通过纳入健康的社会决定因素,在个体层面改善2型糖尿病护理和自我管理。
Improving type 2 diabetes care and self-management at the individual level by incorporating social determinants of health.
作者信息
Frier Amanda, Devine Sue, Barnett Fiona, McBain-Rigg Kris, Dunning Trisha
机构信息
College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland.
College of Healthcare Sciences, James Cook University, Townsville, Queensland.
出版信息
Aust N Z J Public Health. 2022 Dec;46(6):865-871. doi: 10.1111/1753-6405.13296. Epub 2022 Oct 3.
OBJECTIVE
Suboptimal social determinants of health impede type 2 diabetes self-management. They are usually considered at population and community levels, not individually. The study objective was to draw on perspectives of people who have type 2 diabetes to identify and explore the impact of social determinants on self-management and ways to incorporate them into individual care.
METHODS
Purposively selected participants chose to partake in focus groups or interviews. Data were analysed and themes identified through deductive and inductive thematic analysis.
RESULTS
Social issues hinder type 2 diabetes self-management. Additionally, an individual's feelings and poor mental health, competing priorities and understanding about diabetes are important considerations. Support was provided via health professionals, community supports, financial support, personal support and informal self-management support.
CONCLUSIONS
Social determinants of health could be formally incorporated into individual care for people with type 2 diabetes if a socio-ecological view of health is taken as it considers the broader social and environmental circumstances in peoples lives.
IMPLICATIONS FOR PUBLIC HEALTH
Care for people with type 2 diabetes could be transformed if social determinants of health are formally assessed and responded to at an individual level. A socio-ecological view of health in individual care and clinical settings would enable social determinants of health to be formally incorporated into type 2 diabetes care.
目的
健康的社会决定因素不理想会阻碍2型糖尿病的自我管理。这些因素通常在人群和社区层面被考虑,而非个体层面。本研究的目的是借鉴2型糖尿病患者的观点,以识别和探究社会决定因素对自我管理的影响,以及将这些因素纳入个体护理的方法。
方法
通过目的抽样选取参与者,他们选择参加焦点小组或访谈。通过演绎和归纳主题分析对数据进行分析并确定主题。
结果
社会问题阻碍2型糖尿病的自我管理。此外,个人感受、心理健康不佳、相互竞争的优先事项以及对糖尿病的了解也是重要的考虑因素。通过健康专业人员、社区支持、经济支持、个人支持和非正式自我管理支持提供帮助。
结论
如果从健康的社会生态视角出发,将健康的社会决定因素正式纳入2型糖尿病患者的个体护理中,因为该视角考虑了人们生活中更广泛的社会和环境情况。
对公共卫生的启示
如果在个体层面正式评估并应对健康的社会决定因素,那么对2型糖尿病患者的护理可能会得到改善。在个体护理和临床环境中采用健康的社会生态视角,将使健康的社会决定因素能够正式纳入2型糖尿病护理中。