Centre Expert Plaies Chroniques, Centre Hospitalier Max Querrien, Paimpol, France
Centre d'Investigations Cliniques CIC1410, Institut National de la Santé et de la Recherche Médicale, Saint-Pierre Réunion, France.
BMJ Open. 2022 Jun 14;12(6):e046759. doi: 10.1136/bmjopen-2020-046759.
Considering health literacy needs is a key component of health services responsiveness to diabetes self-management among vulnerable individuals. The purpose of this qualitative study was to provide a detailed analysis of the health literacy of people with type 2 diabetes in relation to their daily self-care practices.
Nested qualitative study in the ERMIES randomised controlled trial testing a 2-year structured care in type 2 diabetes. First round of semidirected interviews at the beginning of the trial with thematic analysis of content. Second round at the completion with directed interviews guided by the first round's themes together with Health Literacy Questionnaire.
Interviews conducted at home.
Forty-four (31 females/13 males, 30-79 years, glycated haemoglobin (HbA1c)≥7.5%) consecutive participants out of 100 recruited in the ERMIES trial from 4 diabetology outpatient settings (Reunion Island). Forty-two respondents to the second round interviews.
Three poles structured into eight themes characterised practices in context: health knowledge, disease management, expertise and social support. The relationships of participants in each of the eight themes were differentiated, ranging from functional to interactive and critical. Treatment and follow-up were essentially functional, while diet and exercise remained more interactive. Social support and relationship to health professionals were important determinants of disease management.
Treatment management and disease monitoring remain primarily the job of health professionals, as opposed to diet, physical activity and social support being part of ordinary practice. Decision-making, as a shared social task, as well as resources for participation in health services, should be considered for relevant interventions in type 2 diabetes.
NCT01425866.
考虑健康素养需求是医疗服务对弱势群体糖尿病自我管理做出回应的关键组成部分。本定性研究的目的是详细分析 2 型糖尿病患者的健康素养与其日常自我护理实践之间的关系。
嵌套式定性研究，纳入 ERMIES 随机对照试验，该试验对 2 型糖尿病进行为期 2 年的结构化护理。在试验开始时进行第一轮半定向访谈，采用内容分析法进行主题分析。第二轮在试验结束时进行，采用定向访谈，以第一轮的主题为指导，同时使用健康素养问卷。
在家中进行访谈。
从 ERMIES 试验中招募的 100 名参与者中的 44 名（31 名女性/13 名男性，年龄 30-79 岁，糖化血红蛋白（HbA1c）≥7.5%）连续参与者。第二轮访谈有 42 名受访者。
根据 8 个主题，将参与者的实践分为三个极点：健康知识、疾病管理、专业知识和社会支持。每个主题中参与者的关系各不相同，从功能到互动和批判。治疗和随访主要是功能的，而饮食和运动仍然更具互动性。社会支持和与卫生专业人员的关系是疾病管理的重要决定因素。
治疗管理和疾病监测主要仍然是卫生专业人员的工作，而饮食、体育活动和社会支持则是日常生活的一部分。应该考虑作为共同社会任务的决策以及参与卫生服务的资源，作为 2 型糖尿病的相关干预措施。
NCT01425866。
