Individualized Health Care for Older Diabetes Patients from the Perspective of Health Professionals and Service Consumers

Abstract

Background: Individualized nursing care as a form of person-centered care delivery is a well-known approach in the health care context and is accepted as best practice by organizations and professionals, yet its implementation in everyday practice creates serious challenges. The aim was to assess and compare the perceptions of health professionals and older diabetes patients on their individual care in regard to the patient’s clinical situation, personal life situation, and decisional control. Methods: The quantitative study with a cross-sectional survey design was conducted from March 2019 until January 2021. The Individualized Care Scale was applied for the data collection. Health professionals (nurses and physicians, n = 70) and older diabetes patients (n = 145) participated in the study. The average duration of diabetes was 15.8 years (SD = 10.0) and type 2 diabetes was the most common (89.0%). The current glucose-lowering therapy for 51.0% of the patients was oral medications, 37.9% used injected insulin, and 11.1% were treated by combined therapy. Results: The highest-rated aspects of individualized care on both dimensions of the scale from the health professionals’ perspective related to the clinical situation, and the scores for provision were significantly higher than those for support. The highest means of patients’ ratings on the support dimension related to the clinical situation and the decisions over care sub-scale; for the care provision dimension, the highest individuality in care was assigned to the decisions over care sub-scale. The lowest ratings of individualized care, both in the health professionals’ and patients’ samples, related to the personal life situation sub-scale. Conclusions: Health professionals are more positive in regard to individualized care support and provisions for older diabetes patients than the patients themselves. Patient characteristics, such as the type of glucose-lowering therapy, education, and nutritional status, make a difference in patients’ understanding and experience of individuality in care.

Patients’ Characterization of Medication, Emotions, and Incongruent Perceptions around Adherence

“…By all definitions, open discussion with patients about how they are taking their medication is crucial. Previous studies have demonstrated the benefits of patient-centered care and the association it has with empowerment and adherence [13,[60][61][62][63]. Healthcare and research teams could explore ways to provide individual patients with appropriate parameters for adjusting or strategically managing treatment regimens as needed.…”

Individualized care for older adults with diabetes and its relationship with communication, psychosocial self‐efficacy, resources and support for self‐management and socio‐demographics

“…Detailed results about the assessments of individuality in care of Lithuanian older patients with diabetes were reported previously (Bartkeviciute et al, 2021). This paper presents an analysis of effective health communication, psychosocial self-efficacy of patients, access to diabetes-related resources and support and socio-demographics as they relate to the individualized care of older patients with diabetes mellitus.…”

“…The Communication Assessment Tool (CAT), The Diabetes Empowerment Scale (DES) and The Resources and Support for Self-Management scale (RSSM) were translated into the Lithuanian language and back again into English (Maneesriwongul & Dixon, 2004). Validation of the ICS patient version in Lithuanian was reported in a previous publication (Bartkeviciute et al, 2021).…”

Uncovering the Imprints of Chronic Disease on Patients’ Lives and Self-Perceptions

“…It is imperative to hear and respect patients’ voices and incorporate multidimensional therapies targeting biological and psychological pains concordantly [ 27 , 28 , 29 ]. Research in rheumatology and other medical disciplines have predominately evaluated the patients’ conditions quantitatively [ 30 , 31 ]. This study utilized qualitative methods to uncover and synthesize lesser-understood psychological burdens, whether from or in combination with physical encumbrances.…”