Diabetes care and service access among elderly Vietnamese with type 2 diabetes

Abstract

BackgroundVietnamese patients are disproportionately represented in type 2 diabetes mellitus statistics and also incur high rates of diabetes complications. This situation is compounded by limited access to health care. The aim of this project was to gain a deeper understanding of the difficulties Vietnamese patients experience when accessing services and managing their type 2 diabetes mellitus, and to identify factors that are important in promoting health service use.MethodsThree focus groups with 15 Vietnamese participants with type 2 diabetes mellitus, 60 to >70 years of age, were conducted in Vietnamese. Open-ended questions were used and focussed on experiences of living with diabetes and access to healthcare services in the Inner Northwest Melbourne region. Audio recordings were transcribed and then translated into English. Data were analysed using a thematic analysis framework.ResultsFindings indicate four main themes, which together provide some insight into the experiences of living with diabetes and accessing ongoing care and support, for elderly Vietnamese with type 2 diabetes. Themes included: (1) the value of being healthy; (2) controlling diabetes; (3) staying healthy; and (4) improving services and information access.ConclusionsParticipants in this study were encouraged to adhere to diabetes self-management principles, based largely on a fear of medical complications. Important aspects of healthcare access were identified as; being treated with respect, having their questions answered and having access to interpreters and information in Vietnamese. Attention to these details is likely to lead to improved access to healthcare services and ultimately to improve glycemic control and overall health status for this community.

Incorporating patients’ perspectives into the initial stages of core outcome set development: a rapid review of qualitative studies of type 2 diabetes

“…These 26 included studies involved either qualitative interviews (69%) or focus groups (31%) with a total of 976 patients (median 23 participants, range 5–246) from five continents. All studies included participants with type 2 diabetes with some studies focusing on particular minority groups 37–42. Time since diagnosis of diabetes ranged from less than 1 year up to 51 years, although this was not reported in all studies.…”

“…Relatedly, 10 studies39 42 47–50 52 55–57 described patients feeling worried or anxious about symptoms, complications, health deterioration, and ultimately dying prematurely as a result of their diabetes. Patients also commented on how diabetes was a burden44 47 58 59 and reported experiencing aggression and frustration,38 39 43 47 49 51 56 57 59–61 sadness and depression,37–39 43 47 52 56 59 guilt43 44 54 and hopelessness 43 44 52 54…”

“…Exercise was identified as an outcome in 16 studies, with patients acknowledging the importance of regular exercise and the benefits it brings; however, some patients labelled it a burdensome activity, which they had difficulty engaging in 37 39 40 42–46 48 50 52 53 56–58 61. In 15 studies, patients referred to the self-monitoring activities they engaged in to manage their diabetes, for example, regularly checking blood glucose levels,37–41 44 47 49 50 52 55–57 61 62 with many emphasizing that the need for a strict self-management regime had become a burden on their lives. Dietary restrictions were a common difficulty relating to self-management, with many patients articulating a desire for dietary freedom, where they could eat what they want, when they want 37 38 44 46 49 57 61…”

Experiences of diabetes self‐management: a focus group study among Australians with type 2 diabetes

“…Similar findings appear in earlier work in this field where a number of studies indicate that participants are fearful of future diabetes complications (Carolan‐Olah et al . , Park & Wenzel ), often in excess of the actual risk of those complications (Asimakopoulou et al . ).…”

“…, Carolan‐Olah et al . ), and this prevalence is now considered to have reached epidemic proportions (Zimmet et al . ).…”