Exploring Barriers and Facilitators to Glycemic Control and Shared Medical Appointment Engagement in Underserved Patients with Diabetes

Ganetsky, Valerie S.; Shea, Judy A.; Szapary, Claire; Ikechi, Ronald; Keddem, Shimrit; Kaufman, Steven; Long, Judith A.

doi:10.1353/hpu.2022.0008

Cited by 7 publications

(4 citation statements)

References 27 publications

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“…On the other hand, fatalism may change their attitudes and behaviours regarding their experience of the disease. 62 Once patients attribute their disease to fate; such patients may believe that death is unpredictable and inevitable and that no one and nothing can change the outcome. 63 This belief represents a significant barrier to patients’ health behaviours and adherence.…”

Section: Discussionmentioning

confidence: 99%

“Alive Day is the Day”: A Qualitative Study of Experiences of Learned Helplessness in Maintenance Haemodialysis Patients

Xie¹,

Li²,

Li³

2023

RMHP

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Background Learned helplessness (LH) is a common psychological phenomenon among chronic disease patients. However, LH remains underrecognized in the context of maintenance haemodialysis (MHD) patients. This qualitative study is the first study of this topic to be conducted in a Chinese cultural context, and its purpose is to explore the LH experiences of MHD patients and to highlight their interpretations of LH. Methods We employed a qualitative research design. A purposive sampling method was used to recruit participants. The sample size was determined by data saturation. Data were obtained from MHD patients in a blood purification centre located in Hunan Province, China. Data were collected from June to September 2022. The researchers conducted in-depth, semistructured interviews with participants after obtaining informed consent. Texts were transcribed verbatim from the audio recordings of these interviews. Data processing and analysis were based on Giorgi’s phenomenological approach. Results Twenty-two respondents completed the interviews (aged 29–75 years, including ten females and twelve males). Four themes emerged from the interviews: (1) triggers of helplessness (hope is gone; witnessing renal friends’ helplessness; out of control; nothing works); (2) being tied down (limitation; perceived loss; social isolation; giving in); (3) I am just a loser (self-image disorder; low self-concept; negative attitudes; guilt; abandonment); (4) alive day is the day (fatalism; my duty; downwards comparison). Conclusion The study reveals that multiple stressors drive MHD patients’ LH. These salient phenomena demonstrate the importance of recognizing MHD patients’ LH. We suggest that support services should be developed alongside a framework that addresses MHD patients’ LH from the beginning of treatment.

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Section: Discussionmentioning

confidence: 99%

“Alive Day is the Day”: A Qualitative Study of Experiences of Learned Helplessness in Maintenance Haemodialysis Patients

Xie¹,

Li²,

Li³

2023

RMHP

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“…As SMAs tend to focus on development of self-management skills, including diet and exercise, not accounting for these needs may leave participants unable to enact these behavioral changes. 52,53 For example, screening people with diabetes for social needs such as food insecurity and referring those with needs to services may lead to improved ability to enact behaviors associated with diabetes self-care, as has been demonstrated previously. 54 This The higher use of insulin at FQHCs compared with non-FQHCs is an interesting finding that deserves more investigation.…”

Section: Discussionmentioning

confidence: 91%

The Psychosocial Needs of Patients Participating in Diabetes Shared Medical Appointments

Nederveld¹,

Gurfinkel²,

Hosokawa³

et al. 2022

J Am Board Fam Med

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Background: Patient reported outcomes (PROs) for diabetes are self-reported and often give insight into outcomes important to people with diabetes. Federally Qualified Health Centers (FQHCs) see patients who may have higher levels of diabetes distress and lower levels of self-care behaviors.Methods: The Invested in Diabetes study is a comparative effectiveness trial of diabetes Shared Medical Appointments (SMAs) in FQHCs and non-FQHC settings. PROs measure outcomes including validated measures on diabetes distress.Setting and Participants: 616 people from 22 practices completed PROs prior to SMAs. At FQHCs, participants were younger (average 57.7 years vs 66.9 years, p < 0.0001), more likely to be female (36.8% vs 46.1%, p = 0.02), and fewer spoke English (72.7% vs 99.6%, p < 0.0001).Results: At FQHCs, diabetes distress was higher (2.1 vs 1.8, P = .02), more people were current smokers (14.3% vs 4.7%, P = .0002), on insulin (48.9% vs 22.3%, P < .0001) and reported food insecurity (52.7% vs 26.2%, P < .0001). After controlling for sociodemographic factors, these differences were nonsignificant.Conclusions: Higher numbers of patients at FQHCs report diabetes distress and food insecurity compared with patients in non-FQHC settings, indicating that patient social circumstances need to be considered as part of program implementation.

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“…It is used as the main indicator for assessing the variability of body glucose levels. Variability is used for predicting the final complications of DM, both microvascular and macrovascular complications ( Ganetsky et al, 2022 ; Vigersky et al, 2018 ).…”

Section: Discussionmentioning

confidence: 99%

Spousal Involvement in Collaborative Management and Glycemic Behavior Change among Patients with Diabetes Mellitus: A Systematic Review

Pratiwi,

Nursalam,

Widyawati

et al. 2024

SAGE Open Nursing

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Introduction The marked increase in the number of individuals with diabetes mellitus (DM) worldwide each year has resulted in the importance of the spouse's contribution to the promotion and support of patient self-management programs. Objectives This study aimed to systematically explore the role or involvement of spouses in collaborative management and glycemic behavior change in DM. Methods Five databases including Scopus, PubMed, Cumulative Index of Nursing and Allied Health Literature, SAGE, and Web of Science were reviewed for relevant articles retrieved from 2017 to 2022. Literature search used keywords, including “Spouse,” “Support,” “Self-management,” “Glycemic Control,” and “Diabetes mellitus.” The Joanna Briggs Institute guidelines were used for appraisal review of journals. The component of partner support in the self-management of patients with DM is associated with an increase in the patient's glycemic level. Results Twenty-five studies were identified that describe the different spousal roles and strategies in the promotion and support of DM management. Overall, spouses’ involvement positively impacted healthy diets, higher self-efficacy, improved quality of psychological well-being, increased perceived support, and changes in glycemic-influenced behavior. Adaptation in the spouse patient relationship including maintaining cohesiveness can result in positive coping is essential in normalizing and contextualizing the chronic condition of DM. Partner-based collaboration is important for diabetes management, overcoming management barriers, and generating communal coping. Conclusion This systematic review observed that the involvement of a spouse is important in improving collaborative management and results in better glycemic behavior in patients with DM. A better understanding of the relationship between spousal involvement, coping strategies, and adherence in daily management and the subsequent use of this information are highly useful for creating targeted and effective interventions.

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Exploring Barriers and Facilitators to Glycemic Control and Shared Medical Appointment Engagement in Underserved Patients with Diabetes

Cited by 7 publications

References 27 publications

“Alive Day is the Day”: A Qualitative Study of Experiences of Learned Helplessness in Maintenance Haemodialysis Patients

“Alive Day is the Day”: A Qualitative Study of Experiences of Learned Helplessness in Maintenance Haemodialysis Patients

The Psychosocial Needs of Patients Participating in Diabetes Shared Medical Appointments

Spousal Involvement in Collaborative Management and Glycemic Behavior Change among Patients with Diabetes Mellitus: A Systematic Review

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