Patients with poorly controlled diabetes in primary care: healthcare clinicians' beliefs and attitudes
Patients with poorly controlled diabetes in primary care: healthcare clinicians' beliefs and attitudes
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DOI：
10.1136/pgmj.2005.039545
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发表时间：
2006-05-01
影响因子：
5.1
通讯作者：
Cornford, CS
中科院分区：
文献类型：
--
作者：
Jeavons, D;Hungin, APS;Cornford, CS
目的：确定医生和护士对治疗血糖控制不理想的2型糖尿病患者的态度和信念，同时在初级保健中接受最大限度的口服治疗。设计：焦点小组。设置：初级保健。参与者：23名全科医生和实习护士组成的四个焦点小组。结果：全科医生被认为是管理所有2型糖尿病患者的最佳环境，但人们担心缺乏资源和不熟悉开始胰岛素治疗。围绕依从性的问题进行了广泛的讨论;“失败的糖尿病”有双重含义，即血糖控制失败和患者和医生的依从性和努力失败。虽然关于胰岛素治疗的观点不同，患者被理解为开始胰岛素抵抗，代表他们的糖尿病的一个更严重的阶段，与针头和lowoglycema.Conclusion的恐惧：糖尿病专科护士在初级保健工作的作用将是至关重要的，在管理这些患者，以提高知识，额外的资源，他们的经验，胰岛素的使用，并改变态度。
Objective: To determine doctors' and nurses' attitudes and beliefs about treating patients with type 2 diabetes with less than ideal glycaemic control while receiving maximal oral treatment in primary care.Design: Focus groups.Setting: Primary care.Participants: Four focus groups of 23 GPs and practice nurses.Results: General practice was thought to be the best setting for managing all patients with type 2 diabetes but there were concerns about a lack of resources and unfamiliarity with starting insulin. Issues around compliance were extensively discussed; the "failing diabetic'' had dual meanings of failing glycaemic control and failing compliance and effort by both patient and doctor. Although views about insulin therapy differed, patients were understood to be resistant to starting insulin, representing for them a more serious stage of diabetes, with fears of needles and hypoglycaemia.Conclusion: The role of diabetes specialist nurses working in primary care will be crucial in managing such patients to improve knowledge, for extra resources, for their experience of insulin use, and to change attitudes.