Zarora Reetu, Jani Rati, MacMillan Freya, Pham Anna, Dench Ally, Simmons David
Macarthur Clinical School, School of Medicine, Western Sydney University, Campbelltown, New South Wales, AU.
Nutrition and Dietetics, Faculty of Health, University of Canberra, Australian Capital Territory, AU.
Int J Integr Care. 2020 May 5;20(2):6. doi: 10.5334/ijic.4692.
Diabetes care often requires collaboration between general practitioners, allied health professionals, nurses, and/or medical specialists. This study aimed to describe the establishment of an integrated diabetes prevention and care approach in an area with limited access to primary and secondary care, and the challenges faced in its initial development.
A qualitative research approach to identify challenges was taken. Data included meeting minutes, observational data and reports involving local clinical and non-clinical stakeholders from June 2016- December 2018 and were thematically analysed.
Key challenges were low patient attendance in general practice, healthcare professional time, low participation at health promotion activities/peer support groups and diabetes education reflecting a low priority among people with and at risk of diabetes. Coordination between services remained a challenge.
This study highlights the need to integrate new diabetes services with existing health activities in the community and the importance of allowing flexibility and regular contact with local healthcare professional and community to encourage their involvement. Regular meetings with the funders, internal and external stakeholders are key for sustainability and to adapt programmes to the local situation. Further work is needed to identify and implement strategies to overcome these challenges.
糖尿病护理通常需要全科医生、专职医疗人员、护士和/或医学专家之间的协作。本研究旨在描述在初级和二级护理服务获取有限的地区建立综合糖尿病预防与护理方法的情况，以及其初步发展过程中面临的挑战。
采用定性研究方法来识别挑战。数据包括2016年6月至2018年12月期间涉及当地临床和非临床利益相关者的会议记录、观察数据和报告，并进行了主题分析。
主要挑战包括全科医疗中患者就诊率低、医疗保健专业人员时间有限、健康促进活动/同伴支持小组参与度低以及糖尿病教育不足，这反映出糖尿病患者及其高危人群对其重视程度较低。服务之间的协调仍然是一项挑战。
本研究强调了将新的糖尿病服务与社区现有健康活动相结合的必要性，以及允许灵活性并与当地医疗保健专业人员和社区保持定期联系以鼓励他们参与的重要性。与资助者、内部和外部利益相关者定期开会对于可持续性以及使项目适应当地情况至关重要。需要进一步开展工作来确定并实施克服这些挑战的策略。
