School of Public Health and Primary Care, Fiji National University, Suva, Fiji.
Front Public Health. 2022 Apr 4;10:779266. doi: 10.3389/fpubh.2022.779266. eCollection 2022.
Type 2 Diabetes Mellitus (T2DM) is known as a major cause of mortality globally. Diabetes self-management refers to daily activities undertaken to control or reduce the impact of diabetes on health and well-being to avoid further illness. Health Care Workers' (HCWs) can assist patients to be aware of self-care and solve the challenges diabetes presents. The management of diabetes can improve once HCWs promote measures that facilitate self-care activities by providing necessary information and supporting patients' initiatives to make lifestyle changes. This study aimed to explore HCWs perceptions on factors affecting diabetes self-management among T2DM patients of Fiji.
A qualitative study design was conducted to explore HCWs perceptions on factors affecting diabetes self-management using two Focus Group Discussions (FGDs) in Labasa, Fiji in 2021. The study settings were the Diabetic Hub Center, special outpatient department Labasa hospital and Nasea health Center Labasa. The study settings are located in an urban area. These health facilities provide special outpatient clinics to T2DM patients including clinics for other medical conditions. Nasea Health Center had 1,300 patients, the special outpatient's department Labasa hospital had 560 patients and the diabetic hub center Labasa had 295 patients at the time of the study. These patients either had T2DM or T2DM with other medical conditions. Purposive sampling was employed to recruit HCWs. The data were collected using an interview guide in semi-structured interviews and the interviews were audio recorded. The recorded data was transcribed verbatim and analyzed using thematic analysis process.
The participants were 9 HCWs with age range of 25-49 years. A counselor, a medical officer, physiotherapist, nurses and dieticians were among the HCWs. Three major themes and seven sub themes were identified. These included Theme 1- "availability of services" with the sub themes of clinical services for T2DM and other support services available for T2DM patients. Theme 2- "barriers and challenges to diabetes self-management" with the sub themes of health system factors, socioeconomic factors and health system factors. Theme 3- "Needs for diabetes management" with the sub themes resources and skilled personnel.
The findings of this study demonstrate health system challenges such as lack of material resources and human resources compounded the factors affecting diabetes self-management. HCWs training as diabetes educators and developing policy on diabetes self-management are highly recommended to facilitate diabetes self-management.
2 型糖尿病（T2DM）是全球主要的死亡原因之一。糖尿病自我管理是指为了控制或减少糖尿病对健康和福祉的影响而进行的日常活动，以避免进一步的疾病。卫生保健工作者（HCWs）可以帮助患者了解自我护理，并解决糖尿病带来的挑战。一旦 HCWs 促进了促进自我护理活动的措施，通过提供必要的信息和支持患者改变生活方式的举措，糖尿病的管理就可以得到改善。本研究旨在探索斐济 T2DM 患者中 HCWs 对影响糖尿病自我管理因素的看法。
采用定性研究设计，于 2021 年在斐济拉巴萨通过两次焦点小组讨论（FGD）探讨 HCWs 对影响糖尿病自我管理因素的看法。研究地点为拉巴萨糖尿病中心、拉巴萨医院特殊门诊部和拉巴萨纳西亚保健中心。这些卫生保健设施为 T2DM 患者提供特殊门诊服务，包括其他医疗条件的门诊服务。纳西亚保健中心当时有 1300 名患者，拉巴萨医院特殊门诊部有 560 名患者，拉巴萨糖尿病中心有 295 名患者。这些患者要么患有 T2DM，要么患有 T2DM 合并其他医疗条件。采用目的抽样法招募 HCWs。使用半结构式访谈指南进行访谈，访谈进行录音。将记录的数据逐字转录，并使用主题分析过程进行分析。
参与者为 9 名年龄在 25-49 岁之间的 HCWs。其中包括一名顾问、一名医生、一名物理治疗师、护士和营养师。确定了三个主要主题和七个子主题。这些主题包括主题 1-“服务的可及性”，其子主题包括 T2DM 的临床服务和 T2DM 患者的其他支持服务。主题 2-“糖尿病自我管理的障碍和挑战”，其子主题包括卫生系统因素、社会经济因素和卫生系统因素。主题 3-“糖尿病管理需求”，其子主题包括资源和熟练人员。
本研究结果表明，卫生系统挑战，如缺乏物质资源和人力资源，加剧了影响糖尿病自我管理的因素。强烈建议对 HCWs 进行糖尿病教育者培训，并制定糖尿病自我管理政策，以促进糖尿病自我管理。
