&lt;p&gt;A Qualitative Exploration of Facilitators and Barriers for Diabetes Self-Management Behaviors Among Persons with Type 2 Diabetes from a Socially Disadvantaged Area&lt;/p&gt;

Christensen, Nina Ingemann; Drejer, Sabina; Burns, Karin; Lundstrøm, Sanne Lykke; Hempler, Nana Folmann

doi:10.2147/ppa.s237631

Cited by 24 publications

(38 citation statements)

References 52 publications

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“…23 Such a result matches the findings of previous studies, which considered family members, friends, and peers of patients with diabetes as primary promoters of selfmanagement. 30,59,61 Similarly, quantitative studies have also indicated that a higher level of social support is associated with better adherence to recommended selfmanagement behaviors. [62][63][64] In conclusion, there was insufficient support to encourage diabetic selfmanagement of the isolated patients.…”

Section: Discussionmentioning

confidence: 99%

“… 58 Other qualitative studies have reported similar findings whereby patients with limited resources were particularly challenged when seeking medical services or obtaining care and support. 59 , 60 Apart from the scarcity of guidance from healthcare providers, the participants also identified the lack of family support as another barrier to diabetes self-management. During the isolation period, it is difficult for diabetes patients to obtain knowledge, care, and material support from their family members, although this support was essential for promoting lifestyle changes and improving self-management behavior in patients with diabetes.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

<p>Barriers to Self-Management of Type 2 Diabetes During COVID-19 Medical Isolation: A Qualitative Study</p>

Shi¹,

Zhu²,

Li³

et al. 2020

DMSO

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Purpose: Diabetes self-management behaviors are necessary to obtain optimum glycemic control, reduce the risk of complications, and improve health outcomes. The COVID-19 pandemic imposes an additional struggle for self-management by diabetes patients. Although previous studies have reported socio-demographic, behavioral, psychological, and cultural barriers to diabetes self-management, little is known about perceived barriers to diabetes self-management among patients during isolation following their recovery from COVID-19. The purpose of this study was to explore perceived barriers among type 2 diabetes patients during isolation following their recovery from COVID-19. Patients and Methods: A qualitative, exploratory, and descriptive research design was utilized. Semi-structured telephonic interviews were conducted with 12 patients with diabetes who had been discharged from one COVID-19 designated hospital and underwent isolation in the designated facilities in Wuhan City, Hubei Province, China. Data were analyzed using Colaizzi's seven steps. Results: Barriers to diabetes self-management identified by patients with diabetes during isolation were categorized into five major themes: inadequate knowledge and behavioral beliefs, shortage of resources, suffering from health problems, negative emotions, and lack of support. Conclusion: Perceived barriers to diabetes self-management described by diabetes patients indicated a lack of environmental resources and support strategies to meet their needs. Efforts to remove barriers are important in assisting patients with diabetes to improve their quality of life and health outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

<p>Barriers to Self-Management of Type 2 Diabetes During COVID-19 Medical Isolation: A Qualitative Study</p>

Shi¹,

Zhu²,

Li³

et al. 2020

DMSO

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“…These findings are consistent with studies of DSME with other populations. [17][18][19] The preliminary results of this pilot study are also encouraging. The mean decrease in HbA1c of 0.7% was not statistically significant, likely due to the small sample size.…”

Section: Discussionmentioning

confidence: 56%

Pilot Implementation of Adapted-Family Diabetes Self-Management Education Into a Clinical Setting

McElfish

Long

Scott

et al. 2020

J Prim Care Community Health

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Objectives: Marshallese are a Pacific Islander community that experience a disproportionate rate of type 2 diabetes. The purpose of this study is to evaluate the preliminary effectiveness and feasibility of an Adapted-Family Diabetes Self-Management Education (DSME) intervention among Marshallese adults diagnosed with type 2 diabetes and their family members when delivered in a clinical setting. Methods: Marshallese patients (primary participants) with type 2 diabetes (n = 10) and their family members (n = 10) enrolled in a pilot study deigned to evaluate an Adapted-Family DSME curriculum conducted by community health workers and a certified diabetes educator in a clinical setting. Primary and family participants’ health information and biometric data (HbA1c, blood pressure, cholesterol, and body mass index) were collected at preintervention and 12 weeks postintervention. Results: All 10 primary participants and 8 of the family members received all 10 hours of the education intervention. Nine of the 10 primary participants and 8 of the 10 family members completed the pre- and postintervention data collection events. Primary participants demonstrated a mean decrease in HbA1c of 0.7%, from pre- to postintervention, as well as improved blood pressure and cholesterol. Family members demonstrated minor improvements in HbA1c and blood pressure. Conclusions: Results suggest preliminary effectiveness and feasibility of the Adapted-Family DSME in a clinic setting and will inform implementation of a fully powered study.

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“…Furthermore, peer support has bene tted health outcomes, such as self-reported health status, emotional distress and glycaemic and blood pressure control (8,9,(11)(12)(13). Finally, peer support is highlighted for its potential to support socially vulnerable people in managing their T2D (14)(15)(16). Often, this group is referred to as people with low socioeconomic status, such as low levels of income, education, employment and social relations (14,(16)(17)(18).…”

Section: Introductionmentioning

confidence: 99%

“…Often, this group is referred to as people with low socioeconomic status, such as low levels of income, education, employment and social relations (14,(16)(17)(18). This population group have a higher risk of developing complications of T2D (15,19), often face multiple barriers to accessing healthcare services (14,15,20) and experience worse health outcomes (21). However, even though socioeconomic differences exist in access to healthcare services, as well as the treatment and consequences of T2D (16,19,20,22), no studies have, to our knowledge, focused on the implementation of peer support programmes for socially vulnerable people with T2D.…”

Section: Introductionmentioning

confidence: 99%

Understanding the Mechanisms Generating Outcomes in a Danish Peer support Intervention for Socially Vulnerable People with type 2-Diabetes: A Realist Evaluation

Garn

Glümer

Villadsen

et al. 2021

Preprint

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Background: Despite increasing use and positive effects of peer support interventions, little is known about how they produce outcomes. Thus, it is essential not only to measure outcomes, but also to identify the mechanisms by which they are generated. Using a realist evaluation approach, we aimed to identify the mechanisms generating outcomes in a Danish peer support intervention for socially vulnerable people with type 2-diabetes (peers). By investigating how the peers interacted in the intervention, we further examined how peers’ individual contextual factors facilitated or hindered the mechanisms in operation.Methods: We used a multi-method case-study design (n=9). Data included semi-structured interviews with four key groups of informants (peer, peer supporter, project manager and a diabetes nurse) for each case (n=25). Furthermore, we collected survey data from peers both before and after participation (n=9). The interview data were analysed using a systematic text condensation, and the Intervention-context-actor-mechanism-outcome framework was used to structure the analysis.Results: We identified two groups of mechanisms that improved diabetes self-management and the use of healthcare services (outcomes): ‘perceived needs and readiness’ and ‘encouragement and energy’. However, the mechanisms only generated the intended outcomes among peers with a stable occupation and financial situation, a relatively good health condition, and sufficient energy (all defined as contextual factors). Independent of these contextual factors, ‘experience of social and emotional support’ was identified as a mechanism within all peers that increased self-care awareness (defined as output). Dependent on whether the contextual factors facilitated or hindered the mechanisms to generate outcomes, we categorised the peers into those who achieved outcomes and those who did not. Conclusions: We identified two groups of mechanisms that improved the peers’ diabetes self-management and use of healthcare services. The mechanisms only generated the intended outcomes if peers’ individual contextual factors facilitated an active interaction with the elements of the intervention. However, independent of these contextual factors, a third group of mechanisms increased self-care awareness among all peers. We highlight the importance of contextual awareness of the target groups in the design and evaluation of peer support interventions for socially vulnerable people with type 2-diabetes.Trial registration: ClinicalTrials.gov, Retrospective Registration (01/20/2021), registration number NCT04722289, https://clinicaltrials.gov/ct2/show/NCT04722289?term=The+Together+on+Diabetes+Intervention+-+a+Realist+Evaluation%2C&draw=2&rank=1

show abstract

<p>A Qualitative Exploration of Facilitators and Barriers for Diabetes Self-Management Behaviors Among Persons with Type 2 Diabetes from a Socially Disadvantaged Area</p>

Cited by 24 publications

References 52 publications

<p>Barriers to Self-Management of Type 2 Diabetes During COVID-19 Medical Isolation: A Qualitative Study</p>

<p>Barriers to Self-Management of Type 2 Diabetes During COVID-19 Medical Isolation: A Qualitative Study</p>

Pilot Implementation of Adapted-Family Diabetes Self-Management Education Into a Clinical Setting

Understanding the Mechanisms Generating Outcomes in a Danish Peer support Intervention for Socially Vulnerable People with type 2-Diabetes: A Realist Evaluation

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