College of Nursing, University of Kentucky, Hartford, KY 42347, United States.
Patient Educ Couns. 2009 Jul;76(1):31-7. doi: 10.1016/j.pec.2008.11.022. Epub 2009 Jan 20.
The purpose of this study was to explore how adult women manage their diabetes. Recommendations for improving adherence and opportunities to maximize communication between the healthcare provider and individuals who have type 2 diabetes also were described.
An exploratory qualitative descriptive design was used to describe the experience of living with type 2 diabetes in adult females. Data were obtained via individual in-depth interviews with five women over age 50 with type 2 diabetes. Participants were interviewed individually and participated in a focus group.
Participants clearly identified three major themes affecting adherence to treatment regimens: communication with the healthcare provider, knowledge of diabetes, and the consequences of poor glycemic control. For these participants, patient-provider communication was the most important factor affecting diabetes adherence.
Individual autonomy asserted in day-to-day management is often perceived as non-compliance by the healthcare provider; while provider's descriptions of potential severe complications are viewed as scare tactics by the patients.
Improved communication offers the clinician the opportunity to develop a partnership with patients to build mutually acceptable treatment plans and reach mutually agreed upon goals. Empowering the individual with skills needed to negotiate treatment regimens will encourage positive health decisions and improved outcomes.
本研究旨在探讨成年女性如何管理糖尿病。还描述了改善依从性的建议以及医疗保健提供者与 2 型糖尿病患者之间进行最大限度沟通的机会。
采用探索性定性描述设计来描述 50 岁以上患有 2 型糖尿病的女性的生活体验。通过对五名女性的个体深入访谈获得数据。参与者进行了个体访谈并参加了焦点小组。
参与者清楚地确定了影响治疗方案依从性的三个主要主题:与医疗保健提供者的沟通、对糖尿病的了解以及血糖控制不佳的后果。对于这些参与者来说,医患沟通是影响糖尿病依从性的最重要因素。
日常管理中个人自主主张常被医疗保健提供者视为不遵医嘱;而提供者描述的潜在严重并发症则被患者视为恐吓策略。
改善沟通为临床医生提供了与患者建立伙伴关系的机会,以制定双方均可接受的治疗计划并达成双方共同商定的目标。赋予个人协商治疗方案所需的技能将鼓励做出积极的健康决策和改善结果。