Diabetes at Home

2018 ◽  
pp. 110-128
Author(s):  
Mari Armstrong-Hough
Keyword(s):  
Type 2 Diabetes ◽  
Health Care Providers ◽  
Japanese Patients ◽  
Illness Narratives ◽  
Explanatory Models ◽  
Care Providers ◽  
Healthy Life ◽  
Regular Rhythm

This chapter uses interview data collected from Japanese patients, members of the general public, and health care providers to examine personal explanatory models and illness narratives surrounding type 2 diabetes. Participants articulated a model of health that revolves around the idea of an “ordered” life. In particular, order comes from careful adherence to a classification of time and relies on a clear division of domestic labor. Having a “rhythm” to one’s life, and observing regular, unchanging hours for core activities like waking, eating, and bathing were identified as key to a healthy life. But the responsibility for this temporal maintenance falls largely on women: women work to organize the time of loved ones into a healthy, regular rhythm. Men without mothers, wives, sisters, or daughters to take care of them are thus thought to be particularly at risk of illness.

scholarly journals Understanding Gestational Diabetes, Future Diabetes Risk, and Diabetes Prevention: A Qualitative Study of Patient, Provider and Staff Perspectives

2021 ◽  
Author(s):  
Hannah R. Lucas ◽  
Roxann C. Williams ◽  
Laura N. Hollar ◽  
Bethany Johnson-Javois ◽  
Heidi B. Miller ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Gestational Diabetes ◽  
Health Care Providers ◽  
Diabetes Prevention ◽  
Diabetes Risk ◽  
Care Providers ◽  
Diabetes Screening ◽  
Structured Interviews ◽  
Future Diabetes

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.

scholarly journals Sociocultural Influences on African Americans’ Representations of Type 2 Diabetes: A Qualitative Study

2018 ◽  
Vol 28 (1) ◽  
pp. 25 ◽  
Author(s):  
Olayinka O. Shiyanbola ◽  
Earlise Ward ◽  
Carolyn Brown
Keyword(s):  
Type 2 Diabetes ◽  
African Americans ◽  
Racial Discrimination ◽  
Health Care Providers ◽  
Eating Habits ◽  
Cultural Beliefs ◽  
Sociocultural Factors ◽  
Diabetes Diagnosis ◽  
Care Providers

<p class="Pa7"><strong>Objective: </strong>Illness representations, known as patients’ beliefs and expectations about an illness, may be influenced by cultural beliefs and personal experiences. This study explored African Americans’ perceptions of the sociocultural factors that influence their representations of diabetes.</p><p class="Pa7"><strong>Design: </strong>Six semi-structured focus groups.</p><p class="Pa7"><strong>Setting: </strong>Private space at a convenient site.</p><p class="Pa7"><strong>Participants: </strong>Forty African Americans, aged 45-60 years with type 2 diabetes for at least one year prior.</p><p class="Pa7"><strong>Results: </strong>Participants perceived that there was a race-mediated effect of how they developed diabetes because of poverty due to past slavery, racial discrimination by health care providers, and the stigma associated with diabetes within the African American community. Participants perceived that pov­erty influenced African Americans’ unhealthy eating habits, which led to diabetes diagnosis among their ancestors and their develop­ment of the disease since it was hereditary. Participants also perceived that there was provider ill intention, ie, providers were pur­posefully making people sick, and their lack of education on diabetes from providers was done on purpose, as information on diabetes was withheld and not shared due to racial discrimination. Perceived stigma by the com­munity led to African Americans’ avoidance and denial of the disease, and subsequently the development of diabetes.</p><p class="Pa7"><strong>Conclusions: </strong>To enhance disease manage­ment for African Americans with diabetes, it is important to focus on the sociocultural context of how African Americans view their world that may be influenced by their knowl­edge of negative historical circumstances and their current provider relationship, which, in turn, may be reflected in their perceptions of diabetes.</p><p class="Pa7"><em>Ethn Dis. </em>2018;28(1):25-32; doi:10.18865/ed.28.1.25.</p>

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 ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Health Care ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Health Care Providers ◽  
Diabetes Risk ◽  
Care Providers

scholarly journals A socioecological perspective : the "ups and downs" of living with type 2 diabetes among working adults in the rural south

2019 ◽  
Author(s):  
◽  
Lynn E. Glenn
Keyword(s):  
Type 2 Diabetes ◽  
Health Services ◽  
Health Care Providers ◽  
Preventive Health Services ◽  
Patient Activation ◽  
Preventive Health ◽  
Self Management ◽  
Care Providers ◽  
Working Adults

Persons with higher patient activation levels are more likely to engage in preventive health behaviors. This qualitative study addressed a population that may be particularly vulnerable to poor diabetes outcomes: rural, working adults with type 2 diabetes (T2 DM) with low levels of patient activation. This study sought to gain a better understanding of the individual, interpersonal, health system, and community spheres of influence on engagement in diabetes self-management and recommended preventive health services among rural, working adults. A socioecological approach, based on Fisher's (2005) Resources and Supports for Self-Management Model, guided the study. The Patient Activation Measure (PAM-10) was used to identify individuals with low patient activation. Participants (N = 20) had PAM-10 scores less than 75 (M = 59.4) and were predominately African American (n = 12) and female (n = 14), earning incomes less than $50,000 (n = 13). The overarching theme, "ups and downs" of living with diabetes, emerged from the data. Four other major themes emerged: "the struggle", "you don't talk about it", "diabetes is not the priority", and "we're lucky to have what we have". Most participants had social support, employer health benefits, and a trusting, satisfactory relationship with health care providers. However, a lack of equitable workplace and community resources may have contributed to lack of engagement in diabetes self-management and preventive health services.

scholarly journals Case Report: Type 2 Diabetes Mellitus

2018 ◽  
Vol 1 (2) ◽  
pp. 45
Author(s):  
Shofi Hesfianto
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Health Care ◽  
Chronic Disease ◽  
Health Care Providers ◽  
The Other ◽  
Shared Understanding ◽  
Care Providers ◽  
Patient’S Expectation

.......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.......

scholarly journals Faktor Pemicu Diabetes Tipe 2 Ditinjau dari Mata Pencaharian

2019 ◽  
Author(s):  
Felicia Acramin
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Health Care Providers ◽  
Healthy Lifestyle ◽  
Care Providers ◽  
Diet Pattern ◽  
Unhealthy Diet ◽  
Genetic And Environmental Factors ◽  
P Type

Type 2 diabetes or diabetes mellitus is the most common type of diabetes in which it's prevalence has been increasing globally, especially in Indonesia. Diabetes mellitus is a multifactorial disease, triggered by both genetic and environmental factors (such as sedentary lifestyle, obesity, and unhealthy diet) that are responsible for dysregulation of glucose metabolism in type 2 diabetes. Complications of diabetes have led to the decreasing quality of life in people with DM. The objective of this study was to observe livelihood factor (including lifestyle and diet factors) as factors contributing to type 2 diabetes risk in persons with DM. The method of this study was descriptive design with qualitative approach. The data were gathered by conducting in-depth interview with five DM sufferers that had five different jobs. The result of the interview showed that DM sufferers with various type of jobs had different patterns in lifestyle and diet leading to hyperglycemia and increased insulin resistance. As a result, those pathophysiological features developed into type 2 diabetes in DM sufferers. This study has major implication for the prevention of type 2 diabetes. It is recommended that health care providers should improve the patients and their family understanding about type 2 diabetes and improve the management of healthy lifestyle and diet pattern.

scholarly journals Needs and resources of people with type 2 diabetes in peri-urban Cochabamba, Bolivia: A people-centred perspective.

2021 ◽  
Author(s):  
Christine Leyns ◽  
Niek Couvreur ◽  
Sara Willems ◽  
Ann Van Hecke
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
Health System ◽  
Health Care Providers ◽  
Treatment Plan ◽  
Public Healthcare ◽  
Care Providers ◽  
Low Literacy ◽  
Traditional Use

Abstract Background: The rising prevalence of type 2 diabetes results in a worldwide public healthcare crisis, especially in low- and middle-income countries (LMICs) with unprepared and overburdened health systems mainly focused on infectious diseases and maternal and child health. Studies regarding type 2 diabetes in LMICs describe specific interventions ignoring a comprehensive analysis of the local factors people see influential to their health. This study aims to meet this research gap by exploring what people with type 2 diabetes in Bolivia need to maintain or improve their health, how important they perceive those identified needs and to what extent these needs are met.Methods: From March until May 2019, 33 persons with type 2 diabetes from three periurban municipalities of the department of Cochabamba participated in this study. The concept mapping methodology by Trochim, a highly structured qualitative brainstorming method, was used to generate and structure a broad range of perspectives on what the participants considered instrumental for their health.Results: The brainstorming resulted in 156 original statements condensed into 72 conceptually different needs and resources, structured under nine conceptual clusters and four action domains. These domains illustrated with vital needs were: (1) self-management with use of plants and the possibility to measure sugar levels periodically; (2) healthcare providers with the need to trust and receive a uniform diagnosis and treatment plan; (3) health system with opportune access to care and (4) community with community participation in health and safety, including removal of stray dogs.Conclusions: This study identifies mostly contextual factors like low literacy levels, linguistic problems in care, the need to articulate people's worldview including traditional use of natural remedies with the Bolivian health system and the lack of expertise on type 2 diabetes by primary health care providers. Understanding the needs and structuring them in different areas wherein action is required serves as a foundation for the planning and evaluation of an integrated people centred care program for people with type 2 diabetes. This participative method serves as a tool to implement the often theoretical concept of integrated people centred health care in health policy and program development.

scholarly journals Carbohydrate Knowledge and Expectations of Nutritional Support among Five Ethnic Groups Living in New Zealand with Pre- and Type 2 Diabetes: A Qualitative Study

Nutrients ◽  
2018 ◽  
Vol 10 (9) ◽  
pp. 1225 ◽  
Author(s):  
Zhuoshi Zhang ◽  
John Monro ◽  
Bernard Venn
Keyword(s):  
Type 2 Diabetes ◽  
New Zealand ◽  
Nutrition Education ◽  
Ethnic Groups ◽  
Health Care Providers ◽  
Active Role ◽  
Care Providers ◽  
Nutritional Knowledge ◽  
Plain Language

Despite availability of diabetes and nutrition information for people with pre- and type 2 diabetes, the uptake and understanding of these resources may differ among ethnic groups. Our objective was to explore dietary knowledge and diabetes experiences amongst Māori, European, Pacific Island, Indian and East Asian people living in New Zealand with a focus on carbohydrate-containing foods. A registered diabetes dietitian led ethnic-specific discussions in groups involving 29 people with pre- or type 2 diabetes. Discussions were audio-recorded, fully transcribed and coded independently by two investigators. Themes were developed using deductive and inductive techniques. Five themes emerged: knowledge, concerns, achievements, simplicity and self-determination. Nutritional knowledge was lacking and a greater awareness of trustworthy dietary resources was needed. There were concerns about diabetes complications and appropriate carbohydrate-containing foods and portions. Contrary to this, people felt proud when achieving dietary goals and grateful for support from health care providers and family. Participants were willing to engage in self-care if advice from health professionals was given in plain language, and in a culturally appropriate manner. Given the desire to take an active role in diabetes self-management and willingness to use electronic devices, an ethnic-specific nutrition education resource could be a valuable tool.

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.

Diabetes Self-Management Education and Self-Efficacy Among African American Women Living With Type 2 Diabetes in Rural Primary Care

2017 ◽  
Vol 10 (1) ◽  
pp. 11-16
Author(s):  
Cynthia Harrington ◽  
Heather D. Carter-Templeton ◽  
Susan J. Appel
Keyword(s):  
Type 2 Diabetes ◽  
African American ◽  
African American Women ◽  
Health Care Providers ◽  
Self Efficacy ◽  
Self Management ◽  
Health Clinic ◽  
Care Providers ◽  
American Women

African American women suffer the highest prevalence of type 2 diabetes (T2D). Self-efficacy is important for optimal diabetes self-management (DSM). Purpose: To evaluate DSM by comparing pre- and postintervention responses to a diabetes self-efficacy scale. Design: Descriptive pilot study. Sample: Participants for this study were N = 15 African American women aged 25–65 years (M = 47.4 years) and recruited from a rural health clinic in the Southeastern United States, who received a 4-hr DSM class. Method: Data were collected using the Stanford Self-Efficacy for Diabetes (SED). Results: The increase in the pre- and posttest SED scores were statistically significant, (p < .001). Implications for Nursing: Health care providers should tailor a diabetes education program for these individuals living with T2D. Through a collaborative patient–provider relationship to care, individuals may ultimately experience increased self-efficacy leading to improved DSM.

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