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Health care professionals’ views towards self-management and self-management education for people with type 2 diabetes

Health care professionals’ views towards self-management and self-management education for people with type 2 diabetes
Health care professionals’ views towards self-management and self-management education for people with type 2 diabetes
Objectives Significant problems with patients engaging with diabetes self-management education (DSME) exist. The role of healthcare professionals (HCPs) has been highlighted, with a lack of enthusiasm, inadequate information provision and poor promotion of available programmes all cited as affecting patients’ decisions to attend. However, little is known about HCPs’ views towards DSME. This study investigates the views of HCPs towards self-management generally and self-management in the context of DSME more specifically.

Design A qualitative study using semi-structured interviews to investigate HCPs views of type 2 diabetes self-management and DSME. Data were analysed thematically and emergent themes were mapped on to the constructs of Normalisation Process Theory (NPT).

Setting Two boroughs in London, UK.

Participants Sampling was purposive to recruit a diverse range of professional roles including GPs, practice nurses, diabetes specialist nurses, healthcare assistants (HCAs), receptionists and commissioners of care.

Results Interviews were conducted with 22 participants. The NPT analysis demonstrated that while a self-management approach to diabetes care was viewed by HCPs as necessary and, in principle, valuable, the reality is much more complex. HCPs expressed ambivalence about pushing certain patients into self-managing, preferring to retain responsibility. There was a lack of awareness among HCPs about the content of DSME and benefits to patients. Commitment to and engagement with DSME was tempered by concerns about suitability for some patients. There was little evidence of communication between providers of group-based DSME and HCPs or of HCPs engaging in work to follow-up non-attenders.

Conclusions HCPs have concerns about the appropriateness of DSME for all patients and discussed challenges to engaging with and performing the tasks required to embed the approach within practice. DSME, as a means of supporting self-management, was considered important in theory, but there was little evidence of HCPs seeing their role as extending beyond providing referrals.
2044-6055
Ross, Jamie
55b300ae-4a06-418d-b0b7-fdbab91e9970
Stevenson, Fiona
881eb2a9-d7a8-449d-be50-ead6fda5cd3e
Dack, Charlotte
d3b4f40f-0c5d-4117-9aaa-e500976d4af5
Pal, Kingshuk
7b68a984-eb75-4727-865a-7d27a64a806e
May, Carl
86bf173e-540c-4849-b760-94e85f93c2e3
Michie, Susan
47e0a907-79cb-47d5-b5a9-82d2afe1747a
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Murray, Elizabeth
e08c6b00-813f-4dcb-93b9-fb1782ab23dd
Ross, Jamie
55b300ae-4a06-418d-b0b7-fdbab91e9970
Stevenson, Fiona
881eb2a9-d7a8-449d-be50-ead6fda5cd3e
Dack, Charlotte
d3b4f40f-0c5d-4117-9aaa-e500976d4af5
Pal, Kingshuk
7b68a984-eb75-4727-865a-7d27a64a806e
May, Carl
86bf173e-540c-4849-b760-94e85f93c2e3
Michie, Susan
47e0a907-79cb-47d5-b5a9-82d2afe1747a
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Murray, Elizabeth
e08c6b00-813f-4dcb-93b9-fb1782ab23dd

Ross, Jamie, Stevenson, Fiona, Dack, Charlotte, Pal, Kingshuk, May, Carl, Michie, Susan, Yardley, Lucy and Murray, Elizabeth (2019) Health care professionals’ views towards self-management and self-management education for people with type 2 diabetes. BMJ Open, 9, [e029961]. (doi:10.1136/bmjopen-2019-029961).

Record type: Article

Abstract

Objectives Significant problems with patients engaging with diabetes self-management education (DSME) exist. The role of healthcare professionals (HCPs) has been highlighted, with a lack of enthusiasm, inadequate information provision and poor promotion of available programmes all cited as affecting patients’ decisions to attend. However, little is known about HCPs’ views towards DSME. This study investigates the views of HCPs towards self-management generally and self-management in the context of DSME more specifically.

Design A qualitative study using semi-structured interviews to investigate HCPs views of type 2 diabetes self-management and DSME. Data were analysed thematically and emergent themes were mapped on to the constructs of Normalisation Process Theory (NPT).

Setting Two boroughs in London, UK.

Participants Sampling was purposive to recruit a diverse range of professional roles including GPs, practice nurses, diabetes specialist nurses, healthcare assistants (HCAs), receptionists and commissioners of care.

Results Interviews were conducted with 22 participants. The NPT analysis demonstrated that while a self-management approach to diabetes care was viewed by HCPs as necessary and, in principle, valuable, the reality is much more complex. HCPs expressed ambivalence about pushing certain patients into self-managing, preferring to retain responsibility. There was a lack of awareness among HCPs about the content of DSME and benefits to patients. Commitment to and engagement with DSME was tempered by concerns about suitability for some patients. There was little evidence of communication between providers of group-based DSME and HCPs or of HCPs engaging in work to follow-up non-attenders.

Conclusions HCPs have concerns about the appropriateness of DSME for all patients and discussed challenges to engaging with and performing the tasks required to embed the approach within practice. DSME, as a means of supporting self-management, was considered important in theory, but there was little evidence of HCPs seeing their role as extending beyond providing referrals.

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More information

Accepted/In Press date: 24 June 2019
e-pub ahead of print date: 16 July 2019

Identifiers

Local EPrints ID: 433562
URI: http://eprints.soton.ac.uk/id/eprint/433562
ISSN: 2044-6055
PURE UUID: f20c1015-3178-4b15-b09b-5708e4e845c0
ORCID for Lucy Yardley: ORCID iD orcid.org/0000-0002-3853-883X

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Date deposited: 27 Aug 2019 16:30
Last modified: 07 Oct 2020 01:42

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Contributors

Author: Jamie Ross
Author: Fiona Stevenson
Author: Charlotte Dack
Author: Kingshuk Pal
Author: Carl May
Author: Susan Michie
Author: Lucy Yardley ORCID iD
Author: Elizabeth Murray

University divisions

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