scholarly journals Health Care Transformation Initiatives in Type 2 Diabetes Care: A Qualitative Study in the Cincinnati Beacon Community

2015 ◽  
Vol 28 (2) ◽  
pp. 132-140
Author(s):  
Ronda Christopher ◽  
Tara Trudnak ◽  
Regina Hemenway ◽  
Sara Bolton ◽  
Barbara Tobias ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
Qualitative Study ◽  
Diabetes Care ◽  
Health Care Transformation

scholarly journals Preferences for mHealth Technology and Text Messaging Communication in Patients With Type 2 Diabetes: Qualitative Interview Study (Preprint)

2020 ◽  
Author(s):  
Julie C Lauffenburger ◽  
Renee A Barlev ◽  
Ellen S Sears ◽  
Punam A Keller ◽  
Marie E McDonnell ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
Mobile Technology ◽  
Diabetes Care ◽  
Technology Use ◽  
Text Messages ◽  
Self Management ◽  
Care Providers ◽  
Mhealth Technology

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.

scholarly journals Contacting dropouts from type 2 diabetes care in public primary health care: description of the patient population

2016 ◽  
Vol 34 (3) ◽  
pp. 267-273 ◽  
Author(s):  
Timo Kauppila ◽  
Merja K. Laine ◽  
Mikko Honkasalo ◽  
Marko Raina ◽  
Johan G. Eriksson
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
Primary Health Care ◽  
Diabetes Care ◽  
Patient Population ◽  
Primary Health

scholarly journals Perceptions of Type 2 Diabetes Patients Towards Diabetes Management Visits at Public Primary Health Care Centers with Diverse Opinions Towards Nurse-led Clinics in Muscat, Oman: A Pilot Qualitative Study

2020 ◽  
Vol 35 (6) ◽  
pp. e196-e196
Author(s):  
Kamila Al-Alawi ◽  
Ahmed Al-Mandhari
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
Primary Health Care ◽  
Qualitative Study ◽  
Diabetes Management ◽  
Primary Health ◽  
Primary Health Care Centers ◽  
Health Care Centers ◽  
Diabetes Patients

Objectives: The literature has described several positive outcomes related to diabetes management via nurse-led clinics. This is especially true where a shortage of physicians is recorded within a team-based approach. We sought to explore the perceptions of patients with type 2 diabetes towards the current diabetes management visits at public primary health care centers in Muscat, Oman and their opinions towards nurse-led diabetes management clinics. Methods: This pilot qualitative study included seven semi-structured interviews with type 2 diabetes patients from four purposely selected public primary health care centers in Muscat. Qualitative thematic analysis was applied. Results: Patients with type 2 diabetes expressed their satisfaction with the present diabetes management visits at public primary health care. Their opinions towards nurse-led clinic were diverse and divided patients into three categories: those who totally refused the nurse-led clinics, those who accepted the clinics but with reservations, and patients that totally accepted the nurse-led clinics. The patients’ main concern was the nurses’ abilities to handle and understand the disease and its management. Conclusions: Our pilot study revealed type 2 diabetes patients’ satisfaction with the current diabetes management clinics. However, transformation to nurse-led clinics within team-based approach requires further studies with a bigger sample size. Further studies on requirements related to the Omani health care system and a better understanding of patients’ worries and their readiness to accept the concept of nurse-led clinics and their outcomes are also recommended.

scholarly journals Developing a Shared Patient-Centered, Web-Based Medication Platform for Type 2 Diabetes Patients and Their Health Care Providers: Qualitative Study on User Requirements (Preprint)

2017 ◽  
Author(s):  
Gerda Bernhard ◽  
Cornelia Mahler ◽  
Hanna Marita Seidling ◽  
Marion Stützle ◽  
Dominik Ose ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
Qualitative Study ◽  
Focus Groups ◽  
Self Management ◽  
Care Providers ◽  
Patient Centered ◽  
Web Based ◽  
Access Methods

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.

scholarly journals Patient’s Experiences and Satisfaction in Diabetes Care and Out-of-Pocket Expenditure for Follow-Up Care Among Diabetes Patients in Urban Puducherry, South India

2020 ◽  
Vol 7 (6) ◽  
pp. 1445-1449
Author(s):  
TK Priya ◽  
Venkatachalam Jayaseelan ◽  
Yuvaraj Krishnamoorthy ◽  
Manikandanesan Sakthivel ◽  
Marie Gilbert Majella
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Health Care ◽  
Type 2 Diabetes Mellitus ◽  
Health Facility ◽  
Diabetes Care ◽  
Private Facility ◽  
Level Of Satisfaction ◽  
Diabetes Patients

Introduction: Type 2 diabetes mellitus has huge economic burden for both patient and health-care system. Management of the condition in India faces multiple challenges such as paucity of trained medical and paramedical staff, poor quality, lack of satisfaction with services, and unaffordability of services. Objective: To determine the level of satisfaction and the out-of-pocket expenditure for type 2 diabetes patients receiving treatment from public and private sectors in urban Puducherry. Methods: This was a cross-sectional analytical study conducted in Urban Health Centre area of tertiary care center from August to September 2016. A total of 200 patients suffering from type 2 diabetes mellitus for 1 year or more and resided for at least a year in Puducherry were included in the study. Among the 200 participants, 100 were receiving care from government and 100 from private facility. Result and conclusion: Median cost of diabetes care in government facility was 2000 INR while in private facility was 13050 INR. About 70.1% of the patients were satisfied with the health-care services received. There was no significant difference in the level of satisfaction between government and private health facility. Almost three-fourths of the diabetes patients are satisfied with the care received irrespective of the type of health facility. The cost of diabetes care is more for patients seeking care from private sector than public sector. Availability of insulin and free syringes in the primary health center, provision of specialized footwear, and spectacles free of cost can help in reducing the out-of-pocket expenditure.

scholarly journals Listening to Older Adults' Values and Preferences for Type 2 Diabetes Care: A Qualitative Study

2014 ◽  
Vol 27 (1) ◽  
pp. 44-49 ◽  
Author(s):  
E. A. Beverly ◽  
L. A. Wray ◽  
C. L. LaCoe ◽  
R. A. Gabbay
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Qualitative Study ◽  
Diabetes Care

scholarly journals Using the Self-Management Assessment Scale for Screening Support Needs in Type 2 Diabetes: Qualitative Study (Preprint)

2019 ◽  
Author(s):  
Ulrika Öberg ◽  
Carl Johan Orre ◽  
Åsa Hörnsten ◽  
Lena Jutterström ◽  
Ulf Isaksson
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
Primary Health Care ◽  
Qualitative Study ◽  
Screening Instrument ◽  
The Self ◽  
Self Management ◽  
Management Support ◽  
Primary Health

BACKGROUND Globally, most countries face a common challenge by moving toward a population-based structure with an increasing number of older people living with chronic conditions such as type 2 diabetes. This creates a considerable burden on health care services. The use of digital tools to tackle health care challenges established views on traditional nursing, based on face-to-face meetings. Self-management is considered a key component of chronic care and can be defined as management of the day-to-day impact of a condition, something that is often a lifelong task. The use of a screening instrument, such as the Self-Management Assessment Scale (SMASc), offers the potential to guide primary health care nurses into person-centered self-management support, which in turn can help people strengthen their empowerment and self-management capabilities. However, research on self-management screening instruments is sparse, and no research on nurses’ experiences using a digitalized scale for measuring patients’ needs for self-management support in primary health care settings has been found. OBJECTIVE This paper describes diabetes specialist nurses’ (DSNs) experiences of a pilot implementation of the SMASc instrument as the basis for person-centered digital self-management support. METHODS This qualitative study is based on observations and interviews analyzed using qualitative content analysis. RESULTS From the perspectives of DSNs, the SMASc instrument offers insights that contribute to strengthened self-management support for people with type 2 diabetes by providing a new way of thinking and acting on the patient’s term. Furthermore, the SMASc was seen as a screening instrument with good potential that embraces more than medical issues; it contributed to strengthening person-centered self-management support, and the instrument was considered to lead both parts, that is, DSNs and patients, to develop together through collaboration. CONCLUSIONS Person-centered care is advocated as a model for good clinical practice; however, this is not always complied with. Screening instruments, such as the SMASc, may empower both nurses and patients with type 2 diabetes with more personalized care. Using a screening instrument in a patient meeting may also contribute to a role change in the work and practice of DSNs.

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