Nepalese patients’ perceptions of treatment modalities for type 2 diabetes
Nepalese patients’ perceptions of treatment modalities for type 2 diabetes
复制标题
尼泊尔患者对 2 型糖尿病治疗方式的看法
DOI：
--
复制
发表时间：
2016
影响因子：
2.2
通讯作者：
P. Aslani
中科院分区：
文献类型：
--
作者：
S. Sapkota;J. Brien;P. Aslani
背景对治疗的看法和信念会影响患者对治疗方案的坚持。反过来，感知往往受到患者的社会文化背景的影响。尼泊尔和尼泊尔人有独特的社会文化传统和信仰，他们对糖尿病治疗的看法在很大程度上仍未得到探索。这项研究探讨了尼泊尔参与者对糖尿病治疗的看法，以及居住在澳大利亚和尼泊尔的尼泊尔人对糖尿病治疗的看法是否有所不同。方法对悉尼和加德满都的尼泊尔2型糖尿病患者进行面对面定性访谈(n=48)。所有采访都被录音，逐字转录，并进行主题分析。结果在澳大利亚和尼泊尔的尼泊尔参与者对糖尿病治疗的看法是相似的。人们普遍不愿开始口服抗糖尿病药物，更不愿开始非肠道(胰岛素)治疗。参与者更愿意尝试改变生活方式和替代疗法，如草药和“传统”药物，特别是作为第一步。不愿服药主要与这样一种信念有关，即一旦开始服用，这些药物就需要终生服用，以及对此类药物造成的长期伤害的看法。即使在开始用药时，参与者也反对任何类型的治疗升级，例如转向胰岛素治疗。胰岛素被认为是糖尿病治疗的“最后选择”。然而，大多数参与者在开始治疗后并不觉得服药具有挑战性。结论抗糖尿病药物一旦开始服用，就被认为是有害的和不可阻挡的。这些认知显著影响了参与者开始抗糖尿病药物治疗的意愿，因此有可能对他们的服药行为产生不利影响。因此，这项研究强调了探索这些认知对参与者服药行为的影响的必要性，以及通过信息和教育解决患者对“现代”(常用处方)和“传统”(天然)药物的看法的必要性，以确保更多地了解如何将药物用于糖尿病治疗。
Background Perceptions and beliefs about treatment can influence patients’ adherence to treatment regimens. Perceptions, in turn, are often shaped by patients’ sociocultural context. Nepal and the Nepalese have unique sociocultural traditions and beliefs, and their perceptions of diabetes treatment remain largely unexplored. This study explored Nepalese participants’ perceptions of diabetes treatment, and whether perceptions differed between the Nepalese living in Australia and Nepal. Methods Face-to-face qualitative interviews (n=48) were conducted with Nepalese participants with type 2 diabetes in Sydney and Kathmandu. All interviews were audio-recorded, transcribed verbatim, and thematically analyzed. Results Perceptions of diabetes treatment were similar among Nepalese participants in Australia and Nepal. There was a general reluctance to start oral antidiabetic medications and an even greater reluctance to commence parenteral (insulin) therapy. Participants preferred to try lifestyle modifications and alternative treatments such as herbs and “traditional” medicines, particularly as a first step. Unwillingness to take medications was primarily associated with the belief that, once started, these medications needed to be taken for life, and perceptions of long-term harms caused by such medications. Even when commenced on medication, participants were averse to any type of therapy escalation, for example, moving to insulin therapy. Insulin was perceived as the “last option” available for diabetes treatment. Most participants, however, did not find medication taking challenging once they had commenced treatment. Conclusion Antidiabetic medications were perceived to be harmful and unstoppable once initiated. These perceptions significantly impacted participants’ willingness to commence antidiabetic medications and therefore have the potential to adversely affect their medication-taking behavior. This study therefore highlights the need to explore the impact of these perceptions on participants’ medication-taking behavior, and the need to address patients’ views of “modern” (commonly prescribed) and “traditional” (natural) medications through information and education, to ensure increased understanding of how medications are used for diabetes management.