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Understanding Barriers to Diabetes Self-Care Helps Providers Empower Patients
Posted: Wednesday, April 15, 2009
Understanding barriers to diabetes self-care is the first step in facilitating providers to identify their role in enabling patients to...
Sandra P. Y. Pun, MHA, RN, from the Hong Kong Polytechnic University, Hung Hom, Kowloon, China, writes, "Diabetes mellitus is a global health concern due to rapidly increasing prevalence…. Despite the provision of comprehensive management programs, patients are often unable to achieve the desired outcomes. It is essential to understand the barriers to diabetes self-care in order to promote successfully self-care behaviors."
Using the keywords Type 2 diabetes mellitus, self care, patient compliance, patient adherence, and barriers to diabetes self-care, the reviewers searched OVID Medline, CINAHL, the Cochrane Library, and the British Nursing Index from 1986 to 2007. To extend the search, they also manually searched relevant nursing journals and bibliographies of retrieved articles.
This search identified 16 original research papers describing studies enrolling a total of more than 8,900 patients and 4,550 healthcare providers from more than 28 countries. Survey, descriptive correlational, sequential explanatory mixed-method, and qualitative exploratory design methods were used in these studies. Most studies addressed patient barriers and provider barriers separately rather than concurrently.
Major barriers to self-care, compliance, and adherence perceived by patients included psychosocial, physical, and environmental factors affecting their change of behavior. Social support and knowledge significantly influenced prediction of self-care behaviors. For the healthcare providers, perceived barriers were related to the delivery of care and the provision and quality of diabetes care provided for their patients.
"Healthcare providers can enhance patient empowerment and participation with family support to achieve feasible targets," the review authors write. "Better health care delivery systems and reforms that improve affordability, accessibility, and efficiency of care are essential for helping both providers and patients to meet desirable standards of diabetes care."
"Understanding barriers to diabetes self-care is the first step in facilitating providers to identify their role in enabling patients to overcome these barriers," the review authors conclude.
"Healthcare providers can develop strategies to clarify and individualise treatment guidelines, implement continuing education, improve communication skills, and help motivate patients to achieve desired behavioral changes.... The nurse has a key role in helping achieve optimal care of the patient."
Understanding barriers to diabetes self-care may help providers empower patients, according to the results of a literature review reported in the March issue of the Journal of Nursing and Healthcare of Chronic Illness. 2009; 2:4-19
Source: Diabetes In Control: March issue of the Journal of Nursing and Healthcare of Chronic Illness. 2009; 2:4-19
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