Tidsskr Nor Laegeforen. 2021 Apr 7;141(6). doi: 10.4045/tidsskr.20.0623. Print 2021 Apr 20.
The National Diabetes Plan 2017-21 has implemented measures to improve diagnosis and follow-up of persons with type 2 diabetes by the primary health services. The objective of this study was to explore the experiences and thoughts of Norwegian general practitioners (GPs) with regard to diagnosis and follow-up of this patient group.
In this qualitative study, three focus-group interviews were conducted with a total of 17 GPs. The interviews were recorded, transcribed and analysed using systematic text condensation.
The GPs reported having a busy daily schedule that rarely allowed for targeted identification of patients in the risk zone to be prioritised. They described a patient-centred diabetes care, in which motivating for lifestyle change was considered a necessary but demanding task. The doctors identified the need to find a balance between following the general clinical guidelines on the one hand and individually adapting the follow-up to each patient on the other. Furthermore, the participants reported being less updated on current medical knowledge than they wanted, due to time constraints.
The GPs in the study described a patient-centred diabetes care that was driven by clinical experience. The guidelines have an advisory, but not mandatory function. This approach enables personalised and adapted treatment, but could also be a contributory cause of the failure to provide sufficient follow-up as required by the national guidelines.
2017-2021 年国家糖尿病计划实施了措施，以改善初级卫生服务机构对 2 型糖尿病患者的诊断和随访。本研究的目的是探讨挪威全科医生（GP）在诊断和随访该患者群体方面的经验和想法。
在这项定性研究中，对 17 名全科医生进行了三次焦点小组访谈。对访谈进行了录音、转录和系统文本浓缩分析。
全科医生报告说，他们的日常工作很忙，几乎没有时间有针对性地确定处于危险区域的患者进行优先排序。他们描述了一种以患者为中心的糖尿病护理，他们认为激励生活方式的改变是一项必要但要求很高的任务。医生们发现，一方面需要在遵循一般临床指南和另一方面根据每个患者的情况个别调整随访之间找到平衡。此外，由于时间限制，参与者报告说他们对当前医学知识的了解不如他们希望的那么多。
研究中的全科医生描述了一种以患者为中心的糖尿病护理，由临床经验驱动。这些指南具有咨询作用，但不是强制性的。这种方法可以实现个性化和适应性的治疗，但也可能是导致未能按照国家指南要求提供足够随访的一个原因。
