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Diabetes self-management: a qualitative study on challenges and solutions from the perspective of South African patients and health care providers

BACKGROUND: Health education and self-management are among key strategies for managing diabetes and hypertension to reduce morbidity and mortality. Inappropriate self-management support can potentially worsen chronic diseases outcomes if relevant barriers are not identified and self-management solut...

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Autores principales: Masupe, Tiny, Onagbiye, Sunday, Puoane, Thandi, Pilvikki, Absetz, Alvesson, Helle Mölsted, Delobelle, Peter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9307110/
https://www.ncbi.nlm.nih.gov/pubmed/35856773
http://dx.doi.org/10.1080/16549716.2022.2090098
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author Masupe, Tiny
Onagbiye, Sunday
Puoane, Thandi
Pilvikki, Absetz
Alvesson, Helle Mölsted
Delobelle, Peter
author_facet Masupe, Tiny
Onagbiye, Sunday
Puoane, Thandi
Pilvikki, Absetz
Alvesson, Helle Mölsted
Delobelle, Peter
author_sort Masupe, Tiny
collection PubMed
description BACKGROUND: Health education and self-management are among key strategies for managing diabetes and hypertension to reduce morbidity and mortality. Inappropriate self-management support can potentially worsen chronic diseases outcomes if relevant barriers are not identified and self-management solutions are not contextualised. Few studies deliberately solicit suggestions for enhancing self-management from patients and their providers. OBJECTIVE: This qualitative study aimed to unravel experiences, identify self-management barriers, and solicit solutions for enhancing self-management from patients and their healthcare providers. METHODS: Eight in-depth interviews were conducted with healthcare providers. These were followed by four focus group discussions among patients with type-2- diabetes and or hypertension receiving chronic disease care from two health facilities in a peri-urban township in Cape Town, South Africa. The Self-Management framework described by Lorig and Holman, based on work done by Corbin and Strauss was used to analyse the data. RESULTS: Patients experienced challenges across all three self-management tasks of behavioural/medical management, role management, and emotional management. Main challenges included poor patient self-control towards lifestyle modification, sub-optimal patient-provider and family partnerships, and post-diagnosis grief-reactions by patients. Barriers experienced were stigma, socio-economic and cultural influences, provider-patient communication gaps, disconnect between facility-based services and patients’ lived experiences, and inadequate community care services. Patients suggested empowering community-based solutions to strengthen their disease self-management, including dedicated multidisciplinary diabetes services, counselling services; strengthened family support; patient buddies; patient-led community projects, and advocacy. Providers suggested contextualised communication using audio-visual technologies and patient-centred provider consultations. CONCLUSIONS: Community-based dedicated multidisciplinary chronic disease healthcare teams, chronic disease counselling services, patient-driven projects and advocacy are needed to improve patient self-management.
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spelling pubmed-93071102022-07-23 Diabetes self-management: a qualitative study on challenges and solutions from the perspective of South African patients and health care providers Masupe, Tiny Onagbiye, Sunday Puoane, Thandi Pilvikki, Absetz Alvesson, Helle Mölsted Delobelle, Peter Glob Health Action Research Article BACKGROUND: Health education and self-management are among key strategies for managing diabetes and hypertension to reduce morbidity and mortality. Inappropriate self-management support can potentially worsen chronic diseases outcomes if relevant barriers are not identified and self-management solutions are not contextualised. Few studies deliberately solicit suggestions for enhancing self-management from patients and their providers. OBJECTIVE: This qualitative study aimed to unravel experiences, identify self-management barriers, and solicit solutions for enhancing self-management from patients and their healthcare providers. METHODS: Eight in-depth interviews were conducted with healthcare providers. These were followed by four focus group discussions among patients with type-2- diabetes and or hypertension receiving chronic disease care from two health facilities in a peri-urban township in Cape Town, South Africa. The Self-Management framework described by Lorig and Holman, based on work done by Corbin and Strauss was used to analyse the data. RESULTS: Patients experienced challenges across all three self-management tasks of behavioural/medical management, role management, and emotional management. Main challenges included poor patient self-control towards lifestyle modification, sub-optimal patient-provider and family partnerships, and post-diagnosis grief-reactions by patients. Barriers experienced were stigma, socio-economic and cultural influences, provider-patient communication gaps, disconnect between facility-based services and patients’ lived experiences, and inadequate community care services. Patients suggested empowering community-based solutions to strengthen their disease self-management, including dedicated multidisciplinary diabetes services, counselling services; strengthened family support; patient buddies; patient-led community projects, and advocacy. Providers suggested contextualised communication using audio-visual technologies and patient-centred provider consultations. CONCLUSIONS: Community-based dedicated multidisciplinary chronic disease healthcare teams, chronic disease counselling services, patient-driven projects and advocacy are needed to improve patient self-management. Taylor & Francis 2022-07-20 /pmc/articles/PMC9307110/ /pubmed/35856773 http://dx.doi.org/10.1080/16549716.2022.2090098 Text en © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Masupe, Tiny
Onagbiye, Sunday
Puoane, Thandi
Pilvikki, Absetz
Alvesson, Helle Mölsted
Delobelle, Peter
Diabetes self-management: a qualitative study on challenges and solutions from the perspective of South African patients and health care providers
title Diabetes self-management: a qualitative study on challenges and solutions from the perspective of South African patients and health care providers
title_full Diabetes self-management: a qualitative study on challenges and solutions from the perspective of South African patients and health care providers
title_fullStr Diabetes self-management: a qualitative study on challenges and solutions from the perspective of South African patients and health care providers
title_full_unstemmed Diabetes self-management: a qualitative study on challenges and solutions from the perspective of South African patients and health care providers
title_short Diabetes self-management: a qualitative study on challenges and solutions from the perspective of South African patients and health care providers
title_sort diabetes self-management: a qualitative study on challenges and solutions from the perspective of south african patients and health care providers
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9307110/
https://www.ncbi.nlm.nih.gov/pubmed/35856773
http://dx.doi.org/10.1080/16549716.2022.2090098
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