Department of Community Medicine and School of Public Health, Post-Graduate Institute of Medical Education and Research, Chandigarh, India.
Centre for Sexuality and Health Research and Policy (C-SHaRP), Chennai, India.
PLoS One. 2024 Feb 8;19(2):e0297132. doi: 10.1371/journal.pone.0297132. eCollection 2024.
Diabetes self-care behaviour plays a crucial role in managing the diabetes effectively and preventing complications. Patients with type 2 diabetes mellitus (T2DM) and health care professionals (HCPs) of rural areas often face unique challenges when it comes to diabetes self-care practices (SCPs). Therefore, this study aim to explore the perspectives of patients with T2DM and HCPs on diabetes SCPs.
Eight focus group discussions (FGDs) among individuals with T2DM and In-depth interviews (IDIs) with 15 HCPs were conducted in rural areas of Punjab, North India. Capability, Opportunity, Motivation, and Behaviour model (COM-B) was employed for thematic framework analyses.
The study participants perceived that a limited understanding of diabetes mellitus (DM), beliefs in alternative therapies, drug side effects, attitudes towards DM (psychological capability), comorbidities (physical capability), family support (social opportunity), financial and time constraints, and weather conditions (physical opportunity) contributed to lack of DM SCPs. Physicians' guidance and support were motivating them to adhere to SCPs, especially when aligned with their sense of self-efficacy (reflective motivation). HCPs constraints in providing patient-centred care are due to training limitations (psychological capability) and a lack of essential resources (physical opportunities). Participants expressed need for comprehensive diabetes care (automatic motivation) through structured diabetes education intervention to improve diabetes SCPs.
The study findings indicate that various factors influence diabetes SCPs from the perspectives of both patients with T2DM and HCPs and emphasizes the need for a multi-faceted approach to improve diabetes SCPs in rural areas. Implementing a structured diabetes self-care intervention strategy in rural areas may help for preventing and mitigating the impact of diabetes-related complications in rural areas.
糖尿病自我护理行为对于有效管理糖尿病和预防并发症至关重要。患有 2 型糖尿病(T2DM)的患者和农村地区的医疗保健专业人员(HCP)在进行糖尿病自我护理实践(SCP)时,经常面临独特的挑战。因此,本研究旨在探讨 T2DM 患者和 HCP 对糖尿病 SCP 的观点。
在印度北部旁遮普邦的农村地区,对 T2DM 患者进行了 8 次焦点小组讨论(FGD)和对 15 名 HCP 进行了深入访谈(IDI)。采用能力、机会、动机和行为模型(COM-B)进行主题框架分析。
研究参与者认为,对糖尿病(DM)的了解有限、对替代疗法的信念、药物副作用、对 DM 的态度(心理能力)、合并症(身体能力)、家庭支持(社会机会)、财务和时间限制以及天气条件(物理机会),都导致 DM SCP 的缺乏。医生的指导和支持激励他们坚持 SCP,尤其是当他们的自我效能感(反思动机)与医生的指导和支持一致时。HCP 提供以患者为中心的护理的能力受到培训限制(心理能力)和缺乏基本资源(物理机会)的限制。参与者表示需要通过综合的糖尿病教育干预来改善糖尿病 SCP,从而获得全面的糖尿病护理(自动动机)。
从 T2DM 患者和 HCP 的角度来看,研究结果表明,有各种因素影响糖尿病 SCP,强调需要采取多方面的方法来改善农村地区的糖尿病 SCP。在农村地区实施结构化的糖尿病自我护理干预策略,可能有助于预防和减轻农村地区与糖尿病相关的并发症的影响。