scholarly journals Implementing a research-based innovation to generate intra-familial involvement in type 2 diabetes self-management for use in diverse municipal settings: a qualitative study of barriers and facilitators

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Tue Helms Andersen ◽  
Dan Grabowski
2015 ◽  
Vol 21 (2) ◽  
pp. 103-110 ◽  
Author(s):  
Liliana Laranjo ◽  
Ana L Neves ◽  
Alexandra Costa ◽  
Rogério T Ribeiro ◽  
Luciana Couto ◽  
...  

2017 ◽  
Author(s):  
Gerda Bernhard ◽  
Cornelia Mahler ◽  
Hanna Marita Seidling ◽  
Marion Stützle ◽  
Dominik Ose ◽  
...  

BACKGROUND Information technology tools such as shared patient-centered, Web-based medication platforms hold promise to support safe medication use by strengthening patient participation, enhancing patients’ knowledge, helping patients to improve self-management of their medications, and improving communication on medications among patients and health care professionals (HCPs). However, the uptake of such platforms remains a challenge also due to inadequate user involvement in the development process. Employing a user-centered design (UCD) approach is therefore critical to ensure that user’ adoption is optimal. OBJECTIVE The purpose of this study was to identify what patients with type 2 diabetes mellitus (T2DM) and their HCPs regard necessary requirements in terms of functionalities and usability of a shared patient-centered, Web-based medication platform for patients with T2DM. METHODS This qualitative study included focus groups with purposeful samples of patients with T2DM (n=25), general practitioners (n=13), and health care assistants (n=10) recruited from regional health care settings in southwestern Germany. In total, 8 semistructured focus groups were conducted. Sessions were audio- and video-recorded, transcribed verbatim, and subjected to a computer-aided qualitative content analysis. RESULTS Appropriate security and access methods, supported data entry, printing, and sending information electronically, and tracking medication history were perceived as the essential functionalities. Although patients wanted automatic interaction checks and safety alerts, HCPs on the contrary were concerned that unspecific alerts confuse patients and lead to nonadherence. Furthermore, HCPs were opposed to patients’ ability to withhold or restrict access to information in the platform. To optimize usability, there was consensus among participants to display information in a structured, chronological format, to provide information in lay language, to use visual aids and customize information content, and align the platform to users’ workflow. CONCLUSIONS By employing a UCD, this study provides insight into the desired functionalities and usability of patients and HCPs regarding a shared patient-centered, Web-based medication platform, thus increasing the likelihood to achieve a functional and useful system. Substantial and ongoing engagement by all intended user groups is necessary to reconcile differences in requirements of patients and HCPs, especially regarding medication safety alerts and access control. Moreover, effective training of patients and HCPs on medication self-management (support) and optimal use of the tool will be a prerequisite to unfold the platform’s full potential.


Hypertension ◽  
2012 ◽  
Vol 60 (suppl_1) ◽  
Author(s):  
Xiang Y Chen ◽  
Peng Yue ◽  
Yong L Wang ◽  
Shu Q Xiao ◽  
Xin W Feng ◽  
...  

Background: Self-management has become a key strategy for caring chronic patients in community. However, little is known about peoples’ self-management experiences and their perceived cues and barriers to engagement in self-management. Objective: To explore issues patients with type 2 diabetes experienced in their self-management practices,to understand cues and barriers to engagement in self-management. Design: Qualitative study (Semi-structured interviews) Setting: 11 communities in Beijing, China Participants: Type 2 diabetes patients in community, aged >18, no admission in past 90 days. Methods: 40 critical incident interviews were run during Apr to Sep in 2011 using purposive sampling (20 interviews with patients whose HbA1c well-controlled (<6.5%), while 20 badly-controlled (≥8%)).Themes from interviews were identified using content analysis, which revealed cues and barriers to self-modification for diabetes management. Results: Implications for self- management practice included objectively understanding on the severity and complications of diabetes. In addition to family support such as supervision in family and fully-use of family resource, desires/duties to be responsible for whole family life as a breadwinner was emerged as a key cue to engagement in self-control. Barriers to engagement in self-management stemmed from financial burden to monitor blood glucose daily, dissatisfaction of HbA1c level after efforts, and malignant life events. It is worth mentioning that starving experience of difficult time with natural disasters in1960s- 1970s in China was identified also as a key barrier to engagement in diet management. Discussion and Conclusion: There was a strong desire for Chinese patients to comply with Chinese cultural norms; particularly those relating to family value. It was the patients’ power to be involved in self-management that they could devote their healthy life to family duty. Everyone had his/her own history so experiences in past shaped patients’ behaviors now. The findings highlighted the importance of understanding the family value and the personal experiences as facilitators and barriers to self-management of Chinese patients with type 2 diabetes living in community.


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