Abstract
BackgroundWith the implementation of health care reforms in China, primary care is on a journey to provide care for most patients with type 2 diabetes. While Chinese general practitioners (GPs) have described challenges in communication with diabetes patients in their daily practice, little is known about patients’ experiences in communicating with their GPs.MethodsFive focus groups (of 4–5 participants each) were used to explore views from patients with type 2 diabetes. Purposive sampling was used to recruit a spread of participants from general practices in Guangzhou city, China. Focus groups were audio-recorded, transcribed, and thematically analyzed using the Framework Method.ResultsTen males and 12 female patients from five general practices participated in focus group discussions, with a mean age of 57.3 years and 7.3 years of diabetes duration. Five main themes emerged: patients’ understanding about diabetes, diabetes medication, communication with GPs, physician-patient relationships, and healthcare systems and context. Patients generally searched for information on the internet, but they weren’t always sure if it was trustworthy. Several communication needs were described by diabetes patients, such as explanation of blood glucose monitoring, medication information support, communication in the risk of diabetes complications and cardiovascular disease, and language barriers. Communication was frequently brief and not tailored to their concerns, and some described being scolded or panicked by GPs. Participants acknowledged the pressures within the health system, such as short consultation times, an incoherent GP-hospital interface and high demand.ConclusionsKey issues from the patients’ perspective for the development of primary care based management of diabetes in China were identified. People with type 2 diabetes require more access to trustworthy diabetes information and wish for better channels of communication with their GPs. Strategies may be required to improve GPs’ communication skills with their patients that also consider the context of the wider health system environment in China.
Highlights
With the implementation of health care reforms in China, primary care is on a journey to provide care for most patients with type 2 diabetes
Five main themes were conceptualised from the group discussions: patients’ understanding about diabetes, diabetes medication, communication with general practitioners (GPs), physicianpatient relationships, and healthcare systems and context
Several of the needs described by diabetes patients in communication with GPs, such as medication information support, communication of risk, complications and cardiovascular disease (CVD)
Summary
With the implementation of health care reforms in China, primary care is on a journey to provide care for most patients with type 2 diabetes. The current weakness of the primary care system in China is a major barrier to optimal diabetes care [9, 10]. There is an increasing awareness that the current diabetes care model is unsustainable. To address such issues, the Chinese government has committed to a dramatic increase in the capacity of the primary health care system, including training 400,000 new GPs in the 10 years, and the introduction of a national essential drug system alongside a social health insurance program, introduced to improve access and affordability in primary health care [11,12,13,14]. Patients with chronic non-communicable diseases, including diabetes, will gradually transition from hospitals into primary care settings and receive care by GPs
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