Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.
Centre for Population Health Research and Implementation, SingHealth Regional Health System, Singapore, Singapore.
Front Endocrinol (Lausanne). 2022 Feb 24;13:793473. doi: 10.3389/fendo.2022.793473. eCollection 2022.
The perspectives of healthcare professionals (HCPs) are pivotal to co-development of self-management strategies for patients with diabetes. However, literature has been largely limited to perspectives of patients within the context of a Western healthcare setting. This study aims to explore factors influencing diabetes self-management in adult patients with diabetes from the perspectives of HCPs and their views of the value of mHealth application for diabetes self-management.
We conducted focus group discussions (FGD) with purposively selected HCPs in Singapore. All FGDs were audio-recorded and transcribed verbatim. Thematic analysis was conducted using NVivo 12.
A total of 56 HCPs participated in the study. Barriers to self-management included limited patient commitment to lifestyle changes, suboptimal adherence to medication and treatment, patient resistance to insulin initiation and insufficient rapport between patients and HCPs. Patients' perceived susceptibility to complications, social support from family and community, multidisciplinary team care and patient's understanding of the benefits of self-care were viewed as facilitating self-management. HCPs saw mHealth apps as a vital opportunity to engage patients in the self-management of conditions and empower them to foster behavior changes. Yet, there were concerns regarding patient's limited digital literacy, lack of integration into routine electronic system and reluctance.
We identified a set of factors influencing self-management in adult patients with diabetes and useful app features that can empower patients to manage their conditions. Findings will inform the development of a mHealth application, and its features designed to improve self-care.
医疗保健专业人员(HCPs)的观点对于共同制定糖尿病患者的自我管理策略至关重要。然而,文献主要局限于西方医疗保健环境中患者的观点。本研究旨在从 HCPs 的角度探讨影响糖尿病患者自我管理的因素及其对移动医疗应用于糖尿病自我管理价值的看法。
我们在新加坡对 HCPs 进行了焦点小组讨论(FGD)。所有 FGD 均进行了录音并逐字记录。使用 NVivo 12 进行了主题分析。
共有 56 名 HCPs 参与了研究。自我管理的障碍包括患者对生活方式改变的承诺有限、药物和治疗的依从性不理想、患者对胰岛素起始的抵制以及患者与 HCPs 之间的关系不融洽。患者对并发症的易感性、家庭和社区的社会支持、多学科团队护理以及患者对自我护理益处的理解被认为有助于自我管理。HCPs 认为移动医疗应用程序是一个与患者共同管理疾病并赋予他们促进行为改变的重要机会。然而,他们也担心患者的数字素养有限、缺乏与常规电子系统的整合以及患者的抵触情绪。
我们确定了影响成年糖尿病患者自我管理的一系列因素,以及可以使患者能够管理其病情的有用应用程序功能。研究结果将为移动医疗应用程序的开发以及旨在改善自我护理的功能提供信息。