Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta.
Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta.
Sci Diabetes Self Manag Care. 2023 Dec;49(6):415-425. doi: 10.1177/26350106231201365. Epub 2023 Sep 28.
The purpose of the study was to explore various forms of diabetes self-management education (DSME), including group and individual sessions, for persons with lived experiences of homelessness (PWLEH) in Canada.
A qualitative descriptive study using open-ended interviews with health care and homeless sector service providers was utilized to serve those experiencing homelessness in 5 cities across Canada. NVivo qualitative data analysis software was used to facilitate thematic analysis, focusing on variations in DSME for PWLEH.
We conducted interviews with 96 unique health and social care providers. Four themes were identified through focused coding of interviews. First, the use of a harm reduction approach during diabetes education tailored to PWLEH considered patients' access to food, medications, and supplies and other comorbidities, including mental health and substance use disorders. The second theme related to the unsuitability of the curriculum in mainstream diabetes education in a group setting for PWLEH. Third, the role of group education in community building is to create supportive relationships among members. The final theme was the importance of trust and confidentiality in DSME, which were most easily maintained during individual education, compared to group formats.
Overall, PWLEH experience unique challenges in managing diabetes. DSME adapted to these individuals' unique needs may be more successful and could be delivered in both individual and group settings.
本研究旨在探索各种形式的糖尿病自我管理教育（DSME），包括团体和个体课程，适用于加拿大有流浪经历的人群（PWLEH）。
本研究采用定性描述性研究，对加拿大 5 个城市的医疗保健和无家可归者服务提供者进行了开放式访谈，以服务于无家可归者。使用 NVivo 定性数据分析软件进行主题分析，重点关注 PWLEH 的 DSME 差异。
我们对 96 名独特的医疗和社会护理提供者进行了访谈。通过对访谈的重点编码，确定了四个主题。首先，在针对 PWLEH 的糖尿病教育中采用减少伤害的方法，考虑到患者获得食物、药物和用品的机会以及其他合并症，包括心理健康和物质使用障碍。第二个主题涉及主流糖尿病教育中的课程在团体环境中不适合 PWLEH。第三，团体教育在社区建设中的作用是在成员之间建立支持性关系。最后一个主题是 DSME 中信任和保密性的重要性，与团体形式相比，个体教育更容易保持这种信任和保密性。
总体而言，PWLEH 在管理糖尿病方面面临独特的挑战。针对这些个体独特需求的 DSME 可能更成功，可以在个体和团体环境中提供。
