Type 2 diabetes management: Patient knowledge and health care team perceptions, South Africa

Abstract

BackgroundSouth African research indicates that the highest death rates between 2004 and 2005 were from diabetes mellitus. There is minimal research information on interactions between what patients know about their disease and what health professionals perceive that patients should know to control their disease well.ObjectivesThis study determined the knowledge that patients with type 2 diabetes have about the management of their disease, as well as the perceptions of the health care team about the services given to patients.MethodQualitative data were collected using two focus groups and in-depth interviews. Patient focus group (n = 10) explored patients’ knowledge about management of type 2 diabetes. Patients were recruited from Dr George Mukhari Hospital outpatients’ diabetes clinic. Professional focus group (n = 8) explored the health care team's experiences, barriers and facilitators in managing the disease. Professional focus group participants were recruited because of their expertise in chronic disease management, working in the community (public health) or working directly with patients with type 2 diabetes. Five health care professionals were interviewed using the same guide of questions as for the focus group.ResultsParticipants identified type 2 diabetes as a chronic disease that needs behaviour change for good control. Five major themes were identified: patients’ knowledge; education programmes; behaviour change; support; and a patient-centred approach.ConclusionManagement of type 2 diabetes may be enhanced by reinforcing patients’ knowledge, encouraging behaviour change whilst taking into consideration patients’ backgrounds. The health care team needs to utilise a patient-centred approach.

Assessment of Diabetic Patient Perception on Diabetic Disease and Self-Care Practice in Dilla University Referral Hospital, South Ethiopia

“…However this finding differs where a study conducted in United Arab Emirates (72%) had a negative attitude towards having diabetes [12]. Finding from United Arab Emirates is supported by our qualitative study according to respondent from indepth result one female participant said that "DM patient always ask themselves the following questions after the diagnosis: Why me?…”

“…In this study, the recommended self-care practice was higher (76.8%) where compare to a study conducted in Harer (39.2%) and in United Arab Emirates (37.7%). With regarded to specific recommended self-care practices, dietary intake 154 (49.7%) and regular exercise 138 (44.5%) were less likely practiced with compare to a study conducted in Harer [12,14]. In this study there was a consistence finding from in-depth interview according to one female DM patient she said that "some patients knew about the recommended food practices, but because of socio-economic barriers (lack of finances) were unable to acquire the right kind of food.…”

A systematic review of qualitative research on the contributory factors leading to medicine-related problems from the perspectives of adult patients with cardiovascular diseases and diabetes mellitus

“…A lack of necessary finances prevents patients from buying the appropriate food (for their diet)29 and from going to doctors 26…”

“…They were also aware that a poor diet, including excess alcohol24 and caffeine intake,24 29 exacerbated their conditions. Another group of patients misunderstood the concept of a healthy diet.…”

“…In addition, a lack of exercise was reported in 11 studies from five countries, including Brazil,22 Canada,24 the UK,32–36 South Africa29 and the USA 38–40. A group of patients overestimated the importance of exercise, claiming that it can cure any existing disease 31.…”