马拉维农村一级医院 1 型糖尿病患者使用连续血糖监测的适宜性和可接受性：一项定性研究。

Appropriateness and acceptability of continuous glucose monitoring in people with type 1 diabetes at rural first-level hospitals in Malawi: a qualitative study.

机构信息

Center for Integration Science, Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA.

Partners In Health, Neno, Malawi.

出版信息

BMJ Open. 2024 May 6;14(5):e075559. doi: 10.1136/bmjopen-2023-075559.

DOI:10.1136/bmjopen-2023-075559

PMID:38719287

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11086409/

Abstract

OBJECTIVES

The purpose of this qualitative study is to describe the acceptability and appropriateness of continuous glucose monitoring (CGM) in people living with type 1 diabetes (PLWT1D) at first-level (district) hospitals in Malawi.

DESIGN

We conducted semistructured qualitative interviews among PLWT1D and healthcare providers participating in the study. Standardised interview guides elicited perspectives on the appropriateness and acceptability of CGM use for PLWT1D and their providers, and provider perspectives on the effectiveness of CGM use in Malawi. Data were coded using Dedoose software and analysed using a thematic approach.

SETTING

First-level hospitals in Neno district, Malawi.

PARTICIPANTS

Participants were part of a randomised controlled trial focused on CGM at first-level hospitals in Neno district, Malawi. Pretrial and post-trial interviews were conducted for participants in the CGM and usual care arms, and one set of interviews was conducted with providers.

RESULTS

Eleven PLWT1D recruited for the CGM randomised controlled trial and five healthcare providers who provided care to participants with T1D were included. Nine PLWT1D were interviewed twice, two were interviewed once. Of the 11 participants with T1D, six were from the CGM arm and five were in usual care arm. Key themes emerged regarding the appropriateness and effectiveness of CGM use in lower resource setting. The four main themes were (a) patient provider relationship, (b) stigma and psychosocial support, (c) device usage and (d) clinical management.

CONCLUSIONS

Participants and healthcare providers reported that CGM use was appropriate and acceptable in the study setting, although the need to support it with health education sessions was highlighted. This research supports the use of CGM as a component of personalised diabetes treatment for PLWT1D in resource constraint settings.

TRIAL REGISTRATION NUMBER

PACTR202102832069874; Post-results.

摘要

目的

本定性研究旨在描述在马拉维一级（区）医院中，1 型糖尿病患者（PLWT1D）对连续血糖监测（CGM）的可接受性和适宜性。

设计

我们对参与该研究的 PLWT1D 和医疗保健提供者进行了半结构化定性访谈。标准化访谈指南引出了参与者对 CGM 用于 PLWT1D 和其提供者的适宜性和可接受性的看法，以及提供者对 CGM 在马拉维使用效果的看法。数据使用 Dedoose 软件进行编码，并采用主题分析方法进行分析。

设置

马拉维恩诺区的一级医院。

参与者

参与者是在马拉维恩诺区一级医院进行 CGM 随机对照试验的一部分。在 CGM 和常规护理组的参与者中进行了试验前和试验后访谈，对 5 名医疗保健提供者进行了一组访谈。

结果

纳入了 11 名参加 CGM 随机对照试验的 PLWT1D 和 5 名为 T1D 患者提供护理的医疗保健提供者。其中 9 名 PLWT1D 接受了两次访谈，2 名接受了一次访谈。在 11 名 T1D 患者中，6 名来自 CGM 组，5 名来自常规护理组。主要出现了一些关于在资源较少的环境中使用 CGM 的适宜性和有效性的主题。四个主要主题是：（a）医患关系，（b）污名和心理社会支持，（c）设备使用和（d）临床管理。