Those patients not referred to hospital (n = 5) belonged to general practices with their own diabetes clinic/diabetes specialist. Weiner BJ, Amick HR, Lund JL, Lee SY, Hoff TJ. Initial thematic categories included ‘symptoms’, ‘contact with services’, ‘reaction to diagnosis’, ‘patient concerns’, ‘support networks’, ‘medical therapies’ and ‘lifestyle changes’. Grounded theory methodology. Following the results of the blood test, the majority of patients (n = 35) were referred to a hospital clinic by their GP. This is a pertinent issue for the management of type 2 diabetes, given the importance of implementing disease risk management strategies as quickly as possible. Symptoms such as excessive thirst, frequent urination and weight loss are commonly associated with diabetes, and prompted many of the patients' GPs to carry out urine tests. London: Tavistock; Scrambler G. Epilepsy. Somebody has actually said you have got diabetes'? The implications of the findings are also relevant to the rest of the UK and elsewhere as a shift in routine diabetes care/diabetic review (from secondary to primary health care settings) is also occurring in these locations.17. Callahan D, Williams D. Living with diabetes: issues for nursing practice. Experiences of Using Web-Based and Mobile Technologies to Support Self-Management of Type 2 Diabetes: Qualitative Study. Many patients perceived their GP as unwilling to deliver/confirm the diagnosis. Most patients welcomed this referral, particularly to the dietician, because “I had so many questions that I wanted answered at the time” (R7). Regular team meetings were held to identify recurrent themes, to explore patients' underlying reasoning, to discuss deviant cases and to identify new research questions. I was fine pleased.” (R10), Patients who received a hospital clinic appointment generally perceived delays as inevitable: “you hear about waiting lists and there are often things said on the radio, and television these days” (R19). Despite progress in formulating ⦠MacKinnon K, Marcellus L, Rivers J, Gordon C, Ryan M, Butcher D. JBI Database System Rev Implement Rep. 2015 Jan;13(1):14-26. doi: 10.11124/jbisrir-2015-1694. Aims: To explore the patient perspective on coordinated multidisciplinary diabetes team care among a socioeconomically diverse group of adults with type 2 diabetes. For full access to this pdf, sign in to an existing account, or purchase an annual subscription. Brown SA. London: Sage; Strauss A, Corbin J. Harris MI, Klein R, Welborn TA, Knuiman MW. In: Denzin NK, Lincoln YS (eds), Strategies of Qualitative Enquiry. The exact scope of each LHCC is determined by agreement among member practices and the PCT management. This qualitative study used the focus group interview method to explore the self-management experiences of middle-aged and older adults with type 2 diabetes mellitus. Background: Qualitative research on self-management for people with Type 2 Diabetes Mellitus (T2DM) has typically reported one-off retrospective accounts of individualsâ strategies. Conclusions. This qualitative study aimed to identify causes of diabetes ⦠Patients also attached importance to their consultations with hospital doctors because they perceived these as the settings where an accurate assessment of their disease would be made and the regimen required to manage it would be determined. (He) took my bloods and I was told by the afternoon. In one case, a patient reported that her success in reducing her blood sugar level to within the normal range prior to the clinic appointment led the diabetes consultant (after consulting his notes) to ask: “why are you here? 2018 Apr 20;12:595-606. doi: 10.2147/PPA.S159707. NLM A qualitative study of patient experiences of Type 2 Diabetes care delivered comparatively by General Practice Nurses and Medical Practitioners Eileen Boyle MN, GradDipED, GradDipLang Rosemary Saunders MPubHlth, GradDipHlthâProm, DipNurs Vicki Drury PhD, MCl.Nsg, BA (Ed). Waiting for a hospital appointment could be problematic for patients. Demographic characteristics of the sample. DARTS/MEMO Collaboration. The research relied on purposive sampling to select 28 participants ⦠Particular thanks goes to the health professionals who assisted with recruitment and the patients who took part, without whom this research would not have been possible. It is also important to note that while waiting for the hospital appointment, input from health services was highly valued by patients (who were aware that future health outcomes, linked to diabetes, might be related to lifestyle behaviours) and was only criticized for perceived infrequency and shortness of duration. Patients who were not referred to hospital were unclear why a referral had not taken place. Diabetes; qualitative research; systematic review. Further research may be needed on the issue of referral to secondary care which includes the perspectives of health professionals. 2016. “But at the moment I feel that I'm sort of still on probation you know, whether I've got it or not [laugh]. Qualitative research including research interviews are valuable complements to quantitative research, helping us to understand individuals and to focus on their thoughts and experiences [16, 17]. Patients' preferences for receiving diagnosis from senior medical professionals has been observed elsewhere.26 Our data suggest that this preference may be exacerbated where patients are uncertain about where, and from whom, they will receive their future diabetes care. The findings presented here are based upon an analysis of round 1 interviews, which focused upon patients' experiences of diagnosis. | JBI Database System Rev Implement Rep. 2015. LHCCs are part of the management structure of the Primary Care Trust (PCT). The identification and naming of disease has attracted much research interest because it is an important marker for the subsequent course of treatment.7 Diagnosis tends to be portrayed as occurring at a discrete point in time.8 Research on diagnosis has highlighted the importance of doctor–patient communication,9,10 establishing that the reactions and attitudes of health professionals towards patients may be crucial in influencing patients' perceptions of disease seriousness and consequent compliance.11. Round 1 interviews were carried out in April–July 2002. Clarity, timing and authority of the diagnosis delivery have emerged as salient issues. Our aim was to examine how diagnosis is perceived by a sample of newly diagnosed type 2 diabetes patients. According to the latest numbers by the International Diabetes Federation, 382 million people worldwide have diabetes (IDF, 2014). Data were organized into initial and higher thematic categories once consensus regarding themes had occurred. Social Inclusion Research Unit, University of Wales NEWI, Plas Coch Campus, Wrexham LL11 2AW, aPsychology Department, Aston University, Birmingham B4 7ET, bLothian NHS Board, Deaconess House, 148 Pleasance, Edinburgh EH8 9RS and cResearch Unit in Health, Behaviour and Change, School of Clinical Sciences and Community Health, College of Veterinary Medicine, The University of Edinburgh Medical School, Teviot Place, Edinburgh EH8 9AG, UK, Oxford University Press is a department of the University of Oxford. This site needs JavaScript to work properly. Patients' emotional reactions to diagnosis, and their views about information provision are described elsewhere.25. Agency for Healthcare Research and Quality (US). The study examined the motives that people living with type 2 diabetes (T2D) had for self-managing their condition and ways they used to assess the success of their self-management efforts. HHS The self-management of type diabetes is an essential part of life for the patients with diabetes to have a better and a healthy lifestyle. The research was conducted at the Research Unit in Health, Behaviour and Change which is funded by the SEHD and the Health Education Board for Scotland (HEBS). Waiting was taken by some asymptomatic patients to indicate that they did not have the condition. Although this paper is based wholly upon patients' accounts, it does suggest that delays may be incurred in commencement of treatment because of referral to hospital. Instead of converting sugar into energy, it backs up in the bloodstream and causes a variety of symptoms. The University of Tennessee, Knoxville's institutional review board approved the study before data collection began. The design of the ongoing research project is qualitative explorative which focuses on patient autonomy as perceived by older adults with type 2 diabetes mellitus. Eighty-five per cent of articles reported studies conducted in North America or Europe, with few studies in developing countries. Those referred perceived confirmation of diagnosis by the consultant as a central reason. Those patients who appeared most satisfied with a diagnosis delivered by the GP reported receiving a prompt and clear communication: “When I went to the appointment he (GP) took my sugar level and my urine and it was sky high so he immediately told me to come tomorrow morning, first thing to get my bloods taken. Those patients who saw type 2 diabetes as a potentially serious condition had heightened expectations regarding the level and frequency of input from health services, which were not always met. Introduction Diabetes is a common1 and serious lifelong condition associated with an increased risk of microvascular and macrovascular diseases, death2, 3 and depression.4 Unmet blood glucose targets are still a major concern.5 The experiences and challenges of living with type 1 diabetes mellitus (DM) or type 2 ⦠So he was quick and fast like. The findings also indicate how important it is that GPs and patients perceive how different health services will be integrated to best effect. Hospital education sessions were appreciated because “they [staff] explained everything” (R16) and covered aspects of diabetes management that previously patients “had not thought about” (R28). Input from health services during the period prior to the hospital visit was highly valued. Shifting of care for diabetes from secondary to primary care, 1990–5: review of general practices. For the remainder (n = 15), diagnosis was initiated by medical procedures such as routine blood tests. Most articles reported recruiting clinic-based populations (58%). Over half (54%) of research questions focused on patient experience and 24% on diabetes management. Diagnosis of type 2 diabetes: a qualitative analysis of patients' emotional reactions and views about information provision. Those who claimed not to have received a clear diagnosis from the GP were anxious for a diagnosis to be made. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes. Dissatisfaction stemmed from delays in being seen and/or the perception that the consultation was too short: “How can you sit and get advice from somebody that's supposed to—supposedly only giving you five minutes—and she kept looking at her watch.” (R7). Qualitative methods can provide important insights about socio-cultural aspects of disease to improve disease management. The experience of adaptation to diabetic renal disease. | Type 2 diabetes (formerly called âadult-onsetâ or ânon insulin-dependentâ) is a chronic condition in which the body doesnât produce enough insulin and/or is unable to use insulin properly. Health care providers may not always discuss values and preferences with their patients; however, our findings provide reason for providers to consider these issues. Mean age = 53.5, median age = 50 (range 21–77). doi: 10.2196/diabetes.9743. They reported that their condition had been addressed with appropriate concern and that they had been treated “as though you're something special and they are giving you kid glove treatment sort of thing” (R25). Services are currently in flux in Scotland, making this a particularly pertinent issue. Patients in waiting: a qualitative study of type 2 diabetes patients' perceptions of diagnosis. Clipboard, Search History, and several other advanced features are temporarily unavailable. However, they remain underutilised for understanding the diabetes experience, especially in Africa and Asia and amongst non-clinic populations. Prior to diagnosis, 25 of the 40 patients presented illness symptoms to their GP, 10 of whom suspected their symptoms to be diabetes related. In a previous article we report how people with type 2 diabetes who are being cared for by a DSN in a nurse-led, shared-care unit view autonomy [ 9 ]. Britten N, Jones R, Murphy E, Stacy R. Qualitative research methods in general practice. Goyder EC, McNally PG, Drucquer M, Spiers N, Botha JL. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). R8, for example, thought that a hospital referral only occurred when the clinic was not oversubscribed and/or in the most serious cases: “I thought maybe they (hospital clinic) were just full or you had to be, I don't know, maybe twenty times worse than I am before you got referred. A descriptive qualitative design was used. Pope C, Mays N. Qualitative research: reaching the parts other methods cannot reach: an introduction to qualitative methods in health and health services research. Findings from patient studies tend to portray diagnosis as functional in that it facilitates the process whereby they begin to adapt to their condition.8,12 Patients can also experience diagnosis as very traumatic.13–15 The enormous variation in the psychological and social impact of diabetes upon patients cannot be explained solely by the type or severity of the condition.16 There has, however, been little exploration of the broader context of diagnosis from patients' perspectives; for example, how patients understand and reflect upon their experiences of diagnosis, including the ordering and timing of events, the roles which different health professionals play, patient satisfaction with diagnosis delivery and perceptions of unmet needs. The quality of Australian Indigenous primary health care research focusing on social and emotional wellbeing: a systematic review. RESEARCH ARTICLE Open Access Self-management experiences among men and women with type 2 diabetes mellitus: a qualitative analysis Rebecca Mathew1*, Enza Gucciardi2, Margaret De Melo3 and Paula Barata4 Abstract The study had a qualitative descriptive design. Only a minority of patients reported that their GPs had not suspected diabetes when they first presented with symptoms. Patient engagement in type 2 diabetes mellitus research: what patients want. Most assumed that they had been sent to hospital in order to receive a confirmation of diagnosis by a diabetes consultant. London: Sage; Morris AD, Boyle DI, MacAlpine R et al. We aimed to describe how qualitative methods are used in global research on diabetes and identify opportunities whereby qualitative methods could further benefit our understanding of the human experience of diabetes and interventions to address it. Similarly, R20 reported that his GP “was obviously wanting them (hospital staff) to tell me”. Transforming Qualitative Information: Thematic Analysis and Code Development. Adequate input from practitioners is needed to ensure that diagnosis is fully exploited as a crucial period in which patients learn to adapt to their condition. Holohan A. Type 2 diabetes is a complex, progressive disease which requires a variety of risk management strategies.1,2 It often remains undiagnosed for many years because hyperglycaemia develops gradually and, at early stages, may not be severe enough for patients to recognize classic symptoms.3 The conditions' long subclinical phase is associated with increased morbidity and mortality,4,5 and those affected are at increased risk of developing macro- and microvascular complications.6 It is important that disease self-management begins promptly once a diagnosis has been made. Patients, however, did not generally perceive these benefits as being why they had been referred to hospital. Improving Cultural Competence to Reduce Health Disparities [Internet]. Poroch D. Effect of preparatory patient education on the anxiety and satisfaction of cancer patients receiving radiotherapy. All patients were white (except one Pakistani woman) and, with the exception of one insulin-treated patient, were treated by diet alone or diet and metformin and/or gliclazide. Pinder R. Coherence and incoherence: doctors’ and patients’ perspectives on the diagnosis of Parkinson's disease. J. Lawton, O. Parry, E. Peel, M. DouglasDiabetes service provision: a qualitative study of newly diagnosed type 2 diabetes patientsâ experiences and views Diabetic Med, 22 (2005), pp. Wikblad KF. ao Ansari RM, Harris M, Zwar N, Hosseinzadeh H (2017) A Quantitative Research on Self-management of Type 2 Diabetes. Most of the research being done is centered around this Even where GPs were felt to have been clear about the diagnosis, some patients described how they had been unwilling to accept that they definitely had diabetes until confirmation from a consultant had occurred. Our findings suggest that if GPs are more explicit about the diagnosis at first contact, this may avoid the problem of patients either feeling ‘in limbo’ or being uncertain as to whether they have type 2 diabetes. Type 2 diabetes is a complex, progressive disease which requires a variety of risk management strategies.1,2 It often remains undiagnosed for many years because hyperglycaemia develops gradually and, at early stages, may not be severe enough for patients to recognize classic symptoms.3 The conditions' long subclinical phase is associated with increased morbidity and mortality,4,5 and those affected are at incr⦠Therefore, we explored how adolescents with T2DM experience and perceive social support. He took them. Qualitative research design using 8 focus groups (n=53). London: Croom Helm; Robinson I. Report No. All interviews were conducted by EP, averaged 1 h, and were tape recorded and transcribed verbatim. Patient perspectives of diabetic care and education. 2017 Oct 11;27(4):27341700. doi: 10.17061/phrp27341700. Many patients were depending upon clinic staff to “clear up a lot of anything that's unknown” (R35) and, like R7, described themselves as “still in limbo” while waiting for the appointment, unsure about “what am I doing–the right thing or what?”. Some patients, such as R37, claimed the urine test was almost a formality, as the GP “kind of knew herself when I described the symptoms”. … there's nothing showing” (R31). In addition, the perceived absence of a clear steer from the GP combined with a delayed hospital appointment led some patients to assume that they might not have diabetes: “It wasn't until I saw the doctor at the very end of the course that he said ‘well you do realize you have got diabetes? Waiting for the hospital appointment also appeared to provide a window of opportunity for patients to reassess their situation. Parental consumption of ultra-processed, high-fat products has no association with childhood overweight/obesity: an epidemiological study among 10–12-years-old children in Greece, Witnessing interparental violence in childhood and symptoms of depression in adulthood: data from the 2017 French Health Barometer, Attitudes of medical students to general practice: a multinational cross-sectional survey, Impact of guidelines on antibiotic prescribing approach in primary care—a 10-year study, Hepatomegaly and short stature in a 14-year-old with type 1 diabetes mellitus: case report, Receive exclusive offers and updates from Oxford Academic, Exploring primary health care professionals’ perceptions about a patient feedback intervention to improve patient safety in Spanish primary health care centres: a qualitative study, Perceptions of preconception counselling among women planning a pregnancy: a qualitative study, Family medicine physicians’ report strong support, barriers and preferences for Registered Dietitian Nutritionist care in the primary care setting, Variations in cardiac interventions: doctors' practices and views. 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