scholarly journals Experiences of Using Web-Based and Mobile Technologies to Support Self-Management of Type 2 Diabetes: Qualitative Study (Preprint)

2017 ◽  
Author(s):  
Laura Kelly ◽  
Crispin Jenkinson ◽  
David Morley

BACKGROUND The prevalence of type 2 diabetes is rising, placing increasing strain on health care services. Web-based and mobile technologies can be an important source of information and support for people with type 2 diabetes and may prove beneficial with respect to reducing complications due to mismanagement. To date, little research has been performed to gain an insight into people’s perspectives of using such technologies in their daily management. OBJECTIVE The purpose of this study was to understand the impact of using Web-based and mobile technologies to support the management of type 2 diabetes. METHODS In-depth interviews were conducted with 15 people with type 2 diabetes to explore experiences of using Web-based and mobile technologies to manage their diabetes. Transcripts were analyzed using the framework method. RESULTS Technology supported the users to maintain individualized and tailored goals when managing their health. A total of 7 themes were identified as important to participants when using technology to support self-management: (1) information, (2) understanding individual health and personal data, (3) reaching and sustaining goals, (4) minimizing disruption to daily life, (5) reassurance, (6) communicating with health care professionals, and (7) coordinated care. CONCLUSIONS Patients need to be supported to manage their condition to improve well-being and prevent diabetes-related complications from arising. Technologies enabled the users to get an in-depth sense of how their body reacted to both lifestyle and medication factors—something that was much more difficult with the use of traditional standardized information alone. It is intended that the results of this study will inform a new questionnaire designed to assess self-management in people using Web-based and mobile technology to manage their health.

2016 ◽  
Vol 2016 ◽  
pp. 1-13 ◽  
Author(s):  
Megan Hofmann ◽  
Charlotte Dack ◽  
Chris Barker ◽  
Elizabeth Murray

This mixed-method study assessed the impact of an internet-based, self-management intervention (“HeLP-Diabetes”) on the psychological well-being of adults with type 2 diabetes. Nineteen participants were recruited from 3 general practices. Data were collected at baseline and at 6 weeks follow-up. Access to HeLP-Diabetes was associated with a significant decrease in participants’ diabetes-related distress (Z=2.04,p=0.04, andd=0.28). No significant differences were found in emotional distress or self-efficacy. The qualitative data found that participants reported improvements including increased self-efficacy and support, better management of low mood, greater diabetes awareness, and taking the condition more seriously. Participants also reported making improvements to their eating habits, exercise routine, and medical management. Some negative experiences associated with using the intervention were mentioned including feelings of guilt for not using the intervention as suggested or not making any behavioral changes, as well as technical and navigational frustrations with the intervention. Internet-based self-management interventions may have the potential to decrease diabetes-related distress in people with type 2 diabetes. The qualitative data also suggests internet interventions can positively impact both psychological and behavioural outcomes of adults with type 2 diabetes.


2017 ◽  
Author(s):  
Gerda Bernhard ◽  
Cornelia Mahler ◽  
Hanna Marita Seidling ◽  
Marion Stützle ◽  
Dominik Ose ◽  
...  

BACKGROUND Information technology tools such as shared patient-centered, Web-based medication platforms hold promise to support safe medication use by strengthening patient participation, enhancing patients’ knowledge, helping patients to improve self-management of their medications, and improving communication on medications among patients and health care professionals (HCPs). However, the uptake of such platforms remains a challenge also due to inadequate user involvement in the development process. Employing a user-centered design (UCD) approach is therefore critical to ensure that user’ adoption is optimal. OBJECTIVE The purpose of this study was to identify what patients with type 2 diabetes mellitus (T2DM) and their HCPs regard necessary requirements in terms of functionalities and usability of a shared patient-centered, Web-based medication platform for patients with T2DM. METHODS This qualitative study included focus groups with purposeful samples of patients with T2DM (n=25), general practitioners (n=13), and health care assistants (n=10) recruited from regional health care settings in southwestern Germany. In total, 8 semistructured focus groups were conducted. Sessions were audio- and video-recorded, transcribed verbatim, and subjected to a computer-aided qualitative content analysis. RESULTS Appropriate security and access methods, supported data entry, printing, and sending information electronically, and tracking medication history were perceived as the essential functionalities. Although patients wanted automatic interaction checks and safety alerts, HCPs on the contrary were concerned that unspecific alerts confuse patients and lead to nonadherence. Furthermore, HCPs were opposed to patients’ ability to withhold or restrict access to information in the platform. To optimize usability, there was consensus among participants to display information in a structured, chronological format, to provide information in lay language, to use visual aids and customize information content, and align the platform to users’ workflow. CONCLUSIONS By employing a UCD, this study provides insight into the desired functionalities and usability of patients and HCPs regarding a shared patient-centered, Web-based medication platform, thus increasing the likelihood to achieve a functional and useful system. Substantial and ongoing engagement by all intended user groups is necessary to reconcile differences in requirements of patients and HCPs, especially regarding medication safety alerts and access control. Moreover, effective training of patients and HCPs on medication self-management (support) and optimal use of the tool will be a prerequisite to unfold the platform’s full potential.


Author(s):  
Xiaojia Wang ◽  
Linglan He ◽  
Keyu Zhu ◽  
Shanshan Zhang ◽  
Ling Xin ◽  
...  

Abstract Background Type 2 Diabetes Mellitus (T2DM) is a chronic disease closely related to personal life style. Therefore, achieving effective self-management is one of the most important ways to control it. There is evidence that social support can help to improve the self-management ability of patients with T2DM, but which social support is more effective has been rarely explored. The purpose of this study is to construct an integrated model to analyze which social support has more significant impact on self-management of T2DM, and provide reasonable suggestions to health care providers on how to effectively play the role of social support. Methods We established a social support indicator evaluation system and proposed an integrated model that combines ANP (Analytical Network Process) and CRITIC (CRiteria Importance through Intercriteria Correlation) methods to evaluate the impact of social support on T2DM self-management from both subjective and objective perspectives. The weights calculated by the model will serve as the basis for us to judge the importance of different social support indicators. Results Informational support (weighting 49.26%) is the most important criteria, followed by tangible support (weighting 39.24%) and emotional support (weighting 11.51%). Among 11 sub-criteria, guidance (weighting 23.05%) and feedback (weighting 14.68%) are two most relevant with T2DM self-management. This result provides ideas and evidence for health care providers on how to offer more effective social support. Conclusion To our knowledge, this is the first study in which Multi-Criteria Decision Making (MCDM) tools, specifically ANP and CRITIC, are used to evaluate the impact of social support on improving self-management of type 2 diabetes. The study suggests that incorporating two sub-indicators of guidance and feedback into the diabetes care programs may have great potential to improve T2DM self-management and further control patient blood glucose and reduce complications.


2017 ◽  
Vol 4 (1) ◽  
pp. 205510291770718 ◽  
Author(s):  
Anne M Koponen ◽  
Nina Simonsen ◽  
Sakari Suominen

This study showed, in line with self-determination theory, that of the six central quality dimensions of primary health care (access to care, continuity of care, diabetes counseling, autonomy support from one’s physician, trust, patient-centered care), autonomy support from one’s physician was most strongly associated with autonomous motivation (self-regulation) for effective diabetes self-management among patients with type 2 diabetes ( n = 2866). However, overall support for diabetes care received from friends, family members, other patients with diabetes, and health care professionals may even play a greater role.


2021 ◽  
Vol 26 ◽  
Author(s):  
Iram Osman ◽  
Shaista Hamid ◽  
Veena S. Singaram

Background: During the coronavirus disease 2019 (COVID-19) pandemic, health professionals were pushed to the front line of a global health crisis unprepared and resource constrained, which affected their mental well-being.Aim: This study aimed to investigate the effectiveness of a brief online mindfulness-based intervention (MBI) on stress and burnout for health professionals training and working in South Africa during the COVID-19 crisis.Setting: The context of the study is the overburdened, under-resourced health care system in South Africa during a global pandemic.Methods: A mixed method framework was adopted for this study. The quantitative data was analysed using descriptive analysis and the participants’ qualitative experiences were interpreted using interpretative phenomenological analysis.Results: Forty-seven participants took part in this study. The study found a statistically significant (p 0.05) reduction in stress levels and emotional exhaustion as well as an increase in mindful awareness and feelings of personal accomplishment after the intervention. The participants’ shared experiences were analysed in two parts. The pre-intervention analysis presented with central themes of loss of control and a sense of powerlessness because of COVID-19. The post-intervention analysis comprised themes of a sense of acquired control and empowerment through increased mindfulness.Conclusions: The study found that a brief online MBI can be associated with reduced levels of stress and burnout as well as an increased sense of control and empowerment, felt both personally and professionally, during a global crisis.Contribution: The impact of an online MBI for health care professionals amidst a pandemic has not been previously documented.


JMIR Diabetes ◽  
10.2196/15744 ◽  
2020 ◽  
Vol 5 (1) ◽  
pp. e15744 ◽  
Author(s):  
Shoba Poduval ◽  
Louise Marston ◽  
Fiona Hamilton ◽  
Fiona Stevenson ◽  
Elizabeth Murray

Background Structured education for people with type 2 diabetes improves outcomes, but uptake is low globally. In the United Kingdom in 2016, only 8.3% of people who were referred to education programs attended the program. We have developed a Web-based structured education program named Healthy Living for People with type 2 Diabetes (HeLP-Diabetes): Starting Out (HDSO), as an alternative to face-to-face courses. A Web-based program gives people more options for accessing structured education and may help improve overall uptake. Objective The aim was to explore the feasibility and acceptability of delivering a Web-based structured education program (named HeLP-Diabetes: Starting Out) in routine primary health care and its potential impact on self-efficacy and diabetes-related distress. Methods HDSO was delivered as part of routine diabetes services in primary health care in the United Kingdom, having been commissioned by local Clinical Commissioning Groups. Quantitative data were collected on uptake, use of the program, demographic characteristics, self-reported self-efficacy, and diabetes-related distress. A subsample of people with type 2 diabetes and health care professionals were interviewed about acceptability of the program. Results It was feasible to deliver the program, but completion rates were low: of 791 people with type 2 diabetes registered, only 74 (9.0%) completed it. Completers improved their self-efficacy (change in median score 2.5, P=.001) and diabetes-related distress (change in median score 6.0, P=.001). Interview data suggested that the course was acceptable, and that uptake and completion may be related to nonprioritization of structured education. Conclusions The study provides evidence of the feasibility and acceptability of a Web-based structured education. However, uptake and completion rates were low, limiting potential population impact. Further research is needed to improve completion rates, and to determine the relative effectiveness of Web-based versus face-to-face education.


2021 ◽  
Author(s):  
◽  
Sera Tapu-Ta'ala

<p>Background Pacific people are dying younger compared to other New Zealanders because of complications resulting from uncontrolled type 2 diabetes mellitus. Good diabetes control is achievable with early use of insulin because of its effectiveness, and proven long term benefits to quality of life. An understanding of how Samoan people with type 2 diabetes make their transition to insulin therapy will assist in understanding how insulin is perceived, which will inform health care professionals in their work with those diagnosed with diabetes. Aim of Research The aim of the research is to explore and describe how Samoan people with type 2 diabetes in New Zealand made the transition to insulin therapy for better glycaemic control. Design The Fonofale Model was used as the theoretical framework, from which to understand Samoan peoples' experiences. This research used a qualitative descriptive methodology. In-depth interviews were used to gather the stories of four Samoan participants over the age of 18 years diagnosed with type 2 diabetes. The data was analysed using thematic analysis. Findings Three major themes emerged from the analysis of the participants' stories. These were: living with diabetes, making the transition to insulin therapy and realisation. The findings led to the creation of the Ia Malu model, which describes the experiences of the participants in this study. Conclusion This study confirmed that there are immense challenges and struggles encountered by people with diabetes. Their adjustment to the illness as well as making the transition to using insulin takes time. As a result of this, it is fundamental for nurses/health care professionals to understand that this is the reality for these people, and they must therefore provide time for people to adjust.</p>


2020 ◽  
Author(s):  
Julie C Lauffenburger ◽  
Renee A Barlev ◽  
Ellen S Sears ◽  
Punam A Keller ◽  
Marie E McDonnell ◽  
...  

BACKGROUND Individuals with diabetes need regular support to help them manage their diabetes on their own, ideally delivered via mechanisms that they already use, such as their mobile phones. One reason for the modest effectiveness of prior technology-based interventions may be that the patient perspective has been insufficiently incorporated. OBJECTIVE This study aims to understand patients’ preferences for mobile health (mHealth) technology and how that technology can be integrated into patients’ routines, especially with regard to medication use. METHODS We conducted semistructured qualitative individual interviews with patients with type 2 diabetes from an urban health care system to elicit and explore their perspectives on diabetes medication–taking behaviors, daily patterns of using mobile technology, use of mHealth technology for diabetes care, acceptability of text messages to support medication adherence, and preferred framing of information within text messages to support diabetes care. The interviews were digitally recorded and transcribed. The data were analyzed using codes developed by the study team to generate themes, with representative quotations selected as illustrations. RESULTS We conducted interviews with 20 participants, of whom 12 (60%) were female and 9 (45%) were White; in addition, the participants’ mean glycated hemoglobin A<sub>1c</sub> control was 7.8 (SD 1.1). Overall, 5 key themes were identified: patients try to incorporate <i>cues</i> into their routines to help them with consistent medication taking; many patients leverage some form of technology as a cue to support adherence to medication taking and diabetes self-management behaviors; patients value simplicity and integration of technology solutions used for diabetes care, managing medications, and communicating with health care providers; some patients express reluctance to rely on mobile technology for these diabetes care behaviors; and patients believe they prefer positively framed communication, but communication preferences are highly individualized. CONCLUSIONS The participants expressed some hesitation about using mobile technology in supporting diabetes self-management but have largely incorporated it or are open to incorporating it as a cue to make medication taking more automatic and less burdensome. When using technology to support diabetes self-management, participants exhibited individualized preferences, but overall, they preferred simple and positively framed communication. mHealth interventions may be improved by focusing on integrating them easily into daily routines and increasing the customization of content.


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