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Thirst for Information and Needs Reflections of Type 2 Diabetes Patients Receiving Insulin Treatment in North-East Ethiopia: A Qualitative Exploration

  • Received : 2020.10.15
  • Accepted : 2021.02.17
  • Published : 2021.03.31

Abstract

Objectives: Ongoing, proactive, planned, and patient-centered diabetes education is the cornerstone of care for all persons with diabetes. Thus, the aim of this study was to explore the information needs of type 2 diabetes mellitus patients receiving insulin treatment in North-East Ethiopia. Methods: The study was conducted from July 2019 to January 2020 using a qualitative enquiry (phenomenological approach) with purposive sampling. Face-to-face in-depth interviews were used to collect data until reaching theoretical saturation. The participants were type 2 diabetes patients receiving insulin treatment. They were identified from the diabetes patients' registration book at the diabetes clinic and interviewed at their appointment time, and were selected to include wide variations in terms of socio-demographic characteristics. Twenty-four participants (11 men and 13 women), with a median age of 57 years, were interviewed. The data were organized using QDA Miner Lite version 2.0.7 and analyzed thematically using narrative strategies. Results: Most participants had not heard of diabetes before their diagnosis. They had limited knowledge of diabetes, but ascribed different connotations for it in the local language (Amharic). The needs reflections of patients were categorized into diabetes education and participants' recommendations. Diabetes education was totally absent at hospitals, and patients received education primarily from the Ethiopian Diabetes Association and broadcast and digital media. Thus, the major concern of patients was the availability of diabetes education programs at health institutions. Conclusions: Patients' main concern was the absence of routine diabetes education, which necessitates urgent action to implement diabetes education programs, especially at health institutions.

Keywords

References

  1. Holt RI, Cockram CS, Flyvbjerg A, Goldstein BJ. Textbook of diabetes. 5th ed. Chichester: Wiley Blackwell; 2017, p. 326-340, 1038-1048.
  2. Mensing C. The role of the diabetes educator in the education and management of diabetes mellitus. In: Goldstein BJ, Muller-Wieland D, editors. Type 2 diabetes: principles and practice. 2nd ed. New York: CRC Press; 2008, p. 45-57.
  3. George SR, Thomas SP. Lived experience of diabetes among older, rural people. J Adv Nurs 2010;66(5):1092-1100. https://doi.org/10.1111/j.1365-2648.2010.05278.x
  4. Tabong PT, Bawontuo V, Dumah DN, Kyilleh JM, Yempabe T. Premorbid risk perception, lifestyle, adherence and coping strategies of people with diabetes mellitus: a phenomenological study in the Brong Ahafo Region of Ghana. PLoS One 2018;13(6):e0198915. https://doi.org/10.1371/journal.pone.0198915
  5. Ogunrinu T, Gamboa-Maldonado T, Ngewa RN, Saunders J, Crounse J, Misiri J. A qualitative study of health education experiences and self-management practices among patients with type 2 diabetes at Malamulo Adventist Hospital in Thyolo District, Malawi. Malawi Med J 2017;29(2):118-123. https://doi.org/10.4314/mmj.v29i2.8
  6. International Diabetes Federation Africa Region. Diabetes education training manual for sub-Saharan Africa; 2006 [cited 2020 Oct 1]. Available from: https://www.worlddiabetesfoundation.org/sites/default/files/DETM%20Eng.pdf.
  7. Beverly EA, Wray LA, LaCoe CL, Gabbay RA. Listening to older adults' values and preferences for type 2 diabetes care: a qualitative study. Diabetes Spectr 2014;27(1):44-49. https://doi.org/10.2337/diaspect.27.1.44
  8. Moser A, van der Bruggen H, Widdershoven G, Spreeuwenberg C. Self-management of type 2 diabetes mellitus: a qualitative investigation from the perspective of participants in a nurseled, shared-care programme in the Netherlands. BMC Public Health 2008;8:91. https://doi.org/10.1186/1471-2458-8-91
  9. Anderson P. Patient-centered education to improve health outcomes of adult Jamaicans with diabetes; 2019 [cited 2020 Oct 1]. Available from: https://repository.usfca.edu/cgi/viewcontent.cgi?article=1027&context=dnp_qualifying.
  10. Tan AM, Muthusamy L, Ng CC, Phoon KY, Ow JH, Tan NC. Initiation of insulin for type 2 diabetes mellitus patients: what are the issues? A qualitative study. Singapore Med J 2011;52(11):801-809.
  11. Stenov V, Wind G, Vallis M, Reventlow S, Hempler NF. Group-based, person-centered diabetes self-management education: healthcare professionals' implementation of new approaches. BMC Health Serv Res 2019;19:368. https://doi.org/10.1186/s12913-019-4183-1
  12. Grigorescu ED, Lacatusu CM, Botnariu GE, Popescu RM, Popa AD, Onofriescu A, et al. Communication as a key issue in the care of diabetes mellitus. Rom J Diabetes Nutr Metab Dis 2015; 22(3):305-310. https://doi.org/10.1515/rjdnmd-2015-0037
  13. Williams JS, Walker RJ, Smalls BL, Hill R, Egede LE. Patient-centered care, glycemic control, diabetes self-care, and quality of life in adults with type 2 diabetes. Diabetes Technol Ther 2016; 18(10):644-649. https://doi.org/10.1089/dia.2016.0079
  14. Kalantzi S, Kostagiolas P, Kechagias G, Niakas D, Makrilakis K. Information seeking behavior of patients with diabetes mellitus: a cross-sectional study in an outpatient clinic of a university-affiliated hospital in Athens, Greece. BMC Res Notes 2015;8:48. https://doi.org/10.1186/s13104-015-1005-3
  15. Dimon M. The largest cities in Ethiopia. Ethiopian Gazette; 2018 Sep 16 [cited 2020 Oct 1]. Available from: https://ethiopiangazette.com/the-largest-cities-in-ethiopia.
  16. Getachew E. Annual report. Dessie: Dessie Comprehensive Specialized Hospital (DCSH); 2020.
  17. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care 2007;19(6):349-357. https://doi.org/10.1093/intqhc/mzm042
  18. Ahmed IB, Binnwejim MS, Alnahas TM, Raes AA, Basamad MA, Alqurashi AE, et al. Level of diabetic patients' knowledge of diabetes mellitus, its complications and management. Arch Pharm Pract 2019;10(4):80-86.
  19. Ntontolo PN, Lukanu PN, Ogunbanjo GA, Fina JL, Kintaudi LN. Knowledge of type 2 diabetic patients about their condition in Kimpese Hospital diabetic clinic, Democratic Republic of the Congo. Afr J Prim Health Care Fam Med 2017;9(1):e1-e7.
  20. Bili AA, Zha L. Knowledge of type 2 diabetes mellitus and adherence to management guidelines: a cross-sectional study in Juba, South Sudan. South Sudan Med J 2018;11(4):84-88.
  21. Habte BM, Kebede T, Fenta TG, Boon H. Explanatory models of adult patients with type 2 diabetes mellitus from urban centers of central Ethiopia. BMC Res Notes 2016;9(1):441. https://doi.org/10.1186/s13104-016-2248-3
  22. International Diabetes Federation (IDF). IDF diabetes atlas; 2000 [cited 2021 Feb 28]. Available from: https://www.diabetesatlas.org.
  23. Verma M, Junaid A, Gupta DD. Exploring the role of social media as a support mechanism among persons with diabetes: an online ethnographic study. J Content Community Commun 2019;10:78-85.
  24. Gabarron E, Arsand E, Wynn R. Social media use in interventions for diabetes: rapid evidence-based review. J Med Internet Res 2018;20(8):e10303. https://doi.org/10.2196/10303
  25. Cooper A, Kar P. A new dawn: the role of social media in diabetes education. J Diabetes Nurs 2014;18(2):68-71.
  26. Da Silva E, Toledo MM. The misuse of social media and the propagation of incorrect information about diabetes. J Diab Res Ther 2019. doi: https://dx.doi.org/10.16966/2380-5544.140.
  27. Dunning T, Savage S, Dabkowski S. Information needs of young adults with type 2 diabetes; 2009 [cited 2021 Feb 28]. Available from: http://dro.deakin.edu.au/eserv/DU:30031285/dunning-informationneeds-post-2009.pdf.
  28. Weymann N, Harter M, Dirmaier J. Information and decision support needs in patients with type 2 diabetes. Health inform J 2016;22(1):46-59. https://doi.org/10.1177/1460458214534090
  29. Jarab AS, Mukattash TL, Al-Azayzih A, Khdour M. A focus group study of patient's perspective and experiences of type 2 diabetes and its management in Jordan. Saudi Pharm J 2018;26(3): 301-305. https://doi.org/10.1016/j.jsps.2018.01.013
  30. Carolan M, Holman J, Ferrari M. Experiences of diabetes self-management: a focus group study among Australians with type 2 diabetes. J Clin Nurs 2015;24(7-8):1011-1023. https://doi.org/10.1111/jocn.12724
  31. Johansson K, Osterberg SA, Leksell J, Berglund M. Patients' experiences of support for learning to live with diabetes to promote health and well-being: a lifeworld phenomenological study. Int J Qual Stud Health Well-being 2016;11:31330. https://doi.org/10.3402/qhw.v11.31330
  32. Johansson K, Osterberg SA, Leksell J, Berglund M. Manoeuvring between anxiety and control: patients' experience of learning to live with diabetes: a lifeworld phenomenological study. Int J Qual Stud Health Well-being 2015;10:27147. https://doi.org/10.3402/qhw.v10.27147
  33. Zheng F, Liu S, Liu Y, Deng L. Effects of an outpatient diabetes self-management education on patients with type 2 diabetes in china: a randomized controlled trial. J Diabetes Res 2019; 2019:1073131.
  34. Upsher R, Allen-Taylor M, Reece I, Chamley M, Ismail K, Forbes A, et al. Experiences of attending group education to support insulin initiation in type 2 diabetes: a qualitative study. Diabetes Ther 2020;11(1):119-132. https://doi.org/10.1007/s13300-019-00727-7
  35. Tewahido D, Berhane Y. Self-care practices among diabetes patients in Addis Ababa: a qualitative study. PLoS One 2017;12(1):e0169062. https://doi.org/10.1371/journal.pone.0169062
  36. Mikhael EM, Hassali MA, Hussain SA, Shawky N. Self-management knowledge and practice of type 2 diabetes mellitus patients in Baghdad, Iraq: a qualitative study. Diabetes Metab Syndr Obes 2018;12:1-17.
  37. Muchiri JW, Gericke GJ, Rheeder P. Stakeholders' perceptions of dietary and related self-management challenges and education programme preferences for type 2 diabetes adults. JEMDSA 2018;24(1):1-9.