Department of Health Promotion, Maastricht University, Maastricht, The Netherlands.
Department of Endocrinology and Internal Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands.
Patient Educ Couns. 2018 Jan;101(1):92-98. doi: 10.1016/j.pec.2017.07.009. Epub 2017 Jul 12.
Despite well-known beneficial effects, adherence to core elements of diabetes treatment is suboptimal. This study, conducted in the Netherlands, aimed to explore if and how treatment adherence success factors are applied in diabetes consultations, and to explore salient personal beliefs about type 2 diabetes treatment including both healthy lifestyle adaptations and pharmacotherapy.
A qualitative study using semi-structured interviews among nine Dutch healthcare providers predominantly involved in diabetes management and 19 Dutch type 2 diabetes patients. Data was systematically analysed through deductive coding analysis using Nvivo.
Most patients visited their consultations unprepared. Patients did not or vaguely experience goal-setting in consultations, whereas healthcare providers indicated to set treatment goals. Shared-decision making was applied, however patients were rather passive collaborators as mostly healthcare providers were in charge of making treatment decisions. Despite suboptimal treatment adherence, many advantages and few disadvantages of treatment strategies were reported. Adherence self-efficacy was lower in situations outside daily routine.
Treatment adherence success factors are not optimally applied, and in particular treatment adherence self-efficacy could be improved.
The application of treatment adherence success factors in consultations could be improved, and personal beliefs should be addressed to improve treatment adherence and optimize counselling.
尽管众所周知的有益效果，坚持糖尿病治疗的核心要素是不理想的。本研究在荷兰进行，旨在探讨是否以及如何在糖尿病咨询中应用治疗依从性成功因素，并探讨 2 型糖尿病治疗的突出个人信念，包括健康生活方式的适应和药物治疗。
一项定性研究，使用半结构化访谈，参与者为 9 名主要参与糖尿病管理的荷兰医疗保健提供者和 19 名荷兰 2 型糖尿病患者。使用 Nvivo 通过演绎编码分析对数据进行系统分析。
大多数患者在就诊时没有准备。患者在咨询中没有或模糊地体验到目标设定，而医疗保健提供者表示要设定治疗目标。尽管治疗依从性不理想，但报告了许多治疗策略的优势和少数劣势。在日常生活之外，治疗依从性的自我效能感较低。
治疗依从性成功因素未得到优化应用，特别是治疗依从性自我效能感可以提高。
可以改善咨询中治疗依从性成功因素的应用，并且应该解决个人信念以提高治疗依从性并优化咨询。
