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医生和护士对2型糖尿病患者护理的看法:阿曼初级卫生保健领域的一项访谈研究

Doctors' and nurses' views on patient care for type 2 diabetes: an interview study in primary health care in Oman.

作者信息

Noor Abdulhadi Nadia M, Al-Shafaee Mohammed Ali, Wahlström Rolf, Hjelm Katarina

机构信息

Department of Public Health Sciences, Division of Global Health, Karolinska Institutet, Stockholm, Sweden.

出版信息

Prim Health Care Res Dev. 2013 Jul;14(3):258-69. doi: 10.1017/S146342361200062X. Epub 2012 Dec 21.

Abstract

AIM

This study aimed at exploring the experiences of primary health-care providers of their encounters with patients with type 2 diabetes, and their preferences and suggestions for future improvement of diabetes care.

BACKGROUND

Barriers to good diabetes care could be related to problems from health-care providers' side, patients' side or the health-care system of the country. Treatment of patients with type 2 diabetes has become a huge challenge in Oman, where the prevalence has increased to high levels.

METHOD

Semi-structured interviews were conducted with 26 health-care professionals, 19 doctors and seven nurses, who worked in primary health care in Oman. Qualitative content analysis was applied. Findings Organizational barriers and barriers related to patients and health-care providers were identified. These included workload and lack of teamwork approach. Poor patients' management adherence and influence of culture on their attitudes towards illness were identified. From the providers' side, language barriers, providers' frustration and aggressive attitudes towards the patients were reflected. Decreasing the workload, availability of competent teams with diabetes specialist nurses and continuity of care were suggested. Furthermore, changing professional behaviours towards a more patient-centred approach and need for health education to the patients, especially on self-management, were addressed. Appropriate training for health-care providers in communication skills with emphasis on self-care education and individualization of care according to each patient's needs are important for improvement of diabetes care in Oman.

摘要

目的

本研究旨在探索初级卫生保健提供者与2型糖尿病患者接触的经历,以及他们对未来改善糖尿病护理的偏好和建议。

背景

良好糖尿病护理的障碍可能与卫生保健提供者、患者或该国卫生保健系统方面的问题有关。在阿曼,2型糖尿病患者的治疗已成为一项巨大挑战,其患病率已升至高位。

方法

对在阿曼从事初级卫生保健工作的26名卫生保健专业人员(19名医生和7名护士)进行了半结构化访谈。采用定性内容分析法。结果识别出组织障碍以及与患者和卫生保健提供者相关的障碍。这些障碍包括工作量和缺乏团队协作方法。发现患者管理依从性差以及文化对其疾病态度的影响。从提供者方面来看,反映出语言障碍、提供者的挫败感以及对患者的攻击性态度。建议减少工作量、配备有糖尿病专科护士的能干团队以及提供持续护理。此外,还提到要转变专业行为,采用更以患者为中心的方法,并需要对患者进行健康教育,尤其是自我管理方面的教育。对卫生保健提供者进行沟通技巧方面的适当培训,强调自我护理教育并根据每个患者的需求进行个性化护理,对于改善阿曼的糖尿病护理很重要。

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