Faculty of Pharmacy, Mahasarakham University, Maha Sarakham, 44150, Thailand.
Primary Care Practice Research Unit, Faculty of Pharmacy, Mahasarakham University, Maha Sarakham 44150, Thailand.
Res Social Adm Pharm. 2020 Jul;16(7):854-874. doi: 10.1016/j.sapharm.2019.09.001. Epub 2019 Sep 4.
Despite the availability of evidence-based guidance to deliver effective diabetes care, many patients do not achieve goals as recommendations. This systematic review was to synthesize useful insight perspectives by patients and providers to identify factors related to diabetes management using Chronic Care Model.
This systematic review aimed to synthesize perspectives by patients and providers in order to identify factors related to diabetes management.
Databases were searched including CINAHL, PubMed, Science Direct, and Web of Science from January 2001 to September 2017. Combination of search terms were used like 'qualitative,' 'diabetes management,' 'patients' perspective,' and 'provider's perspective.' All qualitative studies used were in English with available full text. Chronic Care Model framework was used to analyze the content and to organize the findings.
Of 108 articles used, only 23 of this met the inclusion criteria. Nine factors were identified including community linkage, health service system for diabetic patients, continuity of care, self-management, providers' support, referral system, patient-provider interaction, increasing competency of healthcare providers and family support. Community linkage was revealed to be an important factor to encourage diabetic patients to look after their disease while health service system showed the limit of accessibility due to location, medical service availability, finance, information, and time. Continuity of care has shown lack of coordination in referral system within a health care team and self-management was dependent on the knowledge, beliefs, attitude, and behavior of the patient. More so, providers' support through an effective plan and/or strategy has also indicated to help patients get their target goal. Poor interaction between patients and health providers was found to be largely attributed to language barrier and lack of communication skill. Improving competency for the health providers can be achieved through continuing professional education. Both perspectives supported a family involvement and community resources for diabetes patients.
Factors related to diabetes management from nine themes showed various gaps in both perspectives. Further research on new models for diabetes management is required.
尽管有循证指导来提供有效的糖尿病护理，但许多患者并未达到推荐的目标。本系统评价旨在通过患者和提供者的综合观点，利用慢性病照护模式来确定与糖尿病管理相关的因素。
本系统评价旨在综合患者和提供者的观点，以确定与糖尿病管理相关的因素。
从 2001 年 1 月至 2017 年 9 月，我们在 CINAHL、PubMed、Science Direct 和 Web of Science 等数据库中进行了搜索。使用了“定性”、“糖尿病管理”、“患者观点”和“提供者观点”等组合搜索词。所有使用的定性研究均为英文，并提供全文。慢性病照护模式框架用于分析内容并组织研究结果。
在 108 篇文章中，只有 23 篇符合纳入标准。确定了 9 个因素，包括社区联系、糖尿病患者的卫生服务系统、护理连续性、自我管理、提供者支持、转诊系统、医患互动、提高医疗保健提供者的能力和家庭支持。社区联系被揭示为鼓励糖尿病患者照顾自己疾病的重要因素，而卫生服务系统则显示由于位置、医疗服务可用性、财务、信息和时间的限制，可及性有限。护理连续性表明在医疗保健团队内的转诊系统中缺乏协调，自我管理取决于患者的知识、信念、态度和行为。此外，通过有效的计划和/或策略提供提供者支持也有助于患者达到目标。发现患者和卫生提供者之间的互动不佳主要归因于语言障碍和缺乏沟通技巧。通过继续教育可以提高卫生保健提供者的能力。两个观点都支持为糖尿病患者提供家庭参与和社区资源。
来自九个主题的与糖尿病管理相关的因素在两个观点中都显示出了各种差距。需要进一步研究新的糖尿病管理模式。
