Diabetes literacy and informal social support: a qualitative study of patients at a diabetes centre
Diabetes literacy and informal social support: a qualitative study of patients at a diabetes centre
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DOI：
10.1111/jocn.13383
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发表时间：
2017-01-01
影响因子：
4.2
通讯作者：
Orinuela, Kirsty
中科院分区：
文献类型：
--
作者：
Black, Stephen;Maitland, Catherine;Orinuela, Kirsty
目的和目标。目的：探讨2型糖尿病患者在日常生活中管理疾病所利用的资源。2型糖尿病是一种影响澳大利亚成年人的疾病，其发病率被描述为“流行病”。治疗通常侧重于患者的自我管理，这可能需要每天监测血糖，口服药物或注射疗法，以及调节饮食和锻炼。关于病人自我管理的健康研究，包括涉及2型糖尿病的研究，主要侧重于以个人为中心的定义，尽管一些研究，特别是定性研究，表明了社会关系和非正式社会网络的积极作用。探索性,qualitative.Methods。该项目的重点是26名在糖尿病中心接受临床咨询的患者，中心工作人员包括医生、糖尿病教育工作者、足科医生和营养师。对会诊过程进行观察和录音，然后对患者进行半结构化的录音访谈，并对咨询专业人员进行单独访谈。绝大多数患者依靠非正式的社会支持网络来控制疾病。配偶也很重要，有时会以“团队”的方式与患者一起治疗疾病。儿子和女儿也发挥了重要的支持作用，特别是在咨询期间口译和解释健康信息。在某些情况下，邻居和当地社区组织提供了非正式的支持。只有两名患者声称没有使用非正式的社会支持。非正式社会支持在2型糖尿病患者自我管理中是临床医生需要考虑的重要因素。该研究表明，需要制定一个更审慎或更积极的政策，让患者的家庭和其他非正式的社会网络参与到治疗项目中来。与临床实践相关。临床医生在制定和实施病人管理计划时可能需要文件和纳入非正式的社会支持。
Aims and objectives. To explore the resources that patients diagnosed with type 2 diabetes drew upon to manage the disease in their daily lives.Background. Type 2 diabetes is a disease affecting Australian adults at a rate described as an 'epidemic'. Treatment usually focuses on patient self-management, which may require daily blood sugar monitoring, oral medications or injectable therapies, and regulating diet and exercise. Health research studies of patient self-management, including those involving type 2 diabetes, have focused largely on individual-centred definitions, though a number of studies, in particular qualitative studies, have indicated the positive role of social relationships and informal social networks.Design. Exploratory, qualitative.Methods. The project focused on 26 patients attending a diabetes centre for clinical consultations with centre staff including doctors, diabetes educators, podiatrists and dietitians. The consultations were observed and audio recorded, followed by semi-structured, audio-recorded interviews with the patients and separate interviews with the consulting professional staff.Results. Overwhelmingly the patients drew on informal social networks of support to manage the disease. Spouses were significant, sometimes presenting with the patient as a 'team' approach to managing the disease. Sons and daughters also played a significant support role, especially interpreting during consultations and explaining health information. In some cases neighbours and also local community organisations provided informal support. Only two patients claimed not to use informal social support.Conclusions. Informal social support in patients' self-management of type 2 diabetes was found to be an important factor to be considered by clinicians. The study suggested the need for a more deliberate or pro-active policy to involve patients' family and other informal social networks in treatment programs.Relevance to clinical practice. Clinicians may need document and incorporate informal social support in the development and implementation of patient management plans.