Barriers to the self-care of type 2 diabetes from both patients' and providers' perspectives: literature review

Sandra PY Pun, Vivien Coates, Iris FF Benzie

Research output: Contribution to journalArticle

Abstract

Aim. To review systematically the literature about barriers to diabetes self-care from both patients' and healthcare providers' perspectives.Background. Diabetes mellitus is a global health concern due to rapidly increasing prevalence. The healthcare costs for diabetes care and related complications are high. Tight glycaemic control achieved by intensive therapy has been shown to lower the risk of complications. Despite the provision of comprehensive management programmes, 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 behaviours.Methods. A search of OVID Medline (R), CINAHL, Cochrane Library and British Nursing Index was carried out during 1986–2007 using keywords: Type 2 Diabetes Mellitus, self care, patient compliance, patient adherence and barriers to diabetes self care. Manual searching of relevant nursing journals and sourcing of secondary research extended the search.Results. A total of 16 original research papers using various methods including survey, descriptive correlational, sequential explanatory mixed-method and qualitative exploratory design were reviewed. In total, over 8900 patients and 4550 healthcare providers were recruited from over 28 countries in these studies. Major barriers identified included psychosocial, socioeconomic, physical, environmental and cultural factors.Conclusions. Healthcare providers can enhance patient empowerment and participation with family support to achieve feasible targets. 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.Relevance to clinical practice. Understanding barriers to diabetes self-care is the first step in facilitating providers to identify their role in enabling patients to overcome these barriers. 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.
LanguageEnglish
Pages4-19
JournalJournal of Nursing and Healthcare of Chronic Illness
Volume1
Issue number1
DOIs
Publication statusPublished - Feb 2009

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Self Care
Type 2 Diabetes Mellitus
Health Personnel
Patient Participation
Patient Compliance
Nursing Libraries
Delivery of Health Care
Health Care Reform
Continuing Education
Diabetes Complications
Standard of Care
Research
Health Care Costs
Diabetes Mellitus
Nursing
Communication
Guidelines
Therapeutics

Cite this

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abstract = "Aim. To review systematically the literature about barriers to diabetes self-care from both patients' and healthcare providers' perspectives.Background. Diabetes mellitus is a global health concern due to rapidly increasing prevalence. The healthcare costs for diabetes care and related complications are high. Tight glycaemic control achieved by intensive therapy has been shown to lower the risk of complications. Despite the provision of comprehensive management programmes, 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 behaviours.Methods. A search of OVID Medline (R), CINAHL, Cochrane Library and British Nursing Index was carried out during 1986–2007 using keywords: Type 2 Diabetes Mellitus, self care, patient compliance, patient adherence and barriers to diabetes self care. Manual searching of relevant nursing journals and sourcing of secondary research extended the search.Results. A total of 16 original research papers using various methods including survey, descriptive correlational, sequential explanatory mixed-method and qualitative exploratory design were reviewed. In total, over 8900 patients and 4550 healthcare providers were recruited from over 28 countries in these studies. Major barriers identified included psychosocial, socioeconomic, physical, environmental and cultural factors.Conclusions. Healthcare providers can enhance patient empowerment and participation with family support to achieve feasible targets. 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.Relevance to clinical practice. Understanding barriers to diabetes self-care is the first step in facilitating providers to identify their role in enabling patients to overcome these barriers. 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.",
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Barriers to the self-care of type 2 diabetes from both patients' and providers' perspectives: literature review. / Pun, Sandra PY; Coates, Vivien; Benzie, Iris FF.

In: Journal of Nursing and Healthcare of Chronic Illness, Vol. 1, No. 1, 02.2009, p. 4-19.

Research output: Contribution to journalArticle

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