scholarly journals Health Care Providers’ Perceptions of Responsibilities and Resources to Reduce Type 2 Diabetes Risk After Gestational Diabetes Mellitus

2018 ◽  
Vol 36 (2) ◽  
pp. 160-167
Author(s):  
Sumali S. Hewage ◽  
Shweta R. Singh ◽  
Claudia Chi ◽  
Jerry K.Y. Chan ◽  
Tong Wei Yew ◽  
...  
2020 ◽  
Author(s):  
Biswamitra Sahu ◽  
Giridhara R Babu ◽  
Kaveri Siddappa Gurav ◽  
Maithili Karthik ◽  
R Deepa ◽  
...  

Abstract Background Women developing Gestational Diabetes Mellitus are subsequently at a higher risk of developing Type 2 Diabetes later in life. Screening and effective management of women with GDM is essential in preventing progression to type 2 diabetes mellitus. Although the burden of Gestational Diabetes Mellitus is high in India, Gestational Diabetes Mellitus screening and management is suboptimal in public hospitals. We aimed to explore the perspectives of healthcare providers regarding the barriers and facilitators from the health system context that restrict the timely screening and effective management of Gestational Diabetes Mellitus. Methods We conducted six in-depth interviews of health care providers- four with nurses and two with obstetricians in the public hospitals in India's major city (Bengaluru). The interviews were conducted in the preferred language of the participants ( Kannada for nurses, English for the obstetricians) and audio-recorded. All Kannada interviews were transcribed and translated into English for analysis. The primary data were analyzed using grounded theory approach by NVivo 12 plus Results Health care providers recognized and supported the need for design and implementation of Gestational Diabetes Mellitus screening and management services. While obstetricians were aware of the national guidelines regarding screening and management; nurses mentioned that they had unmet training needs in health promotion. Barriers identified to timely screening and management of Gestational Diabetes Mellitus included unmet training needs of nurses regarding Gestational Diabetes Mellitus, delay in screening of pregnant women accessing antenatal care at private clinics initially and subsequently reporting at public hospital in late gestation, migration of pregnant women due to delivery of first born at natal home, lack of follow up system of deferred cases for gestational diabetes screening, resource deficit, and long waiting hours. Conclusion Provided the fact that there is effectiveness of Gestational Diabetes Mellitus screening and management services, there is a pressing need to develop and improve existing Gestational Diabetes Mellitus Screening and Management services to tackle the growing burden of Gestational Diabetes Mellitus in India. With the urgent need for these services, it needs to be extended to public hospitals.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Biswamitra Sahu ◽  
Giridhara R. Babu ◽  
Kaveri Siddappa Gurav ◽  
Maithili Karthik ◽  
Deepa Ravi ◽  
...  

Abstract Background Women developing Gestational Diabetes Mellitus (GDM) are subsequently at a higher risk of developing Type 2 Diabetes later in life. Screening and effective management of women with GDM are essential in preventing progression to type 2 diabetes mellitus. We aimed to explore the perspectives of healthcare providers regarding the barriers from the health system context that restrict the timely screening and effective management of GDM. Methods We conducted six in-depth interviews of health care providers- four with nurses and two with obstetricians in the public hospitals in India’s major city (Bengaluru). The interviews were conducted in the preferred language of the participants (Kannada for nurses, English for the obstetricians) and audio-recorded. All Kannada interviews were transcribed and translated into English for analysis. The primary data were analyzed using the grounded theory approach by NVivo 12 plus. The findings are put into perspective using the socio-ecological model. Results Health care providers identified delayed visits to public hospitals and stress on household-level responsibilities as barriers at the individual level for GDM screening. Also, migration of pregnant women to their natal homes during first pregnancy is a cultural barrier in addition to health system barriers such as unmet nurse training needs, long waiting hours, uneven power dynamics, lack of follow-up, resource scarcity, and lack of supportive oversight. The barriers for GDM management included non-reporting women to follow - up visits, irregular self-monitoring of drug and blood sugar, trained staff shortage, ineffective tracking, and lack of standardized protocol. Conclusion There is a pressing need to develop and improve existing GDM Screening and Management services to tackle the growing burden of GDM in public hospitals of India.


2020 ◽  
Author(s):  
Biswamitra Sahu ◽  
Giridhara R Babu ◽  
Kaveri Siddappa Gurav ◽  
Maithili Karthik ◽  
R Deepa ◽  
...  

Abstract Background Women developing Gestational Diabetes Mellitus (GDM) are subsequently at a higher risk of developing Type 2 Diabetes later in life. Screening and effective management of women with GDM is essential in preventing progression to type 2 diabetes mellitus. We aimed to explore the perspectives of healthcare providers regarding the barriers from the health system context that restrict the timely screening and effective management of GDM. Methods We conducted six in-depth interviews of health care providers- four with nurses and two with obstetricians in the public hospitals in India's major city (Bengaluru). The interviews were conducted in the preferred language of the participants (Kannada for nurses, English for the obstetricians) and audio-recorded. All Kannada interviews were transcribed and translated into English for analysis. The primary data were analyzed using grounded theory approach by NVivo 12 plus. The findings are put into perspective using the socio-ecological model. Results Health care providers identified delayed visits to public hospitals and stress on household-level responsibilities as barriers at the individual level for GDM screening. Also, migration of pregnant women to natal home during first pregnancy is a cultural barrier in addition to health system barriers such as unmet nurse training needs, long waiting hours, uneven power dynamics, lack of follow-up, resource scarcity, and lack of supportive oversight. The barriers for GDM management included non-reporting women to follow - up visits, irregular self-monitoring of drug and blood sugar, trained staff shortage, ineffective tracking, and lack of standardized protocol.Conclusion There is a pressing need to develop and improve existing GDM Screening and Management services to tackle the growing burden of GDM in public hospitals of India.


2021 ◽  
Author(s):  
Biswamitra Sahu ◽  
Giridhara R Babu ◽  
Kaveri Siddappa Gurav ◽  
Maithili Karthik ◽  
R Deepa ◽  
...  

Abstract BackgroundWomen developing Gestational Diabetes Mellitus (GDM) are subsequently at a higher risk of developing Type 2 Diabetes later in life. Screening and effective management of women with GDM are essential in preventing progression to type 2 diabetes mellitus. We aimed to explore the perspectives of healthcare providers regarding the barriers from the health system context that restrict the timely screening and effective management of GDM.MethodsWe conducted six in-depth interviews of health care providers- four with nurses and two with obstetricians in the public hospitals in India's major city (Bengaluru). The interviews were conducted in the preferred language of the participants (Kannada for nurses, English for the obstetricians) and audio-recorded. All Kannada interviews were transcribed and translated into English for analysis. The primary data were analyzed using the grounded theory approach by NVivo 12 plus. The findings are put into perspective using the socio-ecological model.ResultsHealth care providers identified delayed visits to public hospitals and stress on household-level responsibilities as barriers at the individual level for GDM screening. Also, migration of pregnant women to their natal homes during first pregnancy is a cultural barrier in addition to health system barriers such as unmet nurse training needs, long waiting hours, uneven power dynamics, lack of follow-up, resource scarcity, and lack of supportive oversight. The barriers for GDM management included non-reporting women to follow - up visits, irregular self-monitoring of drug and blood sugar, trained staff shortage, ineffective tracking, and lack of standardized protocol.ConclusionThere is a pressing need to develop and improve existing GDM Screening and Management services to tackle the growing burden of GDM in public hospitals of India.


2020 ◽  
Author(s):  
Biswamitra Sahu ◽  
Giridhara R Babu ◽  
Kaveri Siddappa Gurav ◽  
Maithili Karthik ◽  
R Deepa ◽  
...  

Abstract BackgroundWomen developing Gestational Diabetes Mellitus (GDM) are subsequently at a higher risk of developing Type 2 Diabetes later in life. Screening and effective management of women with GDM is essential in preventing progression to type 2 diabetes mellitus. We aimed to explore the perspectives of healthcare providers regarding the barriers from the health system context that restrict the timely screening and effective management of GDM.MethodsWe conducted six in-depth interviews of health care providers- four with nurses and two with obstetricians in the public hospitals in India's major city (Bengaluru). The interviews were conducted in the preferred language of the participants (Kannada for nurses, English for the obstetricians) and audio-recorded. All Kannada interviews were transcribed and translated into English for analysis. The primary data were analyzed using grounded theory approach by NVivo 12 plus. The findings are put into perspective using the socio-ecological model.ResultsHealth care providers identified delayed visits to public hospitals and stress on household-level responsibilities as barriers at the individual level for GDM screening. Also, migration of pregnant women to natal home during first pregnancy is a cultural barrier in addition to health system barriers such as unmet nurse training needs, long waiting hours, uneven power dynamics, lack of follow-up, resource scarcity, and lack of supportive oversight. The barriers for GDM management included non-reporting women to follow - up visits, irregular self-monitoring of drug and blood sugar, trained staff shortage, ineffective tracking, and lack of standardized protocol.ConclusionThere is a pressing need to develop and improve existing GDM Screening and Management services to tackle the growing burden of GDM in public hospitals of India.


2021 ◽  
Author(s):  
Hannah R. Lucas ◽  
Roxann C. Williams ◽  
Laura N. Hollar ◽  
Bethany Johnson-Javois ◽  
Heidi B. Miller ◽  
...  

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.


Author(s):  
Shofi Hesfianto

.......A patient who was first diagnosed with a chronic disease often does not fully understand the meaning or significanceof the chronic disease with which his/ her body suffers, against the risk of future complications if the disease is not well-controlled. On the other hand, in this reported case, the patient’s expectation was that her chronic disease, the T2DM, can be cured. Therefore, a shared understanding between health care providers and patient is likely the key to commencing the course of managing any chronic disease in a patient effectively.......


2014 ◽  
Vol 9 (1) ◽  
pp. 8-13
Author(s):  
MZ Rahman ◽  
MZ Islam ◽  
MJ Alam ◽  
S Sajjad ◽  
R Ara ◽  
...  

Introduction: Diabetes Mellitus (DM) is a major concern for the developed as well as developing countries. It poses with enormous disabilities and economic burden to the victims. The treatment cost of diabetes is increasing day by day. Aim: To ascertain how type 2 diabetes mellitus is incurring economic burden to the patients. Materials and Methods: This descriptive cross sectional study was conducted during the period from January to June 2010 on 110 type 2 diabetes mellitus patients attending Combined Military Hospital, Dhaka. The patients were selected conveniently and data were collected by face to face interview with the help of a semi-structured questionnaire. For estimation of economic burden, both direct and indirect treatment costs were calculated. Results: The study revealed that majority (36.4%) of the patients were in the age group of 46-55 years with the mean age of 53.65 (+10.44) years. Majority (60.0%) of them had lower monthly family income (Tk.5, 000-Tk.10, 000) and 36.4% of them lived in urban area. Most of the patients (90.9%) were under treatment with drug, diet control and physical exercise. Regarding sources of fund for treatment, 31.8% patients used their savings while 27.3% took loan, 20% got help from relatives and the remaining 20.9% got donation and sold wealth. Average treatment cost incurred by the patients was estimated to Tk. 5543.35 (+1273.29). Average direct treatment cost was estimated to Tk.2656.88 (+1367.23) of which average drug cost was Tk.653.36 (+476.36), investigation cost was Tk.596.73 (+375.56), travel cost Tk.530.31 (+795.46), attendant cost Tk.865.87 (+734.22) and consultation fee was Tk.244.48 (+167.22). Average indirect cost was calculated to Tk.3081.27 (+1275.91) which was only due to loss of income due to illness. Conclusion: The study findings will enable the health policy makers and health care providers at different levels to provide need based cost-effective health care services to reduce the economic burden of diabetes mellitus patients. DOI: http://dx.doi.org/10.3329/jafmc.v9i1.18718 Journal of Armed Forces Medical College Bangladesh Vol.9(1) 2013: 8-13


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