5.3.2 Barriers to optimal self-care in Type 2 diabetes from both patients' and nurses' perspectives: Phase II of a mixed method study (110)

Sandra Pun, Clinical Associate, School Nursing, The Hong Kong Polytechnic Universtiy, School of Nursing, Kowloon, Hong Kong Co authors: Vivien Coates & Iris Benzie hspypun@inet.polyu.edu.hk

Abstract:

Background:

Type 2 diabetes is a serious global health problem, and its prevalence rate is increasing particularly in developing countries, including China. Enhancing self-care behaviours is vital for managing chronic illness like diabetes. Previous studies showed that there are barriers to optimal self-care that undermine attempts to achieve desired patient outcomes. Therefore, it is essential to explore and overcome these barriers for improving patient outcomes.

Aim:

To explore barriers to optimal self-care for patients with Type 2 diabetes and suggest strategies to overcome them to improve patient outcomes.

Methods:

A quantitative survey was done (Phase I) with 183 patients recruited from a local diabetes clinic. Interview protocols were developed and patients were selected based on the quantitative results. Both patients (n=22) and diabetes nurses (n=17) were then invited for focus group interviews to investigate barriers to self-care and strategies for overcoming these barriers (Phase II). Content analysis was adopted for data analysis.

Results:

The major barriers to overall self-care behaviours included knowledge deficits, low motivation to change habits and busy lifestyles. Desire to eat and Chinese cultural factors were barriers to diet modification. Physical limitation and lack of interest were major barriers to regular exercise. Financial constrains and fear of pain were the main reasons for non-adherence to self-monitoring of blood glucose. Seeking help from family and professionals, joining self-help groups and self-determination were strategies claimed by patients to overcome barriers. Nurses suggested that using a “named nurse” system, providing cooking classes, and positive reinforcement were effective strategies.

Conclusion:

Barriers to self-care expressed by patients and nurses were similar, which indicated that nurses were able to understand their patients very well. In order to improve patient outcomes, nurses should provide patient education and consider psychological factors and when designing targets for patients so that these are more achievable.

Biography:

Sandra Pun has been a register nurse in the medical, surgical and intensive care units for over 20 years . She has about 10 years of teaching experience for university nursing students. She is currently a Clinical Associate of the Hong Kong Polytechnic University in Hong Kong. She is also a final year PhD candidate at the University of Ulster in UK. Her PhD thesis focuses on the self-care of patients with type 2 diabetes. Her research interest also includes patient education, management of chronic illness, pain management, clinical teaching and assessment.