Diabetes self-management: a qualitative study on challenges and solutions from the perspective of South African patients and health care providers
Background Health education and self-management are among key strategies for managing diabetes and hypertension to reduce morbidity and mortality. Inappropriate self-management support can potentially worsen chronic diseases outcomes if relevant barriers are not identified and self-management soluti...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2022-12-01
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| Series: | Global Health Action |
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| Online Access: | http://dx.doi.org/10.1080/16549716.2022.2090098 |
| _version_ | 1797755706114310144 |
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| author | Tiny Masupe Sunday Onagbiye Thandi Puoane Absetz Pilvikki Helle Mölsted Alvesson Peter Delobelle |
| author_facet | Tiny Masupe Sunday Onagbiye Thandi Puoane Absetz Pilvikki Helle Mölsted Alvesson Peter Delobelle |
| author_sort | Tiny Masupe |
| collection | DOAJ |
| description | Background Health education and self-management are among key strategies for managing diabetes and hypertension to reduce morbidity and mortality. Inappropriate self-management support can potentially worsen chronic diseases outcomes if relevant barriers are not identified and self-management solutions are not contextualised. Few studies deliberately solicit suggestions for enhancing self-management from patients and their providers. Objective This qualitative study aimed to unravel experiences, identify self-management barriers, and solicit solutions for enhancing self-management from patients and their healthcare providers. Methods Eight in-depth interviews were conducted with healthcare providers. These were followed by four focus group discussions among patients with type-2- diabetes and or hypertension receiving chronic disease care from two health facilities in a peri-urban township in Cape Town, South Africa. The Self-Management framework described by Lorig and Holman, based on work done by Corbin and Strauss was used to analyse the data. Results Patients experienced challenges across all three self-management tasks of behavioural/medical management, role management, and emotional management. Main challenges included poor patient self-control towards lifestyle modification, sub-optimal patient-provider and family partnerships, and post-diagnosis grief-reactions by patients. Barriers experienced were stigma, socio-economic and cultural influences, provider-patient communication gaps, disconnect between facility-based services and patients’ lived experiences, and inadequate community care services. Patients suggested empowering community-based solutions to strengthen their disease self-management, including dedicated multidisciplinary diabetes services, counselling services; strengthened family support; patient buddies; patient-led community projects, and advocacy. Providers suggested contextualised communication using audio-visual technologies and patient-centred provider consultations. Conclusions Community-based dedicated multidisciplinary chronic disease healthcare teams, chronic disease counselling services, patient-driven projects and advocacy are needed to improve patient self-management. |
| first_indexed | 2024-03-12T17:50:01Z |
| format | Article |
| id | doaj.art-e9aa7376bc454847b64e532b518ea804 |
| institution | Directory Open Access Journal |
| issn | 1654-9880 |
| language | English |
| last_indexed | 2024-03-12T17:50:01Z |
| publishDate | 2022-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Global Health Action |
| spelling | doaj.art-e9aa7376bc454847b64e532b518ea8042023-08-03T09:07:51ZengTaylor & Francis GroupGlobal Health Action1654-98802022-12-0115110.1080/16549716.2022.20900982090098Diabetes self-management: a qualitative study on challenges and solutions from the perspective of South African patients and health care providersTiny Masupe0Sunday Onagbiye1Thandi Puoane2Absetz Pilvikki3Helle Mölsted Alvesson4Peter Delobelle5University of BotswanaNorth-West University, Potchefstroom CampusUniversity of the Western CapeCollaborative Care Systems FinlandKarolinska InstitutetUniversity of the Western CapeBackground Health education and self-management are among key strategies for managing diabetes and hypertension to reduce morbidity and mortality. Inappropriate self-management support can potentially worsen chronic diseases outcomes if relevant barriers are not identified and self-management solutions are not contextualised. Few studies deliberately solicit suggestions for enhancing self-management from patients and their providers. Objective This qualitative study aimed to unravel experiences, identify self-management barriers, and solicit solutions for enhancing self-management from patients and their healthcare providers. Methods Eight in-depth interviews were conducted with healthcare providers. These were followed by four focus group discussions among patients with type-2- diabetes and or hypertension receiving chronic disease care from two health facilities in a peri-urban township in Cape Town, South Africa. The Self-Management framework described by Lorig and Holman, based on work done by Corbin and Strauss was used to analyse the data. Results Patients experienced challenges across all three self-management tasks of behavioural/medical management, role management, and emotional management. Main challenges included poor patient self-control towards lifestyle modification, sub-optimal patient-provider and family partnerships, and post-diagnosis grief-reactions by patients. Barriers experienced were stigma, socio-economic and cultural influences, provider-patient communication gaps, disconnect between facility-based services and patients’ lived experiences, and inadequate community care services. Patients suggested empowering community-based solutions to strengthen their disease self-management, including dedicated multidisciplinary diabetes services, counselling services; strengthened family support; patient buddies; patient-led community projects, and advocacy. Providers suggested contextualised communication using audio-visual technologies and patient-centred provider consultations. Conclusions Community-based dedicated multidisciplinary chronic disease healthcare teams, chronic disease counselling services, patient-driven projects and advocacy are needed to improve patient self-management.http://dx.doi.org/10.1080/16549716.2022.2090098self-managementtype-2-diabetesbarrierspatient-derived solutionsmultidisciplinarychronic disease care |
| spellingShingle | Tiny Masupe Sunday Onagbiye Thandi Puoane Absetz Pilvikki Helle Mölsted Alvesson Peter Delobelle Diabetes self-management: a qualitative study on challenges and solutions from the perspective of South African patients and health care providers Global Health Action self-management type-2-diabetes barriers patient-derived solutions multidisciplinary chronic disease care |
| title | Diabetes self-management: a qualitative study on challenges and solutions from the perspective of South African patients and health care providers |
| title_full | Diabetes self-management: a qualitative study on challenges and solutions from the perspective of South African patients and health care providers |
| title_fullStr | Diabetes self-management: a qualitative study on challenges and solutions from the perspective of South African patients and health care providers |
| title_full_unstemmed | Diabetes self-management: a qualitative study on challenges and solutions from the perspective of South African patients and health care providers |
| title_short | Diabetes self-management: a qualitative study on challenges and solutions from the perspective of South African patients and health care providers |
| title_sort | diabetes self management a qualitative study on challenges and solutions from the perspective of south african patients and health care providers |
| topic | self-management type-2-diabetes barriers patient-derived solutions multidisciplinary chronic disease care |
| url | http://dx.doi.org/10.1080/16549716.2022.2090098 |
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