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. In: Davis A and Horobin G (eds), Medical Encounters: The Experiences of Illness and Treatment. Following approval from Lothian Research Ethics Committee, clinicians recruited 40 patients who had been clinically diagnosed as having type 2 diabetes within the previous 6 months face to face or by letter (with an ‘opt-in’ procedure). Fingerprint Dive into the research topics of 'Self-care in People with Type 2 Diabetes Mellitus Research Protocol of a Multicenter Mixed Methods Study (SCUDO)'. Patterson B, Thorne S, Crawford J, Tarko M. Living with diabetes as a transformational experience. In most cases, patients waited several months for their hospital appointment. The interviews were semi-structured, and data reported here derive largely (although not exclusively) from the following questions: “can you tell me how you came to be diagnosed with diabetes?”; “how did you feel when you found out you had diabetes?”; “who within the health services have you seen, when and where did you see them?”; and “what do you want from diabetes services?”, Transcripts were read repeatedly by members of the research team (EP, JL and OP) and cross-compared both during and after data collection. The diabetes audit and research in Tayside Scotland (DARTS) study: electronic record linkage to create a diabetes register. Odette Parry, Elizabeth Peel, Margaret Douglas, Julia Lawton, Patients in waiting: a qualitative study of type 2 diabetes patients' perceptions of diagnosis, Family Practice, Volume 21, Issue 2, April 2004, Pages 131–136, https://doi.org/10.1093/fampra/cmh203. 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. However, waiting (even for a short period of time) for an appointment was experienced by some as problematic, especially those who saw diabetes as a potentially serious condition warranting prompt medical attention. 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 Although many patients had low expectations about referral times, waiting for a hospital appointment was experienced as problematic in several ways. Those referred perceived confirmation of diagnosis by the consultant as a central reason. This patient, contrary to the opinion of her GP, now claimed “I'm not diabetic”. Despite progress in formulating â¦ Data were organized into initial and higher thematic categories once consensus regarding themes had occurred. JMIR Diabetes. HHS 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. To date there has been limited research on diabetes-related distress in younger people with Type 1 diabetes. Interview sessions were conducted at diabetes clinicâPenang general hospital. | Keywords: Studies included were English-language qualitative studies in primary care of physiciansâ or nursesâ perceived influences on treatment goals for type 2 diabetes. 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. Parry O, Peel E, Douglas M and Lawton J. Most assumed that they had been sent to hospital in order to receive a confirmation of diagnosis by a diabetes consultant. LHCCs in Scotland are voluntary groupings of GPs and other local health care providers and are intended to strengthen and support the primary health care team in delivering local care. 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. Health care providers may not always discuss values and preferences with their patients; however, our findings provide reason for providers to consider these issues. NLM Type 2 diabetes is a major health concern among underserved populations. The LHCCs spanned poor and affluent areas, enabling the recruitment of patients from different social classes. Epub 2018 Oct 31. Transforming Qualitative Information: Thematic Analysis and Code Development. 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 incrâ¦ Clarity, timing and authority of the diagnosis delivery have emerged as salient issues. In conclusion, the study findings highlight a need for appropriate input to ensure that the process of diagnosis is both tolerable for patients and fully exploited as a crucial period in which patients learn to adapt to their condition. Results A total of 32 studies were included: 17 address general diabetes care, 11 glycaemic control, three blood pressure, and one cholesterol control. Simacek KF, Nelson T, Miller-Baldi M, Bolge SC. | Purposive sampling ensured the sample's demographic characteristics were broadly representative of all newly diagnosed type 2 diabetes patients in Lothian/Scotland22 (see Table 1). Prim Health Care 7: 273. doi: 10.4172/2167-1079.1000273 Page 2 of 2 P ea ae a oe ae oa oe e 2 2 10. 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). Where patients presented with symptoms, the initial stage of the journey towards diagnosis was often speedily expedited. 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. Together they form a unique fingerprint. Patients perceived themselves as the focus of attention at hospital. ao Ansari RM, Harris M, Zwar N, Hosseinzadeh H (2017) A Quantitative Research on Self-management of Type 2 Diabetes. And I said ‘well no really’.” (R20). Most wanted the diagnosis confirmed before they felt confident making lifestyle changes. Design and sampling method. Scientists in Sweden and Finland have found that Type 2 diabetes could be separated out into four subtypes, which have distinct characteristics. 21, No. NIH : 18-05239-EF-1. (He) took my bloods and I was told by the afternoon. This qualitative study aimed to identify causes of diabetes â¦ 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 ]. Qualitative research on self-management for people with Type 2 Diabetes Mellitus (T2DM) has typically reported one-off retrospective accounts of individualsâ strategies. Lifestyle intervention may reduce the development of type 2 diabetes among high-risk individuals. In addition, diabetes self-management is related to enhanced knowledge of diabetes, improved overall behaviour and discipline to adhere to diet and physical activity recommendations â¦ : 16-EHC006-EF. The study had a qualitative descriptive design. I just assumed that, that it must be if you are really bad you know.” (R8). Qualitative studies addressing the experiences of patients with diabetes mainly focus on prevalent complications [ â¦ Our aim was to examine how diagnosis is perceived by a sample of newly diagnosed type 2 diabetes patients. 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. Leicester (UK): BPS Books; Peel E, Parry O, Douglas M, Lawton J. 1246-1251 Google Scholar Participants were recruited at two clinical sites in Appalachian counties in eastern Tâ¦ This ensured that the sample had diverse experiences of primary and secondary care diabetes services, some patients receiving GP-based care only (n = 5), the remainder having varying amounts of contact with both GP and hospital-based services (n = 35). Only a minority of patients reported that their GPs had not suspected diabetes when they first presented with symptoms. In other cases, patients perceived hospital consultants as having more expertise and specialist knowledge than GPs, and hence as having the competence necessary to make a “proper diagnosis” (R37). Harris MI, Klein R, Welborn TA, Knuiman MW. In the interests of developing ‘substantive theory’ in this under-researched area, the study took theoretical direction from grounded theory, otherwise known as the constant comparative method.20 This study used a grounded theory approach from a social (rather than psychological) perspective to examine processes of social action/interaction rather than to create theories about individuals. Van den Arend IJM, Stolk RP, Krans HMJ, Grobee DE, Schrijvers AJP. Changes in physicians’ attitudes towards telling the cancer patient. Factors influencing the attitudes held by women with type 2 diabetes: a qualitative study. Prior to diagnosis, 25 of the 40 patients presented illness symptoms to their GP, 10 of whom suspected their symptoms to be diabetes related. Purposive selection ensured that the sample's demographic characteristics were broadly representative of newly diagnosed type 2 diabetes patients in Lothian/Scotland. Multiple Sclerosis. A qualitative study was carried out in the Lothian region of Scotland using in-depth interviews of 40 newly diagnosed type 2 diabetes patients recruited from 16 general practices in four Local Health Care Co-operatives and three hospital clinics. There are 70 LHCCs in Scotland, based on natural communities. Kinmonth AL. This study aimed to determine self-monitoring practices, awareness to dietary modifications and barriers to medication adherence among physically disabled type 2 diabetes mellitus patients. Results show low use of qualitative methods in diabetes research over the past 30 years. Rockville (MD): Agency for Healthcare Research and Quality (US); 2016 Mar. Initial thematic categories included ‘symptoms’, ‘contact with services’, ‘reaction to diagnosis’, ‘patient concerns’, ‘support networks’, ‘medical therapies’ and ‘lifestyle changes’. Similarly, R20 reported that his GP “was obviously wanting them (hospital staff) to tell me”. 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). Epub 2010 Jul 30. Most of the research being done is centered around this Novak D, Plummer R, Smith PL, Ochitill H, Morrow GR, Bennet JM. Diagnosis: the end of transition. Waiting for a hospital appointment could be problematic for patients. Most articles reported recruiting clinic-based populations (58%). | 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. In some case, patients made this assumption because they perceived their GPs as being unwilling to deliver a definitive diagnosis. Round 1 interviews were carried out in April–July 2002. Common ground on dietary approaches for the prevention, management, and potential remission of type 2 diabetes can be found, argue Nita G Forouhi and colleagues Dietary factors are of paramount importance in the management and prevention of type 2 diabetes. Go to the research in the â¦ Blaxter M. The causes of disease: women talking. We conducted a systematic review of National Librar â¦ 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? However, they remain underutilised for understanding the diabetes experience, especially in Africa and Asia and amongst non-clinic populations. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes. HMSO Standard Occupational Classification London 1995. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide, This PDF is available to Subscribers Only. The invited participants represented â¦ He didn't fob (me off) and say ‘Oh go and get an appointment with the nurse and that’, he was—he was good. Others used the lengthy waiting period to substantiate their view that they had a ‘milder’ form of diabetes than those seen more promptly. R10 described the 2-week wait for an appointment as difficult to bear because: “I've got diabetes that's what they were telling me and oh I was scared”. Implications of the United Kingdom Prospective Diabetes Study for general practice care of type 2 diabetes [editorial]. Although eager to learn what they could do to reduce their health-related risks, patients worried that, without the appropriate medical input, lifestyle modification might prove detrimental rather than beneficial. 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