Upsher Rebecca, Allen-Taylor Maya, Reece Ilse, Chamley Mark, Ismail Khalida, Forbes Angus, Winkley Kirsty
Diabetes, Psychiatry, and Psychology, Department of Psychological Medicine, King's College London and Institute of Psychiatry, Psychology and Neuroscience, London, UK.
Florence Nightingale Faculty of Nursing and Midwifery and Palliative Care, King's College London, London, UK.
Diabetes Ther. 2020 Jan;11(1):119-132. doi: 10.1007/s13300-019-00727-7. Epub 2019 Nov 15.
Type 2 diabetes is a progressive condition and many people require insulin therapy 5-10 years post diagnosis. Considering the global increase in type 2 diabetes, group education programmes to initiate insulin are beneficial as they are cost-effective and provide peer support. However, group education to initiate insulin has not been widely evaluated and there is a need to elicit the views and experience of people with type 2 diabetes who start insulin in groups. The aim of this study was to explore the perspectives of people with type 2 diabetes who receive nurse-led group-based insulin education.
Qualitative, semi-structured interviews of people with type 2 diabetes in south London, UK, who had attended group education sessions to start insulin. Inductive thematic analysis identified themes within the data.
Fifteen people with type 2 diabetes were interviewed. Three main themes were identified: creating a supportive environment; facilitator skills; and effectiveness of group. Factors which created a supportive environment included peer support, providing reassurance and printed materials. Facilitator skills associated with positive experiences included addressing negative insulin beliefs and managing group dynamics. The effectiveness of the group was determined by ongoing self-management success, need for more peer support, and insulin concerns post insulin education group.
Positive experiences of insulin group education for people with type 2 diabetes were associated with sharing experiences with other people starting insulin, reassurance from healthcare professionals, appropriate supportive materials, and skill of the facilitator to address insulin concerns and manage group dynamics. People with type 2 diabetes may benefit more from education if healthcare professionals are skilled in psychological techniques to facilitate group education aimed at addressing concerns around insulin therapy. Further research needs to assess the effectiveness of structured insulin group education for people with type 2 diabetes.
2型糖尿病是一种渐进性疾病，许多患者在确诊后5至10年需要胰岛素治疗。鉴于全球2型糖尿病患者人数的增加，开展胰岛素起始治疗的团体教育项目是有益的，因为它们具有成本效益并能提供同伴支持。然而，胰岛素起始治疗的团体教育尚未得到广泛评估，有必要了解在团体中开始使用胰岛素的2型糖尿病患者的观点和经验。本研究的目的是探讨接受护士主导的团体胰岛素教育的2型糖尿病患者的观点。
对英国伦敦南部参加胰岛素起始治疗团体教育课程的2型糖尿病患者进行定性、半结构化访谈。通过归纳主题分析确定数据中的主题。
对15名2型糖尿病患者进行了访谈。确定了三个主要主题：营造支持性环境；促进者技能；以及团体的有效性。营造支持性环境的因素包括同伴支持、给予安慰和提供印刷材料。与积极体验相关的促进者技能包括解决对胰岛素的负面看法和管理团体动态。团体的有效性取决于持续的自我管理成功、对更多同伴支持的需求以及胰岛素教育团体结束后对胰岛素的担忧。
2型糖尿病患者胰岛素团体教育的积极体验与与其他开始使用胰岛素的人分享经验、医疗保健专业人员的安慰、适当的支持材料以及促进者解决胰岛素相关问题和管理团体动态的技能有关。如果医疗保健专业人员熟练掌握心理技术以促进旨在解决胰岛素治疗相关问题的团体教育，2型糖尿病患者可能会从教育中受益更多。需要进一步研究评估结构化胰岛素团体教育对2型糖尿病患者的有效性。
