Hale Leigh, Higgs Christopher, Keen Donna, Smith Catherine
Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand.
Front Rehabil Sci. 2022 Apr 29;3:829542. doi: 10.3389/fresc.2022.829542. eCollection 2022.
Lifestyle programmes are important in the management of type 2 diabetes (T2D). The Diabetes Community Exercise Programme (DCEP) is an exercise and educational programme for adults living with T2D with the aim of enhancing exercise self-efficacy and supporting wellbeing. DCEP is underpinned by a model of person/whānau-centred care and the spirit of Motivational Interviewing. Person-centred care models in the context of rehabilitation and long-term health conditions are still evolving. This paper explores what those involved in DCEP perceived important to its person/whānau-centredness.
An evaluative qualitative methodological approach was used with data collected by open-ended interviews and a focus-group at completion of the initial 12-week part of DCEP. Interviews were audio-recorded and transcribed verbatim. Participants were 16 DCEP attendees and 13 healthcare professionals (HCPs) involved in DCEP delivering. Data were analysed using the General Inductive Approach.
The three interconnected themes constructed from the analysis were ', and . Through the experience and motivation of positive person-centred relationships, DCEP addressed attendees' T2D health needs, but they were constantly balancing these needs with those of family, employers, finances, other health needs and life interests. DCEP relationships facilitated ongoing discussions between attendees and between attendees and HCPs. The ability to discuss in a supportive and non-judgmental environment helped attendees to make sense and process the information they gained at DCEP. This empowering through knowledge in turn helped attendees to work out ways of balancing the outside world and thus better address their T2D needs.
It is "all about relationships" was key to DCEP's person/whānau-centred approach-all other factors related back to the development and maintenance of relationships. These relationships were between all whānau involved: the attendees, their family, the wider community, the healthcare provider organisations, and the HCPs and personnel involved in delivering DCEPs. These relationships created an accepting, understanding and social atmosphere that enabled attendance and facilitated both knowledge exchange and ability to exercise, both considered to be beneficial by attendees. Importantly, these relationships took time to develop, but the benefits were worth the investment.
生活方式项目在2型糖尿病(T2D)的管理中至关重要。糖尿病社区运动项目(DCEP)是一项针对患有T2D的成年人的运动和教育项目,旨在提高运动自我效能并促进健康。DCEP以个人/家庭为中心的护理模式和动机性访谈精神为基础。康复和长期健康状况背景下的以个人为中心的护理模式仍在不断发展。本文探讨了参与DCEP的人员认为对其以个人/家庭为中心至关重要的因素。
采用评价性定性研究方法,在DCEP最初的12周阶段结束时,通过开放式访谈和焦点小组收集数据。访谈进行了录音并逐字转录。参与者包括16名DCEP参与者和13名参与DCEP实施的医疗保健专业人员(HCP)。使用一般归纳法对数据进行分析。
分析得出的三个相互关联的主题是“ ,以及 。通过积极的以个人为中心的关系的体验和激励,DCEP满足了参与者的T2D健康需求,但他们不断在这些需求与家庭、雇主、财务、其他健康需求和生活兴趣之间进行平衡。DCEP中的关系促进了参与者之间以及参与者与HCP之间的持续讨论。在支持性和非评判性环境中进行讨论的能力帮助参与者理解和处理他们在DCEP中获得的信息。通过知识获得的这种赋能反过来帮助参与者找到平衡外部世界的方法,从而更好地满足他们的T2D需求。
“一切都与关系有关”是DCEP以个人/家庭为中心方法的关键——所有其他因素都与关系的发展和维护相关。这些关系存在于所有相关的家庭中:参与者、他们的家人、更广泛的社区、医疗保健提供组织以及参与实施DCEP的HCP和人员。这些关系营造了一种接纳、理解和社交的氛围,使参与者能够参与其中,并促进了知识交流和运动能力,参与者认为这两者都有益。重要的是,这些关系需要时间来发展,但好处值得投入。