scholarly journals Digital Health Interventions for People With Type 2 Diabetes to Develop Self-Care Expertise, Adapt to Identity Changes, and Influence Other’s Perception: Qualitative Study

10.2196/21328 ◽  
2020 ◽  
Vol 22 (12) ◽  
pp. e21328
Author(s):  
Sophie Turnbull ◽  
Patricia J Lucas ◽  
Alastair D Hay ◽  
Christie Cabral
Keyword(s):  
Type 2 Diabetes ◽  
Digital Health ◽  
Sense Of Self ◽  
Self Care ◽  
Health Technologies ◽  
Digital Interventions ◽  
Identity Changes ◽  
The Individual ◽  
Care Technology

Background A diagnosis of type 2 diabetes (T2D) results in widespread changes to a person’s life and can be experienced as an assault on their sense of self. The resources available to an individual influence how the individual adapts to their diabetic identity and subsequently engages in self-care. Digital interventions can be viewed as a resource that people can draw on to adapt to the diagnosis. However, there is an indication that people from disadvantaged groups find digital health technologies more challenging to access and use, which may increase health inequalities. Objective This study aims to gain insights into how and why people with T2D use digital self-care technology and how experiences vary between individuals and social groups. Methods A purposive sample of people who had used a digital intervention to help them self-care for their T2D were recruited for the study. Semistructured interviews were conducted, and data were analyzed thematically. Results A diverse sample of 21 participants were interviewed. Participants used digital interventions to help them to understand and feel more in control of their bodies. Digital interventions were used by participants to project their chosen identity to others. Participants selected technology that allowed them to confirm and enact their preferred positive identities, both by avoiding stigma and by becoming experts in their disease or treatment. Participants preferred using digital interventions that helped them conceal their diabetes, including by buying discrete blood glucose monitors. Some participants used technology to increase their sense of power in their interaction with clinicians, whereas others used technology to demonstrate their goodness. Conclusions The technology that people with T2D have access to shapes the way they are able to understand and control their bodies and support preferred social identities.

scholarly journals Digital Health Interventions for People With Type 2 Diabetes to Develop Self-Care Expertise, Adapt to Identity Changes, and Influence Other’s Perception: Qualitative Study (Preprint)

2020 ◽  
Author(s):  
Sophie Turnbull ◽  
Patricia J Lucas ◽  
Alastair D Hay ◽  
Christie Cabral
Keyword(s):  
Type 2 Diabetes ◽  
Digital Health ◽  
Sense Of Self ◽  
Self Care ◽  
Health Technologies ◽  
Digital Interventions ◽  
Identity Changes ◽  
The Individual ◽  
Care Technology

BACKGROUND A diagnosis of type 2 diabetes (T2D) results in widespread changes to a person’s life and can be experienced as an assault on their sense of self. The resources available to an individual influence how the individual adapts to their diabetic identity and subsequently engages in self-care. Digital interventions can be viewed as a resource that people can draw on to adapt to the diagnosis. However, there is an indication that people from disadvantaged groups find digital health technologies more challenging to access and use, which may increase health inequalities. OBJECTIVE This study aims to gain insights into how and why people with T2D use digital self-care technology and how experiences vary between individuals and social groups. METHODS A purposive sample of people who had used a digital intervention to help them self-care for their T2D were recruited for the study. Semistructured interviews were conducted, and data were analyzed thematically. RESULTS A diverse sample of 21 participants were interviewed. Participants used digital interventions to help them to understand and feel more in control of their bodies. Digital interventions were used by participants to project their chosen identity to others. Participants selected technology that allowed them to confirm and enact their preferred positive identities, both by avoiding stigma and by becoming experts in their disease or treatment. Participants preferred using digital interventions that helped them conceal their diabetes, including by buying discrete blood glucose monitors. Some participants used technology to increase their sense of power in their interaction with clinicians, whereas others used technology to demonstrate their <i>good</i>ness. CONCLUSIONS The technology that people with T2D have access to shapes the way they are able to understand and control their bodies and support preferred social identities.

scholarly journals Effectiveness of individual and group interventions for people with type 2 diabetes

2015 ◽  
Vol 23 (2) ◽  
pp. 200-207 ◽  
Author(s):  
Maria Fernanda Manoel Imazu ◽  
Barbara Nascimento Faria ◽  
Guilherme Oliveira de Arruda ◽  
Catarina Aparecida Sales ◽  
Sonia Silva Marcon
Keyword(s):  
Quality Of Life ◽  
Type 2 Diabetes ◽  
Group Intervention ◽  
Statistical Significance ◽  
Self Care ◽  
Educational Interventions ◽  
The Individual ◽  
The Impact

OBJECTIVE: to compare the effectiveness of two educational interventions used by a healthcare provider in the monitoring of individuals with type 2 diabetes mellitus (T2DM), regarding knowledge of the disease, impact on quality of life and adoption of self-care actions. METHODS: comparative, longitudinal, prospective study performed with 150 subjects with type 2 diabetes, analyzed according to the type of participation in the program (individual and/or group). Participants of the individual intervention (II) received nursing consultations every six months and those of the group intervention (GI) took part in weekly meetings for three months. Data were collected through four questionnaires: Identification questionnaire, Problem Areas in Diabetes Questionnaire (PAID), Summary of Diabetes Self-Care Activities Questionnaire (SDSCA) and the Diabetes Knowledge Scale (DKN-A). Data were analyzed using the Friedman and Mann Whitney tests, considering a statistical significance of p ≤ 0.05. RESULTS: there was an increase in knowledge about the disease in the II (p<0.003) and GI (p<0.007), with reduction of the impact on the quality of life in the II (p<0.007) and improvement in self-care actions in the GI (p<0.001). CONCLUSION: in both intervention models improvements were observed in the indicators, over the six month monitoring period.

Contribution of an Intelligent Virtual Assistant to Healthy Ageing in Adults With Type 2 Diabetes

2020 ◽  
pp. 194-230
Author(s):  
Mara Pereira Guerreiro ◽  
Isa Brito Félix ◽  
João Balsa ◽  
Maria Beatriz Carmo ◽  
Maria Adriana Henriques ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Healthy Aging ◽  
Self Care ◽  
Care Plan ◽  
Web Based ◽  
Software Application ◽  
Individual Care ◽  
The Individual

This chapter describes the development of a theory-driven and evidence-based digital intervention to facilitate self-care in older adults with Type 2 Diabetes (T2D) and, additionally, its contribution to healthy aging and the individual care plan. T2D is highly prevalent in older adults. Difficulties in adopting and maintaining desirable self-care behaviors is associated with lack of glycemic control and subsequent complications, which significantly burden patients, their families, and the health system. The VASelfCare (Virtual Assistant Self-Care) intervention is a software application that provides an interface with a 3D anthropomorphic virtual assistant targeting three key self-care behaviors: medication-taking, physical activity, and a healthy diet. Other VASelfCare elements are intended for nurses providing diabetes consultations, including a web-based back-office with a patient data dashboard, which streamlines integration of care. The application prototype has been co-produced with older adults with T2D, primary care health professionals, and other stakeholders.

scholarly journals Application of the National Institute for Health and Care Excellence Evidence Standards Framework for Digital Health Technologies in Assessing Mobile-Delivered Technologies for the Self-Management of Type 2 Diabetes Mellitus: Scoping Review

JMIR Diabetes ◽  
10.2196/23687 ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. e23687 ◽  
Author(s):  
Jessica R Forsyth ◽  
Hannah Chase ◽  
Nia W Roberts ◽  
Laura C Armitage ◽  
Andrew J Farmer
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Digital Health ◽  
The Self ◽  
Self Management ◽  
Health Care Settings ◽  
Health Technologies ◽  
Minimum Standards

Background There is a growing role of digital health technologies (DHTs) in the management of chronic health conditions, specifically type 2 diabetes. It is increasingly important that health technologies meet the evidence standards for health care settings. In 2019, the National Institute for Health and Care Excellence (NICE) published the NICE Evidence Standards Framework for DHTs. This provides guidance for evaluating the effectiveness and economic value of DHTs in health care settings in the United Kingdom. Objective The aim of this study is to assess whether scientific articles on DHTs for the self-management of type 2 diabetes mellitus report the evidence suggested for implementation in clinical practice, as described in the NICE Evidence Standards Framework for DHTs. Methods We performed a scoping review of published articles and searched 5 databases to identify systematic reviews and primary studies of mobile device–delivered DHTs that provide self-management support for adults with type 2 diabetes mellitus. The evidence reported within articles was assessed against standards described in the NICE framework. Results The database search yielded 715 systematic reviews, of which, 45 were relevant and together included 59 eligible primary studies. Within these, there were 39 unique technologies. Using the NICE framework, 13 technologies met best practice standards, 3 met minimum standards only, and 23 technologies did not meet minimum standards. Conclusions On the assessment of peer-reviewed publications, over half of the identified DHTs did not appear to meet the minimum evidence standards recommended by the NICE framework. The most common reasons for studies of DHTs not meeting these evidence standards included the absence of a comparator group, no previous justification of sample size, no measurable improvement in condition-related outcomes, and a lack of statistical data analysis. This report provides information that will enable researchers and digital health developers to address these limitations when designing, delivering, and reporting digital health technology research in the future.

scholarly journals Application of the National Institute for Health and Care Excellence Evidence Standards Framework for Digital Health Technologies in Assessing Mobile-Delivered Technologies for the Self-Management of Type 2 Diabetes Mellitus: Scoping Review (Preprint)

2020 ◽  
Author(s):  
Jessica R Forsyth ◽  
Hannah Chase ◽  
Nia W Roberts ◽  
Laura C Armitage ◽  
Andrew J Farmer
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Health Care ◽  
Type 2 Diabetes Mellitus ◽  
Digital Health ◽  
The Self ◽  
Self Management ◽  
Health Care Settings ◽  
Health Technologies

BACKGROUND There is a growing role of digital health technologies (DHTs) in the management of chronic health conditions, specifically type 2 diabetes. It is increasingly important that health technologies meet the evidence standards for health care settings. In 2019, the National Institute for Health and Care Excellence (NICE) published the <i>NICE Evidence Standards Framework for DHTs</i>. This provides guidance for evaluating the effectiveness and economic value of DHTs in health care settings in the United Kingdom. OBJECTIVE The aim of this study is to assess whether scientific articles on DHTs for the self-management of type 2 diabetes mellitus report the evidence suggested for implementation in clinical practice, as described in the <i>NICE Evidence Standards Framework for DHTs</i>. METHODS We performed a scoping review of published articles and searched 5 databases to identify systematic reviews and primary studies of mobile device–delivered DHTs that provide self-management support for adults with type 2 diabetes mellitus. The evidence reported within articles was assessed against standards described in the NICE framework. RESULTS The database search yielded 715 systematic reviews, of which, 45 were relevant and together included 59 eligible primary studies. Within these, there were 39 unique technologies. Using the NICE framework, 13 technologies met <i>best practice</i> standards, 3 met <i>minimum</i> standards only, and 23 technologies did not meet <i>minimum</i> standards. CONCLUSIONS On the assessment of peer-reviewed publications, over half of the identified DHTs did not appear to meet the minimum evidence standards recommended by the NICE framework. The most common reasons for studies of DHTs not meeting these evidence standards included the absence of a comparator group, no previous justification of sample size, no measurable improvement in condition-related outcomes, and a lack of statistical data analysis. This report provides information that will enable researchers and digital health developers to address these limitations when designing, delivering, and reporting digital health technology research in the future.

Self-Care in Adults with Type 2 Diabetes Mellitus: A Systematic Review

2020 ◽  
Vol 16 (6) ◽  
pp. 598-607 ◽  
Author(s):  
Rebeca Barbosa da Rocha ◽  
Cristiano Sales Silva ◽  
Vinícius Saura Cardoso
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Latin American ◽  
Self Care ◽  
Health Science ◽  
Science Literature ◽  
Patients With Diabetes

Background: Self-care is essential for the prevention of complications in patients with diabetes, but several authors report that even with health education programs, the incidence of complications in patients with diabetes continues to increase. Objective: We aimed to examine adherence to self-care strategies and the repercussions of adherence on the clinical profiles of individuals with type 2 diabetes. Methods: We performed a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. We searched for related studies in 4 databases: PubMed, Web of Science, Scopus, and Latin American and Caribbean Health Science Literature (LILACS). We included observational studies in English and Portuguese that evaluated the effects of selfcare in individuals with type 2 diabetes. Results: The search resulted in the identification of 615 articles, of which 34 met all the inclusion criteria. General self-care was considered unsatisfactory. Physical exercise was classified as the self-care activity that was performed less frequently by individuals with type 2 diabetes mellitus; adherence to medication was the most frequent behavior among volunteers. Conclusion: The studies indicated poor adherence of the population to good self-care practices, reflected by the increase in complications related to DM.

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