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2型糖尿病的多学科协调护理:对患者观点的定性分析。

Multidisciplinary coordinated care for Type 2 diabetes: A qualitative analysis of patient perspectives.

作者信息

Berkowitz Seth A, Eisenstat Stephanie A, Barnard Lily S, Wexler Deborah J

机构信息

Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, United States; Diabetes Population Health Research Unit, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.

Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.

出版信息

Prim Care Diabetes. 2018 Jun;12(3):218-223. doi: 10.1016/j.pcd.2018.01.005. Epub 2018 Feb 1.

Abstract

AIMS

To explore the patient perspective on coordinated multidisciplinary diabetes team care among a socioeconomically diverse group of adults with type 2 diabetes.

METHODS

Qualitative research design using 8 focus groups (n=53). We randomly sampled primary care patients with type 2 diabetes and conducted focus groups at their primary care clinic. Discussion prompts queried current perceptions of team care. Each focus group was audio recorded, transcribed verbatim, and independently coded by three reviewers. Coding used an iterative process. Thematic saturation was achieved. Data were analyzed using content analysis.

RESULTS

Most participants believed that coordinated multidisciplinary diabetes team care was a good approach, feeling that diabetes was too complicated for any one care team member to manage. Primary care physicians were seen as too busy to manage diabetes alone, and participants were content to be treated by other care team members, especially if there was a single point of contact and the care was coordinated. Participants suggested that an ideal multidisciplinary approach would additionally include support for exercise and managing socioeconomic challenges, components perceived to be missing from the existing approach to diabetes care.

CONCLUSIONS

Coordinated, multidisciplinary diabetes team care is understood by and acceptable to patients with type 2 diabetes.

摘要

目的

探讨社会经济背景各异的2型糖尿病成年患者对多学科协作糖尿病团队护理的看法。

方法

采用定性研究设计,开展8个焦点小组(n = 53)。我们随机抽取2型糖尿病初级保健患者,并在其初级保健诊所进行焦点小组讨论。讨论提示询问了对团队护理的当前看法。每个焦点小组都进行了录音,逐字转录,并由三位评审员独立编码。编码采用迭代过程,达到了主题饱和。使用内容分析法对数据进行分析。

结果

大多数参与者认为多学科协作糖尿病团队护理是一种很好的方法,觉得糖尿病过于复杂,任何一名护理团队成员都难以单独管理。初级保健医生被认为太忙,无法独自管理糖尿病,参与者愿意接受其他护理团队成员的治疗,特别是如果有一个单一的联系点且护理是协调的。参与者建议,理想的多学科方法还应包括对运动的支持和应对社会经济挑战,这些被认为是现有糖尿病护理方法中缺失的部分。

结论

2型糖尿病患者理解并接受多学科协作糖尿病团队护理。

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