Online Self-Management Tools for Diabetes in China: Current Situation and Heterogeneity Analysis of Platform Functions and User Comments (Preprint)

2021 ◽  
Author(s):  
Lexi Huang ◽  
Yihan Zhang ◽  
Guanhua Fan
Keyword(s):  
Health Care ◽  
Blood Glucose ◽  
Health Care Providers ◽  
Management Plan ◽  
Self Management ◽  
Care Providers ◽  
Management Tools ◽  
User Comments ◽  
Social Media Platforms ◽  
Control Diabetes

BACKGROUND In China, diabetes has become much more common over the past three decades. The latest statistics on chronic diseases in China (2013) as well as the attendant risk factors, as reported by JAMA (2017), reveal that among Chinese adults, the standardized prevalence of diagnosed and undiagnosed diabetes is 10.9% (95% CI: 10.4%–11.5%) and that of prediabetes is 35.7% (95% CI: 34.1%–37.4%). By 2020, an estimated 155 million (10.9% of the population) will have a diabetes diagnosis, and App507 million (35.7%) will have a prediabetes diagnosis. Diabetes, as a chronic disease, requires medical treatment and self-management—such as adjustments to diet and physical activity. Because of the large clinical workload and hectic work schedule of Chinese health care providers, who primarily focus on treatment, crucial elements in health education are neglected and many patients do not have a personalized self-management plan designed by their health care provider. Furthermore, health care providers find it difficult to empathize with their patients emotionally and provide them prompt mental health care. In addition, health care providers, being busy, tend to be unavailable to calibrate their patients’ self-management plan and address problems as soon as they occur. ICT-based diabetes management tools have thus emerged as substitutes for health care providers, providing solutions tailored to the needs of each patient. China, in particular, has become the most promising market for self-management tools. OBJECTIVE To summarize the functions of representative ICT tools in China; analyze these tools’ effectiveness with reference to the literature; compare these AppAppstools with respect to their functions qualitatively and quantitatively; and finally, discuss the status, attendant risks, and further research directions regarding diabetes online communities. METHODS The most commonly used diabetes self-management Applications (DMAs) were searched for using the term “diabetes” in Apple’s App Store and MyApp (a widely used Android App store in China). The Apps’ basic information and main functions were then recorded. In the page for each App in the App stores, two investigators individually analyzed 99 randomly selected user comments, where keyword modifiers were coded. Each user comment was assigned a score, which was then aggregated. User comments were also coded with respect to 11 App functions. The scores for each App function and for the App as a whole Apps were analyzed using the Kruskal–Wallis test. Common online forums (Baidu Tieba, Sweet Home, and Zhihu) were selected according to user volume, number of posts, and depth of discussion. Social media platforms (WeChat and QQ) were selected according to download volume and number of related articles. The basic information and main functions of the forums and social media platforms were also collected and compared with those of the DMAs. The last section of this article reviews the literature on the effectiveness of the specific Apps analyzed here. RESULTS The functions of the ICT tools differed in their form, quality, and advantages offered. Peer communication is the common feature among the Apps. Welltang and DNurse were perceived most and least favorably overall, respectively (p = .024). Regarding App functions, Control Diabetes had the highest score for functions pertaining to diet, blood glucose management, and family support. The Apps did not significantly differ with respect to diabetes education and ancillary functions. Regarding diet management functionality, Control Diabetes scored the highest, primarily because it can recommend recipes, whereas Tang Tang Quan scored the lowest (p = .000). For drug management functionality, Da Tang Yi scored the highest, and Tang Tang Quan scored the lowest (p = .013). All Apps have a drug recording function, and Da Tang Yi scored the highest primarily because only it can remind users to take their medication. For blood glucose management functionality, Control Diabetes scored the highest, significantly higher than DNurse (p = .007) and Tang Tang Quan did (p = .013), possibly because of Control Diabetes’s ability to measure the user’s blood glucose and remind them to do so. For peer communication functionality, Tang Tang Quan was scored much higher than the other Apps (p = .000). We attribute this to the App being developed by the Tang Tang Quan online community, which has a larger user base and greater App development experience. Users trust Tang Tang Quan because it affords peer interaction. For doctor consultation functionality, Welltang scored the highest, whereas DNurse scored the lowest (p = .000). For family support functions, Control Diabetes scored the highest, whereas Tang Tang Quan scored the lowest (p = .026), possibly because of Tang Tang Quan’s complex binding process. Regarding functions classified as “other,” Tang Tang Quan and DNurse differed significantly (P = .027). “This version of Tang Tang Quan is well-optimized” and “operation is easy” are the most frequently used phrases in the comments. Users are deterred from using an App because of privacy concerns, lack of user friendliness, excessive advertisements, and inaccurate measurements by supporting equipment, which, in turn, reduce compliance. All ICT-based tools, except Baidu Tieba, Zhihu, and Da Tang Yi App, have been shown to improve diabetes self-management previously. CONCLUSIONS Each ICT-based tool has unique functionality that brings unique advantages to users in a given aspect of diabetes self-management. The supplementary functions of DMAs (e.g., recommending recipes and reminding users to take their medication or measure their blood glucose) distinguished the DMAs from each other in the function score. Although there are many ICT-based tools in the market, only a small proportion of them have been demonstrated to be effective, and the quality of research is poor. Therefore, high-quality randomized controlled trials are needed to establish the criteria for the design of ICT-based tools.

scholarly journals Gestational diabetes mellitus: a qualitative study of lived experiences of South Asian immigrant women and perspectives of their health care providers in Melbourne, Australia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mridula Bandyopadhyay
Keyword(s):  
Health Care ◽  
Gestational Diabetes ◽  
South Asian ◽  
Health Care Providers ◽  
Lived Experiences ◽  
Lifestyle Modification ◽  
Self Management ◽  
Asian Women ◽  
Care Providers ◽  
South Asian Women

Abstract Background South Asian women are at a high risk of developing gestational diabetes mellitus than other women in Australia. Gestational diabetes affects up to 14–19% of all pregnancies among South Asian, South East Asian, and Arabic populations placing women at risk of adverse pregnancy outcomes. Although, gestational diabetes resolves after childbirth, women with gestational diabetes are up to seven times more likely to develop type 2 diabetes within five to ten years of the index pregnancy. Increasingly, South Asian women are being diagnosed with gestational diabetes in Australia. Therefore, we aimed to gain a better understanding of the lived experiences of South Asian women and their experiences of self-management and their health care providers’ perspectives of treatment strategies. Methods Using an ethnographic qualitative research methodology, semi-structured one-on-one, face-to-face interviews were conducted with 21 health care providers involved in gestational diabetes management and treatment from the three largest tertiary level maternity hospitals in Melbourne, Victoria, Australia. In-depth interviews were conducted with 23 South Asian women post diagnosis between 24–28 weeks gestation in pregnancy. Results Health care providers had challenges in providing care to South Asian women. The main challenge was to get women to self-manage their blood glucose levels with lifestyle modification. Whilst, women felt self-management information provided were inadequate and inappropriate to their needs. Women felt ‘losing control over their pregnancy’, because of being preoccupied with diet and exercise to control their blood glucose level. Conclusions The gestational diabetes clinical practice at the study hospitals were unable to meet consumer expectations. Health care providers need to be familiar of diverse patient cultures, rather than applying the current ‘one size fits all’ approach that failed to engage and meet the needs of immigrant and ethnic women. Future enabling strategies should aim to co-design and develop low Glycaemic Index diet plans of staple South Asian foods and lifestyle modification messages.

scholarly journals Patients’ Views on Self-Management of Chronic Musculoskeletal Pain

2020 ◽  
Vol 5 (4) ◽  
pp. 254-266
Author(s):  
Barbka Huzjan ◽  
Ivana Hrvatin
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Musculoskeletal Pain ◽  
Health Care Providers ◽  
Multidisciplinary Approach ◽  
Research Question ◽  
Chronic Musculoskeletal Pain ◽  
Self Management ◽  
Care Providers ◽  
The Individual

Research Question (RQ): Chronic musculoskeletal pain is a complex condition and one of the most important causes of suffering of modern times. Self-management refers to the individual’s ability to manage the symptoms, treatment, physical and psychosocial consequences and life style changes inherent in living with a chronic condition. The research question is; what is the view on the selfmanagement of chronic musculoskeletal pain from the patient's perspective? Purpose: The purpose of this literature review was to review original articles that reported how selfmanagement educational programmes are viewed from the patient’s perspective. Method: We used an integrative review of the literature. The search was conducted from November 2019 to March 2020 on the PubMed, PEDro and OTseeker databases. We included original studies, written in English that examined the patients’ point of view on self-management. The included studies, needed to be conducted on adult patients of both sexes, that were suffering from chronic pain and were educated on self-management of their pain. Two authors independently searched for original studies. Results: Nine article were included in the review. Most of the studies included a multidisciplinary approach. Patients reported they more frequently used passive strategies to manage their pain. They want to be included in the management and be able to communicate with the provider of selfmanagement. There are several positive aspects of a multidisciplinary and groups approach. Organization: Health care providers can encourage an individual to proactively behave through ongoing processes of communication, partnerships and the creation of appropriate self-management plans over time. Society: We assume that the analysis will help to identify the social responsibility of the individual and society in the common concern for the health of the population and the individual within it. Originality: The research provides an up-to-date, new overview of the patients' perspective on self management on chronic pain. The review can be helpful to health care providers s they can compare their expectations with patients's. Limitations / further research: Further research would focus on high quality studies, and specific forms of multidisciplinary approach, and finding what patients use at a home setting and how to help them continue in the self management of their pain. Limitations of this review include the lack of risk of bias assessment and the fact that this is not a systematic review.

scholarly journals MALAYSIAN DIABETES PATIENTS’ PERCEPTIONS, ATTITUDES AND PRACTICES IN RELATION TO SELF-CARE AND ENCOUNTERS WITH PRIMARY HEALTH CARE PROVIDERS

2018 ◽  
Vol 2 (3) ◽  
pp. 1-10
Author(s):  
Lim Shiang Cheng ◽  
Jens Aagaard-Hansen ◽  
Feisul Idzwan Mustapha ◽  
Ulla Bjerre-Christensen
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Self Management ◽  
Care Providers ◽  
Attitudes And Practices ◽  
Primary Health ◽  
Primary Health Care Providers ◽  
Primary Healthcare Clinics ◽  
Diabetes Patients

Introduction: Studies from many parts of the world have explored factors associated with poor diabetes self-management including Diabetes Self-Management Education (DSME). Research Methodology: This study was conducted among 162 diabetes patients at primary healthcare clinics in Malaysia using semi-structured exit-interviews to explore their perceptions, attitudes and practices in relation to self-care and encounters with primary health care providers. Results and Discussion: Generally, the patients had limited knowledge, lack of motivation and encountered difficulties in diabetes self-management. The DSME was inadequate due to limited time allocated for consultations with doctors, language barriers and the lack of interpersonal and communication skills of HCPs. Conclusion: In view of the positive effects of quality DSME on the health outcomes and quality of life among diabetes patients, it is important for the primary healthcare clinics in Malaysia to strengthen the diabetes services through training in communication of all HCPs, awareness of language difference and task shifting.

scholarly journals Consultations With Health Care Providers and Use of Self-management Strategies for Prevention and Treatment of COVID-19 Related Symptoms. A Population Based Cross-sectional Study in Norway, Sweden and the Netherlands

2021 ◽  
Author(s):  
Agnete Kristoffersen ◽  
Esther van der Werf ◽  
Trine Stub ◽  
Frauke Musial ◽  
Barbara Wider ◽  
...  
Keyword(s):  
Health Care ◽  
The Netherlands ◽  
Dietary Supplements ◽  
Health Care Providers ◽  
Management Strategies ◽  
Self Management ◽  
Use Of Self ◽  
Care Providers ◽  
Self Help ◽  
Prevention And Treatment

Abstract BackgroundThe present study was initiated to determine consultations with health care providers and use of self-management strategies such as herbal remedies, dietary supplements and self-help techniques for prevention and treatment of COVID-19 related symptoms in countries with a full lockdown (Norway), a partial (’intelligent’) lockdown (the Netherlands) and no lockdown (Sweden) during the first three months of the COVID-19 pandemic, and if such use correlates with worries of being infected by COVID-19 disease. MethodsData were collected in collaboration with the global marketing company Ipsos A/S in April-June 2020 during the first wave of the COVID-19 pandemic. An adapted version of the I-CAM-Q was used and the categories “for prevention of COVID-19” and “to treat COVID-19-related symptoms” added to the original “reasons for use” options. Data were collected among a representative sample in Norway, Sweden and the Netherlands using data assisted telephone interviews (Norway, n=990 and Sweden, n=500), and an online survey (the Netherlands, n=1004). Total response rate was 30%. ResultsOnly a very small number of people in any of the three countries consulted a health care provider with the intention to treat or prevent COVID-19 (1.2% and 1.0% respectively) with medical doctors mostly visited (1.0% and 0.9%). Similarly, the use of self-management strategies to prevent or treat COVID-19 was low (3.4% and 0.2% respectively); most commonly used were vitamins and minerals (2.8%) for prevention of COVID-19, primarily vitamin C (1.7%), vitamin D (0.9%), and multivitamins (0.5%). Consultations with health care providers and use of self-management strategies for prevention of COVID-19 were positively associated with worries of being infected with COVID-19. No such associations were found for worries about loved ones or the perception that COVID-19 is more dangerous than ordinary influenza. ConclusionsThe COVID-19 pandemic does not seem to have evoked a large-scale difference in behaviour related to consultations with health care providers or the use of self-management strategies such as dietary supplements and self-help techniques in any of the three countries, despite different containment and mitigation measures.

Empowerment of Patients in the Process of Rehabilitation

2007 ◽  
Vol 27 (2_suppl) ◽  
pp. 32-34
Author(s):  
Lan Wang ◽  
Jie Dong ◽  
Hong-Bin Gan ◽  
Tao Wang
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Patient Empowerment ◽  
Self Management ◽  
Self Awareness ◽  
Care Providers ◽  
Current Health ◽  
Appropriate Treatment

The management and appropriate treatment of peritoneal dialysis (PD) patients is an ongoing challenge in current health care. We believe that health education—consisting of knowledge, skills, and self-awareness—is a useful mechanism for patient empowerment. Patients should have an awareness of their disease, and as health care providers, PD nurses have the role of focusing their patients on preventive care, rather than of simply training patients. An empowerment program is a valuable intervention for improving the self-management of patients. It can both improve quality of life and assist in rehabilitation.

Working Toward an mHealth Platform for Adolescents with Type 1 Diabetes: Focus Groups With Teens, Parents, and Providers

2020 ◽  
Vol 46 (5) ◽  
pp. 444-454
Author(s):  
Manuela Sinisterra ◽  
Katherine Patterson Kelly ◽  
Caitlin Shneider ◽  
Ashley El-Zein ◽  
Ellen Swartwout ◽  
...  
Keyword(s):  
Health Care ◽  
Type 1 Diabetes ◽  
Focus Groups ◽  
Health Care Providers ◽  
Diabetes Management ◽  
Self Management ◽  
Care Providers ◽  
Open Communication ◽  
Management Behaviors

Purpose The purpose of the study was to explore facilitators and barriers to self-management behaviors in adolescents with type 1 diabetes (T1D) to inform the development of an mHealth platform. Methods Eight adolescents with T1D, 9 parents, and 13 health care providers participated in separate focus groups that explored teen self-management behaviors. Results Adolescents and their parents have distinct preferences for handling diabetes management and use of mHealth technologies. Health care providers support the use of new technologies yet acknowledge concern meeting the potential increased volume of communication requests from teens and families. Conclusion Stakeholders agreed that an ideal mHealth platform would facilitate open communication between teens and their care network and easily integrate with other diabetes technologies. Future directions include incorporating additional feedback from stakeholders to build and modify the mHealth platform. The use of mHealth platforms could be integrated into clinical practice to optimize self-management and support communication between educators, providers, and families in between clinic visits.

scholarly journals 2017 National Standards for Diabetes Self-Management Education and Support

2018 ◽  
Vol 45 (1) ◽  
pp. 34-49 ◽  
Author(s):  
Joni Beck ◽  
Deborah A. Greenwood ◽  
Lori Blanton ◽  
Sandra T. Bollinger ◽  
Marcene K. Butcher ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Management Education ◽  
Positive Impact ◽  
National Standards ◽  
Self Management ◽  
Current Evidence ◽  
Critical Element ◽  
Care Providers ◽  
Health Care Environment

Purpose The purpose of this study is to review the literature for Diabetes Self-Management Education and Support (DSMES) to ensure the National Standards for DSMES (Standards) align with current evidence-based practices and utilization trends. Methods The 10 Standards were divided among 20 interdisciplinary workgroup members. Members searched the current research for diabetes education and support, behavioral health, clinical, health care environment, technical, reimbursement, and business practice for the strongest evidence that guided the Standards revision. Results Diabetes Self-Management Education and Support facilitates the knowledge, skills, and ability necessary for diabetes self-care as well as activities that assist a person in implementing and sustaining the behaviors needed to manage their condition on an ongoing basis. The evidence indicates that health care providers and people affected by diabetes are embracing technology, and this is having a positive impact of DSMES access, utilization, and outcomes. Conclusion Quality DSMES continues to be a critical element of care for all people with diabetes. The DSMES services must be individualized and guided by the concerns, preferences, and needs of the person affected by diabetes. Even with the abundance of evidence supporting the benefits of DSMES, it continues to be underutilized, but as with other health care services, technology is changing the way DSMES is delivered and utilized with positive outcomes.

A Social-Ecological Approach to Determine Barriers of DMSM Practice For Patients with Type 2 Diabetes Mellitus: A literature review

2018 ◽  
Vol 1 (1) ◽  
pp. 1-20
Author(s):  
Andi Mayasari Usman ◽  
Rian Adi Pamungkas
Keyword(s):  
Diabetes Mellitus ◽  
Health Care ◽  
Health Care Provider ◽  
Health Care Providers ◽  
Care Provider ◽  
Diabetes Care ◽  
Diabetes Management ◽  
Self Management ◽  
Care Providers

Diabetes mellitus is one of the global problems the world. Since the complexity of the patient’s tasks is required in the diabetes care, the consistency to engage this various health behavior for addressing the glycemic control target is difficult to achieve. Failure management may reflect by patient, family, inadequate intervention strategies by health care provider as well as organization factor. Three databases used such as PubMed, MIDLINE, and CINAHL to address patient’s barriers, family’s barriers, and provider’s barriers as well as organization barriers for diabetes management. Patient’s attitudes and belief, knowledge, culture, and ethnicity, self-efficacy, financial resources and economic status, lack of Social Support Perceived, and lack of time may influence the diabetes self-management. Family factors lead to patients’ diabetes self-management such as lack of knowledge and skill to support patients in diabetes management and quality of the relationship between patients-family. Health care providers factors included beliefs, attitudes, knowledge and skill and patient–family-provider interaction and communication. Other factors lead to diabetes self-management and health care provider performance to provide the intervention from organization level such as integrated health system sufficiency health insurance to support resources. A deeper understanding of the barriers in diabetes management is necessary to improve the diabetes care and quality of health care services for patients with diabetes. Further research needs to consider these barriers before designing the effective, sensitive interventions and problem solving for diabetes care

A qualitative thematic analysis of online UK diabetes health forums to assess experiences and perspectives of insulin therapy in Type 2 Diabetes (Preprint)

2021 ◽  
Author(s):  
Maya Allen-Taylor ◽  
Laura Ryan ◽  
Rebecca Upsher ◽  
Kirsty Winkley-Bryant
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
Insulin Therapy ◽  
Health Care Providers ◽  
Thematic Analysis ◽  
Self Management ◽  
Search Term ◽  
Care Providers ◽  
Study Results

BACKGROUND Despite the advent of newer therapeutic agents, many individuals with T2D will require insulin treatment. Insulin refusal and cessation of treatment in this group is common and their needs under explored. OBJECTIVE To understand the experiences and perspectives of individuals with type 2 diabetes who have been recommended or prescribed insulin therapy, expressed on online health forums. METHODS Setting: Retrospective archived forum threads from the two largest, freely and publicly accessible diabetes health forums in the UK were screened over a 12-month period (August 2019-20). Design: Within the Diabetes UK forum, the search term ‘insulin (title only)’ was employed to identify relevant threads. Within Diabetes.co.uk, threads were screened within an existing ‘Type 2 with insulin’ message board. Three independent researchers coded the forum threads and posts. Pertinent themes and subthemes were identified and have been illustrated by paraphrasing of members quotes, to ensure anonymity. Participants: n=299 posts from 29 threads from Diabetes UK and n=295 posts from 28 threads from Diabetes.co.uk, were analysed over the study period. Fifty-seven threads in total met the inclusion criteria and were included in the thematic analysis. RESULTS Four overarching themes with subthemes were generated to illustrate the unmet needs that had prompted members to seek information, advice and support outside of their usual care provision, via the forums: (1) unmet practical needs and self-management support; including insulin injection technique, titration, travel, driving with insulin and utilising new technology, (2) psychological and peer support; advice, encouragement and empathy, which was readily offered and well received, (3) seeking and providing extended lifestyle advice; discussions around alternative diet strategies, types of activity and their effects on glycaemia and body weight, and (4) relationships with health care professionals (HCPs); including recounting of problematic experiences such as paternalism, lack of HCP knowledge and inadequate provision of effective insulin focused diabetes self-management education. CONCLUSIONS This is the first study to utilise data from online health forums, to characterise the experiences and perspectives of people with T2D who are recommended or prescribed insulin therapy. The observed naturalistic conversations have generated useful insights. Our findings suggest there are additional needs that are not being currently met by health care providers. They also suggest that problematic relationships with HCPs remain a barrier to effective insulin therapy. The study results will help to directly inform insulin focused diabetes self-management and support strategies, in order to enable individuals to achieve their best outcomes.

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