Kulliyyah of Nursing, International Islamic University Malaysia, Kuantan Pahang, Malaysia.
School of Healthcare, University of Leeds, Leeds, UK.
J Clin Nurs. 2018 Oct;27(19-20):3758-3767. doi: 10.1111/jocn.14559. Epub 2018 Jul 23.
To explore self-care and self-care support in patients with Type 2 diabetes in urban Malaysia.
The prevalence of Type 2 diabetes in Malaysia and associated long-term and life-changing complications is increasing. With effective self-care and self-care support, severe complications of the condition can be avoided or reduced. Prior to this study, no evidence existed about Malaysian patients' management of the condition or support for self-care from the healthcare system.
A single embedded qualitative case study.
Semistructured interviews with 18 patients with Type 2 diabetes aged 28-69 years, healthcare professionals (n = 19), observations (n = 13) of clinic appointments from two urban settings in Malaysia and a documentary analysis. Recordings were transcribed verbatim, field notes were made during observations and the data analysed and synthesised within and across case using Framework analysis.
Three main themes explained self-care and self-care support in Malaysia: fatalism, faith and fear. Patients were fatalistic about developing diabetes-they perceived it as inevitable because it is so common in Malaysia. However, faith in God, coupled with fear of the consequences of diabetes, motivated them to engage in self-care practices. The fear was largely induced by diabetes healthcare professionals working in overcrowded clinics, and stretched thinly across the service, who used a direct and uncompromising approach to instil the importance of self-care to avoid severe long-term complications.
This study provided important insight on how people in Malaysia developed diabetes, their responses to the disease and the approach of healthcare professionals in supporting them to engage with self-care.
Any future development of self-care programmes in Malaysia needs to recognise the factors that motivate patients to self-care and include components that build self-efficacy.
探索马来西亚城市 2 型糖尿病患者的自我护理和自我护理支持。
马来西亚 2 型糖尿病的患病率及其相关的长期和改变生活的并发症正在增加。通过有效的自我护理和自我护理支持，可以避免或减少该疾病的严重并发症。在此研究之前，马来西亚患者对该疾病的管理或医疗系统对自我护理的支持方面没有任何证据。
单个嵌入式定性案例研究。
对 18 名年龄在 28-69 岁的 2 型糖尿病患者进行半结构化访谈，访谈对象为 19 名医疗保健专业人员，对马来西亚两个城市地区的诊所就诊进行 13 次观察，并进行文献分析。记录被逐字转录，在观察期间做了现场记录，并在案例内和跨案例中使用框架分析对数据进行分析和综合。
三个主要主题解释了马来西亚的自我护理和自我护理支持：宿命论、信仰和恐惧。患者对患糖尿病感到宿命论——他们认为这是不可避免的，因为马来西亚的糖尿病发病率很高。然而，对上帝的信仰，加上对糖尿病后果的恐惧，促使他们进行自我护理实践。这种恐惧主要是由在人满为患的诊所工作的糖尿病医疗保健专业人员引起的，他们在服务中分布得很稀疏，采用直接和毫不妥协的方法向患者灌输自我护理的重要性，以避免严重的长期并发症。
本研究深入了解了马来西亚人如何患上糖尿病、他们对疾病的反应以及医疗保健专业人员支持他们进行自我护理的方法。
马来西亚任何未来的自我护理计划的发展都需要认识到激励患者进行自我护理的因素，并包括增强自我效能的组成部分。
