these. Objective: The study aims to identify these knowledges and to report on how it is produced, based on an analysis of the experiences of diabetic patients in Yaoundé, Cameroon. Methods The study combines a phenomenographic approach aiming at ethnographing the form and contents of lessons learned from life experiences with diabetes; and an operation of reflexive ethnography centered on the patient, apprehending the process of elaboration or production of these teachings. It includes six diabetics selected from the typical sampling method. The data collected were analysed using paradoxical analysis and interpreted in a pragmatic perspective. Results The results reveal various mechanisms of self-management of the disease and stigma, developed by patients, such as: identity recomposition; valorization of treatment by promoting its benefits to others; control of information about one’s illness oscillating between concealment and disclosure; therapeutic adjustments according to the life situations or interactions; rearrangement of individual and family habits; listening and decoding of the language of illness, body and the effects of food on the body; learning of conceptualized knowledge about diabetes and nutrition through various sources of information. Conclusions the study suggests that these mechanisms should be considered as relevant forms of knowledge; and the should be used to improve both preventive, therapeutic and educational practices and the quality of life of the diabetics. Key messages The mechanisms of self-management of diabetes and stigma develop by diabetics trough their experience of planning a new life with diabetes should be considered as relevant forms of knowledge. These mechanisms should be used by health professionnals and patients’ education professionals to improve their practices and the quality of life of diabetics.

scholarly journals The effect of self-management education through weblogs on the quality of life of diabetic patients

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Amal Mohammad Rasoul ◽  
Rostam Jalali ◽  
Alireza Abdi ◽  
Nader Salari ◽  
Mehrali Rahimi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Management Education ◽  
T Test ◽  
Self Management ◽  
Diabetic Patients ◽  
Control Groups ◽  
Patients With Diabetes ◽  
The Mean ◽  
And Control

Abstract Background Self-management education of diabetes which is one of the most important noncommunicable diseases worldwide involves facilitating knowledge, skills, and ability required for self-care in these patients. Concerning the progressive growth of use of Internet for educating patients and absence of different studies about education through use of weblogs in patients with diabetes in Iran, the present study was conducted with the aim of determining the effect of self-management education through weblogs on the quality of life of affect the patients. Methods This study was performed as intervention on patients referring to diabetes clinic of Talghani hospital in Kermanshah in winter 2018 and spring 2019. The samples consisted of 98 patients with diabetes chosen through available sampling and randomly assigned into study and control groups. For data collection, diabetes quality of life (DQOL) short form clinical questionnaire, Persian version, was used. The intervention involved training self-management conducted through 60 sessions via a designed weblog. The obtained information was introduced into SPSS 21, and analyzed through Mann-Whitney, t-test, and paired t-test. Results According to the results of this study, the mean age of the examined patients was 32.1 ± 4.9 years, where the major participants were male (n = 52 in the test group, 52.5%). The results showed that after the intervention, the test and control groups were different in terms of anthropometric variables and metabolic indicators; the mean waist circumference in the test and control groups was 98.6 ± 9.8 and 101.5 ± 7.8, respectively; the mean FBS following the intervention in the test and control groups was 131.08 ± 16.04 and 238.2 ± 40, respectively; and the mean BMI postintervention in the test and control groups was obtained as 27.3 ± 3.4 and 30.1 ± 3.8 respectively, where these differences were significant according to independent t-test (p < 0.05). The mean score of quality of life postintervention in the test and control groups was obtained as 56.1 and 49.9 respectively; according to Mann-Whitney test, the difference between the two groups was significant (p < 0.05). Conclusion The results of the present study revealed the positive effect of weblog based self-management on the quality of life of patients with diabetes following the intervention. Further, reduced levels of FBS, BMI, as well as systolic and diastolic blood pressure were also observed, which could be due to increased awareness of patients about their abilities, its risks, as well as the ways to control and treat it.

scholarly journals Regularity of Clinical Visits and Medication Adherence of Patients with Hypertension or Diabetes in Rural Yunnan Province of China

2020 ◽  
Vol 17 (24) ◽  
pp. 9297
Author(s):  
Qiufeng Gao ◽  
Lanxi Peng ◽  
Wenbin Min ◽  
Jingchun Nie ◽  
Aiqin Wang ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Yunnan Province ◽  
Rural China ◽  
Cross Sectional Study ◽  
Individual Characteristics ◽  
Self Management ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Structured Questionnaire

Chronic diseases can be controlled through effective self-management. The purpose of this study is to explore the regularity of clinical visits and medication adherence of patients with hypertension or diabetes (PWHD), and its association with the first experience with care and individual factors in rural Southwestern China. This cross-sectional study was carried out in Yunnan province in 2018 and recruited 292 PWHD and 122 village clinics from 122 villages in 10 counties. Participants were interviewed using a structured questionnaire. Results show around 39% of hypertensive and 25% of diabetic patients neither visited physicians nor took medicine regularly during the preceding three months of the interview date. The regression results further indicated that individual characteristics of the PWHD, including patient age, health status, and economic level, as well as their first experience with care, were significantly associated with their regular healthcare behavior. In addition to providing medical services, on average each sample village clinic, with around two physicians, simultaneously managed 180 hypertensive and 45 diabetic patients. This study revealed the need for further reforms in terms of improving self-management and thus recommends an increase in the quantity and the quality of human resources in the primary healthcare realm in rural China.

scholarly journals ‘We need someone to deliver our voices’: reflections from conducting remote qualitative research in Syria

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Yazan Douedari ◽  
Mervat Alhaffar ◽  
Diane Duclos ◽  
Mohamed Al-Twaish ◽  
Samer Jabbour ◽  
...  
Keyword(s):  
Qualitative Research ◽  
Health Research ◽  
Research Institutions ◽  
Social Scientists ◽  
Face To Face ◽  
Travel Restrictions ◽  
Conducting Research ◽  
Study Participants ◽  
Meaningful Research

AbstractThe need to generate evidence in spaces considered insecure and inhabited by potentially extremely vulnerable individuals (e.g. conflict-affected people who may not have means to move) has led researchers to study conflict-affected settings remotely. Increased attention to remote research approaches from social scientists, due to COVID-19-related travel restrictions, is sparking interest on appropriate methods and tools. Drawing on several years’ experience of remotely conducting qualitative research in Syria, we discuss challenges and approaches to conducting more inclusive, participatory, and meaningful research from a distance. The logistics, ethics, and politics of conducting research remotely are symptomatic of broader challenges in relation to the decolonisation of global and humanitarian health research. Key to the success of remote approaches is the quality of the relationships researchers need to be able to develop with study participants without face-to-face interactions and with limited engagement ‘in the field’. Particularly given overdue efforts to decolonise research institutions and methods, lead researchers should have a meaningful connection with the area in which they are conducting research. This is critical both to reduce chances that it will be extractive and exploitative and additionally for the quality of interpretation.

scholarly journals Perspectives from Underserved African Americans and their Healthcare Providers on the Development of a Diabetes Self-Management Smartphone Application: Exploratory Study (Preprint)

2020 ◽  
Author(s):  
Tai Barber-Gumbs ◽  
Ylva Trolle Lagerros ◽  
Laura M. Sena ◽  
Joel Gittelsohn ◽  
Larry W. Chang ◽  
...  
Keyword(s):  
African American ◽  
African Americans ◽  
Low Income ◽  
Diabetes Education ◽  
Healthcare Providers ◽  
Smartphone Application ◽  
Self Management ◽  
The Us ◽  
Management Recommendations ◽  
P Type

BACKGROUND Type 2 diabetes mellitus (T2DM) affects ~10% of the US population, disproportionately affecting African Americans. Smartphone applications (apps) have emerged as promising tools to improve diabetes self-management, yet little is known about the use of this approach in low-income minority communities. OBJECTIVE The goal of the study was to explore which features of an app were prioritized for people with T2DM in a low-income African-American community. METHODS Between February 2016 and May 2018, we conducted formative qualitative research with 78 participants to explore how a smartphone app could be used to improve diabetes self-management. Information was gathered on desired features and app mockups were presented to receive comments and suggestions of improvements from smartphone users with prediabetes/T2DM, their friends and family members, and healthcare providers (in 6 interactive forums, 1 focus group and 15 in-depth interviews). We carried out thematic data analysis using an inductive approach. RESULTS All three types of participants reported that difficulties with access to healthcare was a main problem and suggested that an app could help address this. Participants also indicated that an app could provide information for diabetes education and self-management. Other suggestions included that the app should allow people with T2DM to log and track diabetes care-related behaviors and receive feedback on their progress in a way that would increase a person with T2DM’s engagement in self-management. CONCLUSIONS We identified educational and tracking smartphone features that can guide development of diabetes self-management apps for a low-income African-American population. Considering those features in combination gives rise to opportunities for more advanced support, such as determining self-management recommendations based on data in user's logs. CLINICALTRIAL

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