School of Public Health and Primary Care, Fiji National University, Suva, Fiji.
Faculty of Health, Education and Life Science. School of Nursing and Midwifery, Birmingham City University, Birmingham, United Kingdom.
PLoS One. 2024 May 31;19(5):e0304708. doi: 10.1371/journal.pone.0304708. eCollection 2024.
The prevalence of diabetes has increased globally where Type 2 Diabetes Mellitus (T2DM) is more common than any other type of diabetes. Self- care management education of diabetes provides skills and information for diabetic patients to effectively perform their own self diabetic self-care for optimum glycemic index control. As T2DM is a growing health issue in Fiji, promoting diabetes self manages among patients is a need, however there is lack of evidence in this regard. Therefore, the aim of this study is to explore the perception of T2DM patients on diabetic self-care management.
This study used a qualitative method among T2DM patients regarding diabetic self-care management in Central Division, Fiji in 2022. This study was conducted in SOPD (Special Out Patient Department) clinics in the three chosen governmental health centers in the central division of Fiji. The study sample inclusion criteria were only T2DM patients, and no other types of diabetes, patients who are 18years and above, patients who are attending clinic at least for more than 6 months, self-identified as Fijian participants of any ethnicity or gender. The study settings were also purposively selected but the study sample was selected using purposive sampling. In depth interview using semi-structured open-ended questionnaires was used to collect data. Thematic analysis was done, followed by reviewing themes, defining and naming them.
Thirty patients participated in this study. Five major themes emerged from the in-depth interview including; patient factors that affect diabetes self-care management, behavior and attitude towards T2DM self-care management, health services delivery, challenges and barriers faced by patients to perform diabetes self-care management, and recommendations to improve patient self-care management. Patients in this study have good knowledge about T2DM and the self-care management they have to perform. It is the patients' attitude and behavior towards T2DM self-care management that affects patients to perform self-care management. The study also showed patients have gained good knowledge from Health Care Workers (HCW). Socio-economic and psychological status also played a vital part in patients' self-care management. Apart from challenges, there were opportunities to learn the difficulties patients face in order to perform self-care management.
The results of this study revealed a combination of individual, cultural, and health systematic related factors as the mots influencer of diabetes self-management among patients in Fiji. Patients have to take ownership of their own health in order to improve their blood sugar reading and reduce complication of diabetes. Tailored interventions that consider patients' belief and address potential challenges would be useful. A lot is needed in terms of upgrading facilities for the comfort of patients and need to collaborate more with other multidisciplinary team and stakeholders.
糖尿病的患病率在全球范围内有所增加,其中 2 型糖尿病(T2DM)比其他任何类型的糖尿病都更为常见。糖尿病自我管理教育为糖尿病患者提供了技能和信息,使他们能够有效地进行自我糖尿病自我护理,以实现最佳血糖指数控制。由于 T2DM 是斐济日益严重的健康问题,因此需要在患者中推广糖尿病自我管理,但这方面缺乏证据。因此,本研究旨在探讨 T2DM 患者对糖尿病自我管理的看法。
本研究于 2022 年在斐济中央行政区采用定性方法对 T2DM 患者进行糖尿病自我管理。本研究在斐济中央行政区的三个选定政府卫生中心的 SOPD(特殊门诊)诊所进行。研究样本纳入标准仅为 T2DM 患者,不包括其他类型的糖尿病患者,年龄在 18 岁及以上,至少在诊所就诊 6 个月以上,自我认定为斐济任何种族或性别的参与者。研究地点也是有目的地选择的,但研究样本是使用目的抽样选择的。采用半结构式开放式问卷进行深入访谈收集数据。采用主题分析法,然后对主题进行回顾、定义和命名。
本研究共有 30 名患者参与。深入访谈中出现了五个主要主题,包括:影响糖尿病自我管理的患者因素、对 T2DM 自我管理的行为和态度、卫生服务提供、患者执行糖尿病自我管理面临的挑战和障碍、以及改善患者自我管理的建议。研究中的患者对 T2DM 有很好的了解,并且知道他们必须进行自我护理管理。影响患者进行自我护理管理的是他们对 T2DM 自我护理管理的态度和行为。研究还表明,患者从医疗保健工作者(HCW)那里获得了很好的知识。社会经济和心理状况也在患者的自我护理管理中起着至关重要的作用。除了挑战,还有机会了解患者在执行自我护理管理方面所面临的困难。
本研究结果揭示了个人、文化和卫生系统相关因素的综合影响,这些因素是斐济患者自我管理糖尿病的最大影响因素。患者必须为自己的健康负责,以改善血糖读数并减少糖尿病并发症。考虑到患者的信念并解决潜在挑战的量身定制的干预措施将是有用的。在设施升级方面还有很多工作要做,以提高患者的舒适度,还需要与更多多学科团队和利益相关者合作。