scholarly journals Attitudes and opinions of Oral healthcare professionals on screening for Type-2 diabetes

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rodrigo Mariño ◽  
Andre Priede ◽  
Michelle King ◽  
Geoffrey G. Adams ◽  
Diego Lopez
Keyword(s):  
Type 2 Diabetes ◽  
Oral Health ◽  
Healthcare Professionals ◽  
Healthcare Setting ◽  
Successful Implementation ◽  
Medical Screening ◽  
Structured Interviews ◽  
Healthcare Settings ◽  
Collaboration And Communication

Abstract Background As part of a larger study on the identification of undiagnosed Type 2 diabetes (T2D), and prediabetes patients in dental settings, this study explored oral healthcare professionals’ (OHP) attitudes with respect to the relevance and appropriateness of screening for prediabetes/T2D in general oral healthcare settings. It also aims to gain a deeper understanding of OHPs’ concerns and perceived barriers to screening for T2D. Methods Semi-structured interviews were conducted with 11 OHPs: eight dentists, two dental hygienists and one oral health therapist. Interviews were audio recorded, transcribed verbatim and analysed using thematic analysis. Results Themes that emerged from the interviews were organised under three major categories: 1) Implementation: OHPs willingness to screen for prediabetes/T2D; 2) Barriers to implementation of screenings; subdivided into: a) lack of knowledge and formal training about T2D screening methodology; b) concerns about patients’ awareness and acceptance of T2D screening in oral healthcare settings; c) costs and reimbursement for the time and resources required to screen patients; and d) legal and scope of practice; and 3) Collaboration and communication between OHPs and General practitioners (GP). Conclusions The oral healthcare setting was considered as appropriate for medical screening, and OHPs were willing to participate in screening for prediabetes/T2D. Nonetheless, for the successful implementation of a screening programme, several barriers need to be addressed, and effective medical screening would require collaboration between oral health and medical and other health professionals, as well as clarification of legal and reimbursement issues.

scholarly journals An Exploration of the Patient Lived Experience of Remission and Relapse of Type 2 Diabetes Following Bariatric Surgery

2021 ◽  
Author(s):  
Alexis C. Sudlow ◽  
Dimitri J. Pournaras ◽  
Helen Heneghan ◽  
Zsolt Bodnar ◽  
Carel W. le Roux ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Lived Experience ◽  
Patient Experience ◽  
Healthcare Professionals ◽  
Structured Interviews ◽  
Disease Remission ◽  
Obesity Stigma ◽  
Self Worth

Abstract Background Bariatric surgery is the most effective treatment for patients with obesity and type 2 diabetes (T2DM), inducing profound metabolic changes associated with improvements in glycaemic control. In spite of the recognition of the physiological changes associated with bariatric surgery, what remains underappreciated is the patient experience of surgery to treat T2DM. Objectives This study explored the patient experience with regard to motivations, expectations and outcomes, including remission and relapse of diabetes. Methods An in-depth qualitative approach was adopted, encompassing semi-structured interviews with patients (n=17) living with obesity and T2DM both pre- and postsurgery. Interpretive thematic analysis identified emergent themes using a grounded approach. Results Analysis revealed a number of themes throughout the interviews which included motivations and perceived benefits of surgery, obesity stigma and its impact on self-worth as well as perceptions of remission or relapse and the implications for sense of control. Conclusions The motivation for undergoing bariatric surgery was driven by health concerns, namely T2DM and the desire to reduce the risk of developing diabetes-related complications. Patients highlighted social and self-stigmatisation associated with obesity and T2DM, leading to feelings of shame and an inability to seek support from family or healthcare professionals. Stigmatisation created a sense of failure and feeling of guilt for having T2DM. As a result, patients felt responsible for maintaining disease remission postoperatively and regarded the need for medication as a sign of treatment failure.

Integrating eHealth within a transforming healthcare setting: a qualitative study into values, challenges, and prerequisites. (Preprint)

2021 ◽  
Author(s):  
Karin CAG Lorenz-Artz ◽  
Joyce JPA Bierbooms ◽  
Inge MB Bongers
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Healthcare Service ◽  
Healthcare Setting ◽  
Successful Implementation ◽  
Structured Interviews ◽  
Community Based ◽  
Access To Treatment ◽  
Healthcare Settings

BACKGROUND The EU has stated that mental health care services should become more person-centered and community-based. eHealth may contribute to this change by allowing clients to take an active, decision-making role in their healthcare service. In the Netherlands, five organizations currently use the open dialogue (OD) approach, which is an example of a person-centered and community-based healthcare service. OD is a unique approach to organizing care and therapeutic intervention for people who need mental health support. One of these Dutch organizations has integrated the OD approach with eHealth. OBJECTIVE The aim of this study is to help the transition towards person-centered and community-based care models by improving our understanding of eHealth and by showing how eHealth can best be integrated into a transforming healthcare service. The objective is to better understand the value of eHealth within OD practice, and to define the challenges and prerequisites for implementing eHealth within this transforming practice. METHODS This qualitative, practice-oriented field study is part of a pilot project of an ambulatory OD team in a Dutch mental health care institute. In total, 29 semi-structured interviews were held with clients, social network members, and OD professionals between December 2017 and March 2019. We used a thematic coding approach for analyses. RESULTS eHealth was considered mainly beneficial outside the treatment meetings as it improves communication, simplifies planning of treatment meetings, and provides a broader access to treatment. Videoconferencing was considered an acceptable alternative if someone could not attend treatment meetings in person. Several challenges were identified regarding the implementation of eHealth into OD practices: (1) a lack of trust and interest in eHealth, (2) a lack of knowledge about eHealth, (3) the strong conviction that face-to-face contact is needed for effective care, (4) normative pressure to offer eHealth, and (5) introducing eHealth during the start-up of a new OD team. This study has highlighted the multi-level complexity of implementing eHealth and has identified several prerequisites for successful implementation on individual, organization, society, and digital-product levels. CONCLUSIONS The benefits and challenges of eHealth have been identified as well as the prerequisites for its implementation. An important dilemma is to what extent eHealth should be used in healthcare settings when the client is not motivated to use it. We need to find the balance between using eHealth and letting clients refuse to use it. Interviewees emphasized the relevance of a continuous dialogue about eHealth to improve understanding of the possibilities and limitations of eHealth within healthcare settings that are transitioning towards client-centered and network-oriented care, such as OD.

scholarly journals Healthcare Professionals’ Perspectives on the Cross-Sectoral Treatment Pathway for Women with Gestational Diabetes during and after Pregnancy—A Qualitative Study

2021 ◽  
Vol 10 (4) ◽  
pp. 843
Author(s):  
Anne Timm ◽  
Karoline Kragelund Nielsen ◽  
Ulla Christensen ◽  
Helle Terkildsen Maindal
Keyword(s):  
Type 2 Diabetes ◽  
Qualitative Study ◽  
Gestational Diabetes ◽  
Healthcare Professionals ◽  
Care Pathway ◽  
Adverse Outcomes ◽  
Treatment Pathway ◽  
Healthy Behaviors ◽  
The Cross

Gestational diabetes mellitus (GDM) increases the risk of adverse outcomes during and after pregnancy, including a long-term risk of type 2 diabetes. Women with GDM are treated by numerous healthcare professionals during pregnancy and describe a lack of preventive care after pregnancy. We aim to investigate healthcare professionals’ perspectives on the cross-sectoral treatment pathway for women with GDM—during and after pregnancy. A qualitative study was conducted using systematic text condensation. Nine healthcare professionals (two general practitioners, four midwives, two obstetricians and one diabetes nurse) were interviewed and eight health visitors participated in two focus group discussions., Three major themes emerged: (1) “professional identities”, which were identified across healthcare professionals and shaped care practices; (2) ”unclear guidelines on type 2 diabetes prevention after GDM”, which contributed to uncertainty about tasks and responsibilities during and after pregnancy; and (3) “cross-sectoral collaboration”, which relied heavily on knowledge transfers between hospitals, general practice and the local municipality. The findings implicate that clear, transparent guidelines for all sectors should be prioritized to strengthen cross-sectoral care to women with GDM during and after pregnancy. As a result, strong cross-sectoral care throughout the GDM care pathway may improve maternal health by supporting healthy behaviors, facilitate weight loss and reduce the risk of subsequent GDM and early onset diabetes.

Same goals, different challenges: a systematic review of perspectives of people with diabetes and healthcare professionals on Type 2 diabetes care

2021 ◽  
Author(s):  
Soraia de Camargo Catapan ◽  
Uthara Nair ◽  
Len Gray ◽  
Maria Cristina Marino Calvo ◽  
Dominique Bird ◽  
...  
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Diabetes Care ◽  
Healthcare Professionals

scholarly journals Alignment between outcomes and minimal clinically important differences in the Dutch type 2 diabetes mellitus guideline and healthcare professionals’ preferences

2021 ◽  
Vol 9 (3) ◽  
Author(s):  
Marloes Dankers ◽  
Marjorie H. J. M. G. Nelissen‐Vrancken ◽  
Bertien H. Hart ◽  
Anke C. Lambooij ◽  
Liset Dijk ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Healthcare Professionals

Conversations and Reactions Around Severe Hypoglycaemia (CRASH): Results from the German Cohort of a Global Survey of People with Type 1 Diabetes or Insulin-Treated Type 2 Diabetes and Caregivers

2020 ◽  
Author(s):  
Elisabeth Mönnig ◽  
Erik Spaepen ◽  
Beatrice Osumili ◽  
Beth D. Mitchell ◽  
Frank Snoek ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Online Survey ◽  
Healthcare Professionals ◽  
Severe Hypoglycaemia ◽  
Insulin Regimen ◽  
Hypoglycaemic Event ◽  
Cross Sectional Survey

Abstract Background A global cross-sectional survey (CRASH) was designed to provide information about the experiences of people with diabetes (PWD) and their caregivers in relation to severe hypoglycaemic events. Methods Adults with type 1 diabetes or insulin-treated type 2 diabetes who had experienced one or more severe hypoglycaemic events within the past 3 years, and adult caregivers for such people, were recruited from medical research panels using purposive sampling. We present here results from Germany. Results Approximately 100 individuals in each of the four participant groups completed a 30-minute online survey. Survey results indicated that the most recent severe hypoglycaemic event made many participants feel scared (80.4%), unprepared (70.4%), and/or helpless (66.5%). Severe hypoglycaemia was discussed by healthcare professionals at every visit with only 20.2% of participants who had ever had this conversation, and 53.5% of participants indicated that their insulin regimen had not changed following their most recent event. 37.1% of PWD/people with diabetes cared for by caregivers owned a glucagon kit at the time of survey completion. Conclusions The survey identified areas for improvement in the prevention and management of severe hypoglycaemic events. For healthcare professionals, these include enquiring more frequently about severe hypoglycaemia and adjusting blood glucose-lowering medication after a severe hypoglycaemic event. For individuals with diabetes and their caregivers, potential improvements include ensuring availability of glucagon at all times. Changes in these areas could lead not only to improved patient wellbeing but also to reduced use of emergency services/hospitalisation and, consequently, lower healthcare costs.

An integrated pre-pregnancy care programme framework theoretically modelled from the perspectives of women with Type 2 diabetes and healthcare professionals.

Midwifery ◽  
2021 ◽  
pp. 103130
Author(s):  
Rita Forde ◽  
Jacqueline Collin ◽  
Anna Brackenridge ◽  
Mark Chamley ◽  
Katharine Hunt ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Healthcare Professionals ◽  
Care Programme ◽  
Pregnancy Care

scholarly journals "The group facilitates everything": meanings patients with type 2 diabetes mellitus assigned to health education groups

2014 ◽  
Vol 22 (6) ◽  
pp. 980-987 ◽  
Author(s):  
Lucas Pereira de Melo ◽  
Edemilson Antunes de Campos
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Health Education ◽  
Healthcare Workers ◽  
Participant Observation ◽  
Ethnographic Study ◽  
Public Health Care ◽  
Structured Interviews

OBJECTIVE: to interpret the meanings patients with type 2 diabetes mellitus assign to health education groups.METHOD: ethnographic study conducted with Hyperdia groups of a healthcare unit with 26 informants, with type 2 diabetes mellitus, and having participated in the groups for at least three years. Participant observation, social characterization, discussion groups and semi-structured interviews were used to collect data. Data were analyzed through the thematic coding technique.RESULTS: four thematic categories emerged: ease of access to the service and healthcare workers; guidance on diabetes; participation in groups and the experience of diabetes; and sharing knowledge and experiences. The most relevant aspect of this study is the social use the informants in relation to the Hyperdia groups under study.CONCLUSION: the studied groups are agents producing senses and meanings concerning the process of becoming ill and the means of social navigation within the official health system. We expect this study to contribute to the actions of healthcare workers coordinating these groups given the observation of the cultural universe of these individuals seeking professional care in the various public health care services.

scholarly journals Understanding Gestational Diabetes, Future Diabetes Risk, and Diabetes Prevention: A Qualitative Study of Patient, Provider and Staff Perspectives

2021 ◽  
Author(s):  
Hannah R. Lucas ◽  
Roxann C. Williams ◽  
Laura N. Hollar ◽  
Bethany Johnson-Javois ◽  
Heidi B. Miller ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Gestational Diabetes ◽  
Health Care Providers ◽  
Diabetes Prevention ◽  
Diabetes Risk ◽  
Care Providers ◽  
Diabetes Screening ◽  
Structured Interviews ◽  
Future Diabetes

Gestational diabetes mellitus (GDM) increases type 2 diabetes risk; however, postpartum diabetes screening rates are low. Using semi-structured interviews and focus groups, this study investigates the understanding of GDM and its relationship to future diabetes risk and diabetes prevention among patients with public or no insurance (<i>n </i>= 36), health care providers (<i>n </i>= 21), and clinic staff (<i>n </i>= 9) from Federally Qualified Health Centers. Five main themes emerged: <i>1</i>) general understanding of GDM diagnosis with focus on neonatal complications; <i>2</i>) variable recall of diet, exercise, and weight recommendations; <i>3</i>) overwhelming medication and self-monitoring routines; <i>4</i>) short-term focus of type 2 diabetes risk and screening; and <i>5</i>) limited understanding of all options for diabetes prevention. The results may inform diabetes screening and prevention interventions in primary care settings.

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