Kasteleyn Marise J, Gorter Kees J, van Puffelen Anne L, Heijmans Monique, Vos Rimke C, Jansen Hanneke, Rutten Guy E H M
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.
Prim Care Diabetes. 2014 Oct;8(3):195-206. doi: 10.1016/j.pcd.2013.12.001. Epub 2014 Jan 3.
Despite diabetes patients' efforts to control their disease, many of them are confronted with an acute coronary event. This may evoke depressive feelings and self-management may be complicated. According to the American Diabetes Association, the transition from hospital to home after an acute coronary event (ACE) is a high-risk time for diabetes patients; it should be improved. Before developing an intervention for diabetes patients with an ACE in the period after discharge from hospital, we want to gain a detailed understanding of patients' views, perceptions and feelings in this respect.
Qualitative design. Two semi-structured focus groups were conducted with 14 T2DM patients (71% male, aged 61-77 years) with a recent ACE. One focus group with partners (67% male, aged 64-75 years) was held. All interviews were transcribed verbatim and analyzed by two independent researchers.
Patients believed that coping with an ACE differs between patients with and without T2DM. They had problems with physical exercise, sexuality and pharmacotherapy. Patients and partners were neither satisfied with the amount of information, especially on the combination of T2DM and ACE, nor with the support offered by healthcare professionals after discharge. Participants would appreciate tailored self-management support after discharge from hospital.
Patients with T2DM and their partners lack tailored support after a first ACE. Our findings underpin the ADA recommendations to improve the transition from hospital to home. The results of our study will help to determine the exact content of a self-management support program delivered at home to help this specific group of patients to cope with both conditions.
尽管糖尿病患者努力控制病情，但许多人仍面临急性冠状动脉事件。这可能引发抑郁情绪，自我管理也可能变得复杂。根据美国糖尿病协会的说法，急性冠状动脉事件（ACE）后从医院过渡到家庭对糖尿病患者来说是一个高危时期，需要加以改善。在为出院后患有ACE的糖尿病患者制定干预措施之前，我们希望详细了解患者在这方面的观点、看法和感受。
采用定性设计。对14名近期发生ACE的2型糖尿病患者（71%为男性，年龄61 - 77岁）进行了两个半结构化焦点小组访谈。还与患者的伴侣进行了一个焦点小组访谈（67%为男性，年龄64 - 75岁）。所有访谈均逐字转录，并由两名独立研究人员进行分析。
患者认为，患有和未患有2型糖尿病的患者应对ACE的方式有所不同。他们在体育锻炼、性功能和药物治疗方面存在问题。患者及其伴侣对信息的数量，尤其是关于2型糖尿病和ACE合并情况的信息不满意，对出院后医护人员提供的支持也不满意。参与者希望出院后能得到量身定制的自我管理支持。
2型糖尿病患者及其伴侣在首次发生ACE后缺乏量身定制的支持。我们的研究结果支持了美国糖尿病协会关于改善从医院到家庭过渡的建议。我们的研究结果将有助于确定在家中提供的自我管理支持项目的确切内容，以帮助这一特定患者群体应对两种疾病。
