Are patients with type 2 diabetes in the Waikato District provided with adequate education and support in primary care to self-manage their condition? A qualitative study.

IF 1.1 Q4 PRIMARY HEALTH CARE Journal of primary health care Pub Date : 2024-03-01 DOI:10.1071/HC23141
Rebekah Crosswell, Kimberley Norman, Shemana Cassim, Valentina Papa, Rawiri Keenan, Ryan Paul, Lynne Chepulis
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Abstract

Introduction In Aotearoa New Zealand (NZ), type 2 diabetes (T2D) is predominantly managed in primary care. Despite established guidelines, patients are often suboptimally managed, with inequitable health outcomes. To date, few NZ studies have evaluated the primary care management of T2D at the time of diagnosis. Aim This study aims to explore patients' the provision of education and delivery of care to patients at the time of diagnosis, which is a crucial time in the disease trajectory. Methods Participants were recruited from a Māori health provider in the Waikato District, and diagnosed with T2D after January 2020. Patients were texted a link to opt into a survey (larger study) and then registered interest by providing contact details for an interview (current study). Semi-structured interviews were conducted and were audio recorded, transcribed, and thematically analysed. Results In total, 11 participants aged 19-65 years completed the interviews (female n  = 9 and male n  = 20); the comprised Māori (n  = 5), NZ European (n  = 5) and Asian (n  = 1) participants. Three overarching themes were identified, including: (1) ineffective provision of resources and education methods; (2) poor communication from healthcare practitioners; and (3) health system barriers. Discussion Evidently, there are difficulties in primary care diabetes mellitus diagnosis and management. Improvements could include locally relevant resources tailored to patients' experiences and cultural identities. Utilising whānau support and a non-clinical workforce, such as health navigators/kaiāwhina, will drastically address current workforce issues and assist patient self-management. This will allow improved diagnosis experiences and better health outcomes for patients and whānau.

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怀卡托地区的 2 型糖尿病患者是否在初级保健中获得了足够的教育和支持,以自我管理病情?一项定性研究。
导言:在新西兰奥特亚罗瓦,2 型糖尿病(T2D)主要由初级医疗机构负责管理。尽管制定了相关指南,但患者往往得不到最佳管理,造成不公平的健康结果。迄今为止,新西兰很少有研究对 T2D 诊断时的初级医疗管理进行评估。目的 本研究旨在探讨患者在确诊时的教育和护理提供情况,这是疾病轨迹中的关键时期。方法 从怀卡托地区的一家毛利医疗机构招募参与者,并在 2020 年 1 月之后诊断出患有 T2D。患者会收到短信链接,选择参加调查(大型研究),然后通过提供详细联系信息来登记是否有兴趣参加访谈(当前研究)。研究人员进行了半结构式访谈,并对访谈内容进行了录音、转录和主题分析。结果 共有 11 名年龄在 19-65 岁之间的参与者完成了访谈(女性 9 人,男性 20 人);其中包括毛利人(5 人)、新西兰欧洲人(5 人)和亚洲人(1 人)。研究发现了三个重要主题,包括:(1)资源和教育方法的无效提供;(2)医疗从业人员的沟通不畅;以及(3)医疗系统的障碍。讨论 显然,基层医疗机构在糖尿病诊断和管理方面存在困难。改进措施可包括根据患者的经历和文化特性提供与当地相关的资源。利用whānau支持和非临床劳动力,如健康导航员/kaiāwhina,将极大地解决目前的劳动力问题,并帮助患者进行自我管理。这将改善诊断体验,为患者和土著居民带来更好的健康结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of primary health care
Journal of primary health care PRIMARY HEALTH CARE-
CiteScore
2.70
自引率
16.70%
发文量
79
审稿时长
28 weeks
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