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《2 型糖尿病个体的内在现实:通过扎根理论方法影响自我管理信念的中介因素》

The Internal Realities of Individuals With Type 2 Diabetes: Mediators Influencing Self-Management Beliefs via Grounded Theory Approach.

机构信息

Seremban Primary Health Care Clinic, Jalan Rasah, Seremban, Negeri Sembilan, Malaysia.

Monash University Malaysia, Bandar Sunway, Selangor, Malaysia.

出版信息

J Prim Care Community Health. 2020 Jan-Dec;11:2150132719900710. doi: 10.1177/2150132719900710.

Abstract

There has been an unabated rise in the prevalence of type 2 diabetes (T2D) worldwide. Although T2D is highly preventable, these trends suggest that a paradigm change is much needed in the way both clinicians and policy makers view what effective T2D strategies conventionally entail. Hence, it is becoming increasingly clear that T2D patients require more than just a pharmacological approach to their disease. Evidence indicate that culturally specific mediators can help foster better self-management practices. We intend to discover psychosocial mediators that influence and support self-management beliefs in T2D patients. We adopted the grounded theory approach to guide in-depth interviews with T2D patients and health care professionals (HCP) at a regional primary care clinic in Malaysia. Twenty-four T2D patients and 10 HCPs were recruited through purposive sampling method to examine the inner psychological narratives about how they perceive and what they believe beliefs about the disease. Two focus group discussions were also were conducted for data triangulation. A functional framework for the psychosocial mediators influencing self-management beliefs in T2D patients was designed and characterized by 4 major processes: (1) health promotion, (2) personal expectations, (3) person-centered care, and (4) psychosocial support. The fulfillment of patients' personal expectations is central to better self-management beliefs. Positive emotional states are important in providing a positive environment to nurture self-management practices. A person-centered consultation that focuses on empathy and cultural sensitivities has the potential to foster behavioral change required to sustain self-care practices.

摘要

全球 2 型糖尿病(T2D)的患病率一直在上升。尽管 T2D 是可以高度预防的,但这些趋势表明,临床医生和政策制定者需要改变传统的有效 T2D 策略观念。因此,越来越明显的是,T2D 患者不仅需要药物治疗,还需要其他方法来治疗他们的疾病。有证据表明,特定于文化的调解因素可以帮助培养更好的自我管理实践。我们旨在发现影响和支持 T2D 患者自我管理信念的心理社会调解因素。我们采用扎根理论方法,在马来西亚的一家地区基层医疗诊所对 T2D 患者和医疗保健专业人员(HCP)进行深入访谈。通过目的抽样法招募了 24 名 T2D 患者和 10 名 HCP,以检查他们对疾病的看法和信念的内在心理叙述。还进行了两次焦点小组讨论以进行数据三角测量。设计了影响 T2D 患者自我管理信念的心理社会调解因素的功能框架,并由 4 个主要过程进行了描述:(1)健康促进,(2)个人期望,(3)以患者为中心的护理,以及(4)心理社会支持。满足患者的个人期望是更好的自我管理信念的核心。积极的情绪状态对于提供培养自我管理实践的积极环境很重要。以同理心和文化敏感性为重点的以患者为中心的咨询有可能促进维持自我护理实践所需的行为改变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4077/7257383/7479355438b4/10.1177_2150132719900710-fig1.jpg

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