Identifying Key Moments in Type 2 Diabetes Management: A Qualitative Study of the Experiences of People With Type 2 Diabetes and Diabetes Health Coaches

IF 3 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Health Expectations Pub Date : 2024-11-21 DOI:10.1111/hex.70108

Jack B. Joyce, Carolyn Newbert, Nicola Guess, Kate Fryer, Caroline A. Mitchell, Liliia Bespala, Elizabeth Morris, Paul Aveyard, Susan A. Jebb, Charlotte Albury

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Abstract

Objective

For people with type 2 diabetes who are overweight, weight loss increases the likelihood of achieving diabetes remission. The aim here was to draw on the experiences of people living with type 2 diabetes and coaches who deliver type 2 diabetes prevention and remission programmes. This was done to develop a service that increases the proportion of people who achieve remission by identifying an effective weight management service.

Research Design and Methods

A qualitative researcher and co-researcher with type 2 diabetes conducted 37 narrative interviews with adults with type 2 diabetes (October 2022–June 2023) and 16 semi-structured interviews with health coaches delivering type 2 diabetes programmes in England. Data were analysed using Reflexive Thematic Analysis. Participants were diverse in ethnicity, socioeconomic status, age, gender and years since diabetes diagnosis.

Results

Four themes were generated relating to moments in a person's diabetes care: (1) coming to terms with diagnosis, (2) lightbulb moments, (3) sustaining change as normal and (4) becoming expert/building confidence. These four themes were united under a high-level interpretivist theme: ‘Same journey, different experience’, capturing the mismatch between a linear rigid care pathway described by coaches and the diversity of experience of people living with type 2 diabetes.

Conclusions

Coaches and people with type 2 diabetes are aligned on their reports of key moments in adapting to diabetes. Participants’ desire for flexibility in their care contrasted with coach reports of rigid service provision. These insights may enable more people with type 2 diabetes to engage and adhere to weight management services aimed at diabetes remission.

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识别 2 型糖尿病管理中的关键时刻：关于 2 型糖尿病患者和糖尿病健康指导员经历的定性研究》。

目的：对于超重的 2 型糖尿病患者来说，减轻体重可增加糖尿病缓解的可能性。本文旨在借鉴 2 型糖尿病患者和提供 2 型糖尿病预防和缓解计划的教练的经验。这样做的目的是通过确定有效的体重管理服务来开发一种服务，以提高实现缓解的人数比例：一名定性研究人员和一名患有 2 型糖尿病的合作研究人员对英格兰的 2 型糖尿病成人患者进行了 37 次叙述式访谈（2022 年 10 月至 2023 年 6 月），并对提供 2 型糖尿病项目的健康教练进行了 16 次半结构式访谈。数据采用反思性主题分析法进行分析。参与者的种族、社会经济地位、年龄、性别和糖尿病诊断年限各不相同：结果：得出了与糖尿病患者护理过程中的时刻有关的四个主题：(1) 接受诊断，(2) 亮灯时刻，(3) 保持正常变化，(4) 成为专家/建立信心。这四个主题被归纳为一个高层次的解释学主题："相同的旅程，不同的经历"，反映了教练所描述的线性僵化护理路径与 2 型糖尿病患者经历的多样性之间的不匹配：结论：教练和 2 型糖尿病患者对适应糖尿病的关键时刻的报告是一致的。参与者对灵活护理的渴望与教练对僵化服务的报告形成了鲜明对比。这些见解可能会让更多的 2 型糖尿病患者参与并坚持体重管理服务，从而达到缓解糖尿病的目的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Health Expectations 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.20

自引率

9.40%

发文量

251

审稿时长

>12 weeks

期刊介绍： Health Expectations promotes critical thinking and informed debate about all aspects of patient and public involvement and engagement (PPIE) in health and social care, health policy and health services research including: • Person-centred care and quality improvement • Patients'' participation in decisions about disease prevention and management • Public perceptions of health services • Citizen involvement in health care policy making and priority-setting • Methods for monitoring and evaluating participation • Empowerment and consumerism • Patients'' role in safety and quality • Patient and public role in health services research • Co-production (researchers working with patients and the public) of research, health care and policy Health Expectations is a quarterly, peer-reviewed journal publishing original research, review articles and critical commentaries. It includes papers which clarify concepts, develop theories, and critically analyse and evaluate specific policies and practices. The Journal provides an inter-disciplinary and international forum in which researchers (including PPIE researchers) from a range of backgrounds and expertise can present their work to other researchers, policy-makers, health care professionals, managers, patients and consumer advocates.