Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia.
H.C. Andersen Children Hospital and Centre for Innovative Medical Technology, Odense University Hospital, Odense, Denmark.
Diabet Med. 2022 Sep;39(9):e14886. doi: 10.1111/dme.14886. Epub 2022 Jun 23.
Globally, type 2 diabetes care is often fragmented and still organised in a provider-centred way, resulting in suboptimal care for many individuals. As healthcare systems seek to implement digital care innovations, it is timely to reassess stakeholders' priorities to guide the redesign of diabetes care. This study aimed to identify the needs and wishes of people with type 2 diabetes, and specialist and primary care teams regarding optimal diabetes care to explore how to better support people with diabetes in a metropolitan healthcare service in Australia.
Our project was guided by a Participatory Design approach and this paper reports part of the first step, identification of needs. We conducted four focus groups and 16 interviews (November 2019-January 2020) with 17 adults with type 2 diabetes and seven specialist clinicians from a diabetes outpatient clinic in Brisbane, Australia, and seven primary care professionals from different clinics in Brisbane. Data were analysed using reflexive thematic analysis, building on the Capability, Opportunity, Motivation and Behaviour model.
People with diabetes expressed the wish to be equipped, supported and recognised for their efforts in a holistic way, receive personalised care at the right time and improved access to connected services. Healthcare professionals agreed and expressed their own burden regarding their challenging work. Overall, both groups desired holistic, personalised, supportive, proactive and coordinated care pathways.
We conclude that there is an alignment of the perceived needs and wishes for improved diabetes care among key stakeholders, however, important gaps remain in the healthcare system.
在全球范围内,2 型糖尿病的护理往往是分散的,仍然以提供者为中心的方式组织,导致许多人无法得到最佳的护理。随着医疗保健系统寻求实施数字护理创新,现在是重新评估利益相关者的优先事项,以指导糖尿病护理的重新设计的时候了。本研究旨在确定 2 型糖尿病患者、专科和初级保健团队对最佳糖尿病护理的需求和愿望,以探索如何在澳大利亚大都市医疗保健服务中更好地支持糖尿病患者。
我们的项目以参与式设计方法为指导,本文报告了第一步的部分结果,即确定需求。我们在澳大利亚布里斯班的一家糖尿病门诊诊所进行了四项焦点小组和 16 次访谈(2019 年 11 月至 2020 年 1 月),参与者包括 17 名 2 型糖尿病成年人和 7 名来自该诊所的专科临床医生,以及来自布里斯班不同诊所的 7 名初级保健专业人员。数据使用基于能力、机会、动机和行为模型的反思性主题分析进行分析。
糖尿病患者表示希望以整体的方式得到装备、支持和认可他们的努力,在适当的时间得到个性化的护理,并改善对互联服务的获取。医疗保健专业人员也表示同意,并表达了他们对自己工作挑战的负担。总的来说,两组人都希望得到全面、个性化、支持性、积极主动和协调一致的护理途径。
我们的结论是,关键利益相关者对改善糖尿病护理的需求和愿望存在一致看法,但医疗保健系统仍存在重要差距。