Abstract
The main objective of this research work was to explore the healthcare professionals’ perspectives of type 2 diabetes patients’ experiences of self-management of diabetes in the rural area of Pakistan. In this study, we have carried out a methodological approach to use a self-management framework to direct the interview guide for healthcare professionals to examine their perceptions and expectations of their diabetes patients’ adherence to the medications prescribed. Twenty healthcare professionals were recruited in this study consisting of ten general practitioners and ten nurses from various clinics (medical centres) of Al-Rehman Hospital at Abbottabad, Pakistan. This qualitative study explored the feelings and opinions of general practitioners on patients’ compliance and adherence by using the semi-structured interview guide using a methodological framework. All interviews of participants were audiotaped and transcribed for content analysis. Six major themes were identified: patient–doctor relationship; patient’s non-adherence to diet and exercise; conflicts with the patients; low self-efficacy and feeling of “resignation with poor care”; the influence of culture on patients’ self-management activities and lack of support for patients by health care providers, patients, and their families. We have derived relevant solutions from qualitative studies and considered that communication, tailored, and shared care is the best approach for patient adherence to treatment. GPs felt that a structured consultation and follow-up in a multidisciplinary team might help to increase adherence. The results of this qualitative health research highlighted the challenges healthcare professionals are facing in rural Pakistan in managing patients with type 2 diabetes and supporting their management activities. Healthcare professionals and patients may benefit by adopting a methodological framework approach to ensure meaningful participation and adjusting the patient–doctor relationship, and setting up achievable management and self-management goals.
Highlights
The management of diabetes relies on the active self-management by patients [1].The disease requires patient commitment and the ability to carry out self-management activities in their routine life [2]
The current literature review identified that diabetes self-management is the cornerstone of diabetes care [3]
The qualitative design of this study was guided by a methodological framework approach and the results of the systematic review of self-management of type 2 diabetes [27,28]
Summary
The management of diabetes relies on the active self-management by patients [1].The disease requires patient commitment and the ability to carry out self-management activities in their routine life [2]. The management of diabetes relies on the active self-management by patients [1]. The current literature review identified that diabetes self-management is the cornerstone of diabetes care [3]. Several studies [4,5] supported the concept that diabetes self-management is associated with improved diabetes knowledge, self-management behaviours, and clinical outcomes [6]. To self-manage, patients need to have awareness and knowledge about diabetes, its management, and its complications [8,9]. This entails adherence to a healthy diet, physical activity, self-monitoring of blood glucose, and adherence to prescribed medicines [10]
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