Perceptions of healthcare professionals and people with type 2 diabetes on emotional support: a qualitative study

BackgroundType 2 diabetes mellitus (T2DM) is a demanding condition that impacts the person living with the condition physically and psychologically. Promoting emotional support is a key strategy to improve diabetes care.AimTo explore the views and experiences of people with T2DM and healthcare professionals (HCPs) on emotional support in diabetes care, and identify barriers and facilitators to the provision of emotional support in clinical practice.Design & settingA qualitative study in England with data collected from four focus groups.MethodFocus group discussions were conducted with people with T2DM (n = 10) and HCPs (n = 10). The analysis was informed by the framework method and principles of the constant comparative approach.ResultsEmotional support was lacking in diabetes primary care, and there was a need to normalise the emotional impact of T2DM. Barriers to emotional support included: lack of HCP confidence to discuss emotional issues; lack of counselling training; and time constraints in consultations. Inappropriate use of the word ‘depression’ creates a sense of taboo for those experiencing emotions other than depression.ConclusionConsensus between the two target groups indicated a strong need to integrate emotional support in diabetes care, and the need to support and train HCPs in addressing psychosocial aspects of T2DM. Shared language is recommended across diabetes services to appropriately refer to wellbeing. Addressing barriers and considering ways to incorporate emotional management in diabetes consultations is recommended, includings introducing HCP training to increase confidence and enhance counselling skills.

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Healthcare Professionals’ Perspectives on the Cross-Sectoral Treatment Pathway for Women with Gestational Diabetes during and after Pregnancy—A Qualitative Study

Journal of Clinical Medicine ◽

10.3390/jcm10040843 ◽

2021 ◽

Vol 10 (4) ◽

pp. 843

Author(s):

Anne Timm ◽

Karoline Kragelund Nielsen ◽

Ulla Christensen ◽

Helle Terkildsen Maindal

Keyword(s):

Type 2 Diabetes ◽

Qualitative Study ◽

Gestational Diabetes ◽

Healthcare Professionals ◽

Care Pathway ◽

Adverse Outcomes ◽

Treatment Pathway ◽

Healthy Behaviors ◽

The Cross

Gestational diabetes mellitus (GDM) increases the risk of adverse outcomes during and after pregnancy, including a long-term risk of type 2 diabetes. Women with GDM are treated by numerous healthcare professionals during pregnancy and describe a lack of preventive care after pregnancy. We aim to investigate healthcare professionals’ perspectives on the cross-sectoral treatment pathway for women with GDM—during and after pregnancy. A qualitative study was conducted using systematic text condensation. Nine healthcare professionals (two general practitioners, four midwives, two obstetricians and one diabetes nurse) were interviewed and eight health visitors participated in two focus group discussions., Three major themes emerged: (1) “professional identities”, which were identified across healthcare professionals and shaped care practices; (2) ”unclear guidelines on type 2 diabetes prevention after GDM”, which contributed to uncertainty about tasks and responsibilities during and after pregnancy; and (3) “cross-sectoral collaboration”, which relied heavily on knowledge transfers between hospitals, general practice and the local municipality. The findings implicate that clear, transparent guidelines for all sectors should be prioritized to strengthen cross-sectoral care to women with GDM during and after pregnancy. As a result, strong cross-sectoral care throughout the GDM care pathway may improve maternal health by supporting healthy behaviors, facilitate weight loss and reduce the risk of subsequent GDM and early onset diabetes.

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Same goals, different challenges: a systematic review of perspectives of people with diabetes and healthcare professionals on Type 2 diabetes care

Diabetic Medicine ◽

10.1111/dme.14625 ◽

2021 ◽

Author(s):

Soraia de Camargo Catapan ◽

Uthara Nair ◽

Len Gray ◽

Maria Cristina Marino Calvo ◽

Dominique Bird ◽

...

Keyword(s):

Systematic Review ◽

Type 2 Diabetes ◽

Diabetes Care ◽

Healthcare Professionals

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

Diabetes Spectrum ◽

10.2337/diaspect.28.2.132 ◽

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

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A qualitative study of patient experiences of Type 2 Diabetes care delivered comparatively by General Practice Nurses and Medical Practitioners

Journal of Clinical Nursing ◽

10.1111/jocn.13219 ◽

2016 ◽

Vol 25 (13-14) ◽

pp. 1977-1986 ◽

Cited By ~ 15

Author(s):

Eileen Boyle ◽

Rosemary Saunders ◽

Vicki Drury

Keyword(s):

Type 2 Diabetes ◽

General Practice ◽

Qualitative Study ◽

Diabetes Care ◽

Patient Experiences ◽

Medical Practitioners ◽

Practice Nurses

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Community Diabetes: An East London Perspective

Journal of the Royal Society of Medicine ◽

10.1177/014107680509800303 ◽

2005 ◽

Vol 98 (3) ◽

pp. 96-100 ◽

Cited By ~ 2

Author(s):

Susan V Gelding ◽

Shanti Vijayaraghavan ◽

Clare Davison ◽

Tahseen A Chowdhury

Keyword(s):

Type 2 Diabetes ◽

Primary Healthcare ◽

Diabetes Care ◽

Healthcare Professionals ◽

National Service ◽

High Quality ◽

National Service Framework ◽

The Uk ◽

Service Framework

The rising prevalence of type 2 diabetes in the UK has necessitated a change in the delivery of diabetes care, with a shift of focus from hospital to community. The National Service Framework for Diabetes has enshrined this approach, and the new General Medical Services (GMS2) contract rewards primary healthcare professionals for developing high-quality diabetes care. New approaches cross the primary/secondary care divide and are patient focused. The evolution of diabetes care in the UK is illustrated by service developments in Newham, East London.

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

Diabetes Spectrum ◽

10.2337/diaspect.27.1.44 ◽

2014 ◽

Vol 27 (1) ◽

pp. 44-49 ◽

Cited By ~ 6

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

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Diabetes care provided by national standards can improve patients' self‐management skills: A qualitative study of how people with type 2 diabetes perceive primary diabetes care

Health Expectations ◽

10.1111/hex.13247 ◽

2021 ◽

Author(s):

Rebecka Husdal ◽

Eva Thors Adolfsson ◽

Janeth Leksell ◽

Lena Nordgren

Keyword(s):

Type 2 Diabetes ◽

Qualitative Study ◽

Diabetes Care ◽

National Standards ◽

Self Management ◽

Management Skills

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Management of type 2 diabetes mellitus in people with severe mental illness: an online cross-sectional survey of healthcare professionals

BMJ Open ◽

10.1136/bmjopen-2017-019400 ◽

2018 ◽

Vol 8 (2) ◽

pp. e019400 ◽

Cited By ~ 6

Author(s):

Hayley McBain ◽

Frederique Lamontagne-Godwin ◽

Mark Haddad ◽

Alan Simpson ◽

Jacqui Chapman ◽

...

Keyword(s):

Mental Health ◽

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Mental Illness ◽

Type 2 Diabetes Mellitus ◽

Diabetes Care ◽

Health Professionals ◽

Healthcare Professionals ◽

Cross Sectional

ObjectivesTo establish healthcare professionals’ (HCPs) views about clinical roles, and the barriers and enablers to delivery of diabetes care for people with severe mental illness (SMI).DesignCross-sectional, postal and online survey.SettingTrusts within the National Health Service, mental health and diabetes charities, and professional bodies.ParticipantsHCPs who care for people with type 2 diabetes mellitus (T2DM) and/or SMI in the UK.Primary and secondary outcome measuresThe barriers, enablers and experiences of delivering T2DM care for people with SMI, informed by the Theoretical Domains Framework.ResultsRespondents were 273 HCPs, primarily mental health nurses (33.7%) and psychiatrists (32.2%). Only 25% of respondents had received training in managing T2DM in people with SMI. Univariate analysis found that mental health professionals felt responsible for significantly fewer recommended diabetes care standards than physical health professionals (P<0.001). For those seeing diabetes care as part of their role, the significant barriers to its delivery in the multiple regression analyses were a lack of knowledge (P=0.003); a need for training in communication and negotiation skills (P=0.04); a lack of optimism about the health of their clients (P=0.04) and their ability to manage T2DM in people with SMI (P=0.003); the threat of being disciplined (P=0.02); fear of working with people with a mental health condition (P=0.01); a lack of service user engagement (P=0.006); and a need for incentives (P=0.04). The significant enablers were an understanding of the need to tailor treatments (P=0.04) and goals (P=0.02) for people with SMI.ConclusionsThis survey indicates that despite current guidelines, diabetes care in mental health settings remains peripheral. Even when diabetes care is perceived as part of an HCP’s role, various individual and organisational barriers to delivering recommended T2DM care standards to people with SMI are experienced.

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Understanding the experiences of long-term maintenance of self-worth in persons with type 2 diabetes in Japan: a qualitative study

BMJ Open ◽

10.1136/bmjopen-2019-034758 ◽

2020 ◽

Vol 10 (8) ◽

pp. e034758

Author(s):

Asuka Kato ◽

Kazuhiro Yoshiuchi ◽

Yuko Fujimaki ◽

Shin Fujimori ◽

Yuka Kobayashi ◽

...

Keyword(s):

Type 2 Diabetes ◽

Glycaemic Control ◽

Qualitative Study ◽

Healthcare Professionals ◽

Sense Of Self ◽

Self Management ◽

Diabetes Treatment ◽

Cross Sectional ◽

Self Worth

ObjectivePersons with type 2 diabetes are often stigmatised for having what is considered a lifestyle-related disease. Accordingly, some blame themselves for their condition, resulting in feelings of low self-worth that ultimately impact their self-management behaviours. However, there are no studies examining why some do not blame themselves for their condition and manage to maintain their self-worth in relation to their illness. This study aimed to explore an understanding of how such persons experience the maintenance of self-worth in relation to their illness over the lifelong course of treatment.DesignA cross-sectional qualitative study. Face-to-face semistructured interviews were conducted with a purposive sampling strategy. The data was analysed using a qualitative descriptive method that involved concurrent data collection and constant comparative analysis.SettingTwo tertiary-level hospitals in Japan.ParticipantsThirty-three outpatients with type 2 diabetes who currently had good glycaemic control but had previously had poor glycaemic control.ResultsThree themes explaining the maintenance of self-worth were identified: (1) Participants gained ‘control’ over their illness by living a ‘normal life.’ They found a way to eat preferred foods, dine out with family and friends, travel and work as usual; (2) Participants discovered the positive aspects of type 2 diabetes, as they felt ‘healthier’ from the treatment and felt a sense of security and gratitude for the care they received from healthcare professionals; (3) Participants discovered a new sense of self-worth by moving towards goals for type 2 diabetes treatment and experienced inner growth through positive lifestyle choices.ConclusionsThe process of restoring and maintaining self-worth should be brought to the attention of healthcare professionals in diabetes care. These professionals could help patients discover positive self-representations through diabetes treatment (eg, a realisation that one does not lack self-control) and could aid in increasing patient engagement in diabetes self-management.

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