Ogunrinu Temidayo, Gamboa-Maldonado Thelma, Ngewa R Ndinda, Saunders Jasmine, Crounse Jamie, Misiri James
School of Public Health, Loma Linda University, Loma Linda, California, USA.
Department of Public Health, Malamulo Adventist Hospital, Makwasa, Malawi.
Malawi Med J. 2017 Jun;29(2):118-123. doi: 10.4314/mmj.v29i2.8.
The aim of this study was to understand the perceptions and experiences of health education and self-management practices on Malamulo Adventist Hospital type 2 diabetic patients.
In this qualitative study, key informant interviews (KIIs; n=4) and focus group discussions (3 FGDs; n=16) were conducted amongst type 2 diabetes patients who had been treated at Malamulo Adventist Hospital in southern Malawi at least once. Key informant interviews and focus group discussions were audio recorded, transcribed verbatim and translated for analysis. Grounded theory methods were used to identify line-by-line emerging codes and were categorized and examined in Atlas.ti. The data was analyzed for emergent themes and supported by critical quotes.
Content analysis revealed participants had a positive regard for the diabetes education classes and had satisfactory health literacy. Participants expressed their ability to integrate diabetes education, such as exercise into their lifestyle. Due to financial constraints subjects experienced trouble maintaining their medication regimen, and had difficulty adopting healthier nutritional alternatives. Although patients expressed efficacy in controlling their blood sugar they subsequently expressed having limited knowledge when dealing with diabetes complications.
Diabetes self-management is comprised of a complex set of processes. Patients with type 2 diabetes at Malamulo Adventist Hospital are deeply impacted by these processes which includes their understanding of the disease process, effects of medication, economic challenges to acquiring health care services and medications, and one's unique life experience. For all patients with type 2 diabetes to successfully manage their condition, support from their family, the medical community, and health policies must be readily available.
本研究的目的是了解马拉穆洛基督复临安息日会医院2型糖尿病患者对健康教育和自我管理实践的认知与体验。
在这项定性研究中，对至少在马拉维南部的马拉穆洛基督复临安息日会医院接受过一次治疗的2型糖尿病患者进行了关键 informant 访谈（KIIs；n = 4）和焦点小组讨论（3个FGDs；n = 16）。关键 informant 访谈和焦点小组讨论进行了音频录制，逐字转录并翻译以供分析。采用扎根理论方法识别逐行出现的代码，并在Atlas.ti中进行分类和检查。对数据进行分析以找出新出现的主题，并辅以关键引语。
内容分析显示参与者对糖尿病教育课程持积极态度，且健康素养令人满意。参与者表示他们有能力将糖尿病教育，如运动融入生活方式。由于经济限制，受试者在维持药物治疗方案方面遇到困难，并且难以采用更健康的营养替代方案。尽管患者表示在控制血糖方面有成效，但随后表示在应对糖尿病并发症方面知识有限。
糖尿病自我管理由一系列复杂的过程组成。马拉穆洛基督复临安息日会医院的2型糖尿病患者深受这些过程的影响，这些过程包括他们对疾病过程的理解、药物的作用、获得医疗服务和药物的经济挑战以及个人独特的生活经历。对于所有2型糖尿病患者要成功管理自己的病情，必须随时获得家人、医疗界和卫生政策的支持。
