Health literacy in context: struggling to self-manage diabetes. A longitudinal qualitative study

Mapping Intimacies ◽

10.21203/rs.3.rs-24192/v2 ◽

2020 ◽

Author(s):

Xavier Debussche ◽

Maryvette Balcou-Debussche ◽

Delphine Ballet ◽

Jessica Caroupin-Soupoutevin

Keyword(s):

Social Support ◽

Type 2 Diabetes ◽

Health Literacy ◽

Disease Management ◽

Qualitative Study ◽

Health Professionals ◽

Health Knowledge ◽

Diet And Exercise

Abstract ObjectiveConsidering health literacy is a key element for health service responsiveness to self-management needs in diabetes. This qualitative study aimed to provide a detailed analysis of the health literacy of people with type 2 diabetes in relation to their daily self-care practices.MethodsInterviews (n=86) were conducted as part of the qualitative study ERMIES-ethnosocio, at the beginning and at the end of a structured educational care. The interviews focused on food practices, exercise, treatment, relationship to health information and professionals.ResultsThree poles structured into eight themes characterized practices in context: health knowledge, disease management, expertise and social support. The relationships of participants in each of the eight themes were differentiated, ranging from functional to interactive and critical. Treatment and follow-up were essentially functional, while diet and exercise remained more interactive. Social support and relationship to health professionals were important determinants of disease management. Conclusion and Practice implicationsTreatment management and disease monitoring remain primarily the job of health professionals, as opposed to diet, physical activity and social support being part of ordinary practice. Decision-making, as a shared social task, as well as resources for participation in health services, should be considered for relevant interventions in type 2 diabetes.

Download Full-text

Treatment and monitoring remain the purview of the doctor: Health literacy of people struggling with insufficiently controlled type 2 diabetes. A longitudinal qualitative study

10.21203/rs.3.rs-24192/v1 ◽

2020 ◽

Author(s):

Xavier Debussche ◽

Maryvette Balcou-Debussche ◽

Delphine Ballet ◽

Jessica Caroupin-Soupoutevin

Keyword(s):

Social Support ◽

Type 2 Diabetes ◽

Health Literacy ◽

Disease Management ◽

Qualitative Study ◽

Health Knowledge ◽

Care Providers ◽

Structured Care ◽

Relation Type

Abstract Background Assessing complex health literacy needs is a key element to improve management of diabetes in vulnerable people. This study aimed to analyse health literacy and practices in insufficiently controlled type 2 diabetes. Methods Data are issued from the qualitative ERMIES-ethnosocio study nested in the ERMIES randomized controlled trial testing a 2 years structured care in type 2 diabetes. A total of 42 participants were seen at the beginning and after the completion of the trial. Interviews explored experiences and views on daily management of diabetes. Health literacy was assessed via the multidimensional Health Literacy Questionnaire. Results Eight themes grouped in 3 main poles could be individualized: health knowledge, disease management, expertise and social support. Participants exhibited a primarily one-way relationship to treatment and monitoring, leaving the health care providers (HCP) the initiatives. In contrast, relation to food practices and exercise were more interactive. After 2 years participants tended to engage a more interactive relation to treatment. Having sufficient, appraising, and feeling able to find good health information were at stake while social support for health and relation to HCP and services were important determinants for managing health. Conclusion This longitudinal qualitative study shows the inter-individual et intra-individual variations of health literacy related to disease management, with the importance of the relation type to HCP, as well as social context with complex and evolving interactions. Decision-making as a shared social task beside the resources for engaging with health services are key considerations in the co-design of relevant interventions in type 2 diabetes.

Download Full-text

People With Type 2 Diabetes Report Dietitians, Social Support, and Health Literacy Facilitate Their Dietary Change

Journal of Nutrition Education and Behavior ◽

10.1016/j.jneb.2020.09.003 ◽

2020 ◽

Cited By ~ 1

Author(s):

George Siopis ◽

Stephen Colagiuri ◽

Margaret Allman-Farinelli

Keyword(s):

Social Support ◽

Type 2 Diabetes ◽

Health Literacy ◽

Dietary Change

Download Full-text

Preferring to manage by myself: A qualitative study of the perspectives of hardly reached people with type 2 diabetes on social support for diabetes management

Journal of Clinical Nursing ◽

10.1111/jocn.14783 ◽

2019 ◽

Vol 28 (9-10) ◽

pp. 1889-1898

Author(s):

Laura K. Bech ◽

Camilla Borch Jacobsen ◽

Anne Sophie Mathiesen ◽

Thordis Thomsen

Keyword(s):

Social Support ◽

Type 2 Diabetes ◽

Qualitative Study ◽

Diabetes Management

Download Full-text

‘Oh it’s a wonderful practice … you can talk to them’: a qualitative study of patients’ and health professionals’ views on the management of type 2 diabetes

Health & Social Care in the Community ◽

10.1046/j.1365-2524.2001.00307.x ◽

2001 ◽

Vol 9 (5) ◽

pp. 318-326 ◽

Cited By ~ 60

Author(s):

Colin G. Pooley ◽

Catherine Gerrard ◽

Sally Hollis ◽

Stephen Morton ◽

John Astbury

Keyword(s):

Type 2 Diabetes ◽

Qualitative Study ◽

Health Professionals

Download Full-text

The Diabetes and Emotional Health Handbook and Toolkit for Health Professionals Supporting Adults With Type 1 and Type 2 Diabetes: Formative Evaluation

JMIR Formative Research ◽

10.2196/15007 ◽

2020 ◽

Vol 4 (2) ◽

pp. e15007 ◽

Cited By ~ 1

Author(s):

Jennifer A Halliday ◽

Jane Speight ◽

Andrea Bennet ◽

Linda J Beeney ◽

Christel Hendrieckx

Keyword(s):

Type 2 Diabetes ◽

Qualitative Study ◽

Health Professionals ◽

Formative Evaluation ◽

Emotional Health ◽

Psychological Problems ◽

Evidence Based ◽

Stakeholder Consultation

Background Health professionals have expressed unmet needs, including lacking the skills, confidence, training, and resources needed to properly attend to the psychological needs of people with diabetes. Objective Informed by needs assessments, this study aimed to develop practical, evidence-based resources to support health professionals to address the emotional needs of adults with type 1 or type 2 diabetes. Methods We developed a new handbook and toolkit informed by formative evaluation, including literature reviews, stakeholder consultation and review, and a qualitative study. In the qualitative study, health professionals participated in interviews after reading sections of the handbook and toolkit. Results The literature review uncovered that psychological problems are common among adults with diabetes, but health professionals lack resources to provide related support. We planned and drafted resources to fill this unmet need, guided by stakeholder consultation and an Expert Reference Group (ERG). Before finalizing the resources, we implemented feedback received from stakeholders (ERG, health professionals, academics, and people with diabetes). The resulting resources were the practical, evidence-based Diabetes and Emotional Health handbook and toolkit. A total of 19 health professionals took part in the qualitative study about the handbook and toolkit. They viewed the resources favorably, felt empowered to support people with diabetes experiencing psychological problems, and felt motivated to share the resources with others. Some gave examples of how they had used the handbook in clinical practice. A perceived highlight was the inclusion of a process model outlining 7 steps for identifying and supporting people with emotional problems: the 7 A’s model. With funding from the National Diabetes Services Scheme (NDSS), more than 2400 copies of Diabetes and Emotional Health have been distributed. It is freely available on the Web. The NDSS is an initiative of the Australian Government administered with the assistance of Diabetes Australia. Conclusions The new evidence-based resources are perceived by stakeholders as effective aids to assist health professionals in providing emotional support to adults with diabetes. The 7 A’s model may have clinical utility for routine monitoring of other psychological and health-related problems, as part of person-centered clinical care.

Download Full-text