<institution content-type="university">Waikato Medical Research Centre, University of Waikato, Te Huataki Waiora, School of Health</institution>, <addr-line>Private Bag 3105</addr-line>, <city>Hamilton</city> <postal-code>3240</postal-code>, <country>New Zealand</country>.
<institution content-type="university">Waikato Medical Research Centre, University of Waikato, Te Huataki Waiora, School of Health</institution>, <addr-line>Private Bag 3105</addr-line>, <city>Hamilton</city> <postal-code>3240</postal-code>, <country>New Zealand</country>; and <institution content-type="university">School of Psychology, Massey University</institution>, <city>Auckland</city>, <country>New Zealand</country>.
J Prim Health Care. 2024 Mar;16(1):61-69. doi: 10.1071/HC23141.
Introduction In Aotearoa New Zealand (NZ), type 2 diabetes (T2D) is predominantly managed in primary care. Despite established guidelines, patients are often suboptimally managed, with inequitable health outcomes. To date, few NZ studies have evaluated the primary care management of T2D at the time of diagnosis. Aim This study aims to explore patients' the provision of education and delivery of care to patients at the time of diagnosis, which is a crucial time in the disease trajectory. Methods Participants were recruited from a Māori health provider in the Waikato District, and diagnosed with T2D after January 2020. Patients were texted a link to opt into a survey (larger study) and then registered interest by providing contact details for an interview (current study). Semi-structured interviews were conducted and were audio recorded, transcribed, and thematically analysed. Results In total, 11 participants aged 19-65 years completed the interviews (female n = 9 and male n = 20); the comprised Māori (n = 5), NZ European (n = 5) and Asian (n = 1) participants. Three overarching themes were identified, including: (1) ineffective provision of resources and education methods; (2) poor communication from healthcare practitioners; and (3) health system barriers. Discussion Evidently, there are difficulties in primary care diabetes mellitus diagnosis and management. Improvements could include locally relevant resources tailored to patients' experiences and cultural identities. Utilising whānau support and a non-clinical workforce, such as health navigators/kaiāwhina, will drastically address current workforce issues and assist patient self-management. This will allow improved diagnosis experiences and better health outcomes for patients and whānau.
简介
在新西兰(NZ),2 型糖尿病(T2D)主要在初级保健中进行管理。尽管有既定的指南,但患者的管理往往并不理想,健康结果也存在不平等。迄今为止,很少有 NZ 研究在诊断时评估 T2D 的初级保健管理。
目的
本研究旨在探讨患者在诊断时接受教育和护理的情况,这是疾病发展过程中的关键时期。
方法
参与者从怀卡托地区的毛利医疗服务提供者招募,在 2020 年 1 月后被诊断为 T2D。患者通过短信收到参加调查(更大规模的研究)的链接,然后通过提供联系方式来注册接受采访(当前研究)。对参与者进行半结构化访谈,并进行音频记录、转录和主题分析。
结果
共有 11 名年龄在 19-65 岁的参与者完成了访谈(女性 n = 9,男性 n = 20);参与者包括毛利人(n = 5)、新西兰欧洲人(n = 5)和亚洲人(n = 1)。确定了三个总体主题,包括:(1)资源和教育方法的提供效率低下;(2)医疗保健从业者沟通不畅;(3)卫生系统障碍。
讨论
显然,初级保健中的糖尿病诊断和管理存在困难。改进措施可以包括根据患者的经验和文化身份量身定制的本地相关资源。利用家庭支持和非临床工作人员,如健康导航员/凯阿温纳,将极大地解决当前的劳动力问题,并帮助患者自我管理。这将改善诊断体验,并为患者和家庭带来更好的健康结果。