高收入国家的粮食不安全、糖尿病自我管理和自我管理支持:定性系统回顾和综合(2008年至2024年)

IF 2 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Flora Douglas, Emma MacIver, Catriona Kennedy
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引用次数: 0

摘要

高收入国家中患有糖尿病和粮食不安全的人的健康相关结果比粮食安全的人差。糖尿病是一项重大的全球健康挑战。与此同时,家庭粮食不安全的普遍现象继续增加。这一定性系统综述和综合探讨了高收入国家糖尿病和粮食不安全患者自我管理的实际经验和对自我管理的支持。关键词和搜索词是在2008年1月至2024年8月之间使用PICo框架开发的。根据纳入和排除标准筛选标题和摘要,并使用质性研究的关键评价清单和CERQual评估纳入论文的方法学质量。18篇文章(详细介绍了17项研究)的研究结果确定了四个相互关联的主题:结构性挑战、日常挑战、粮食不安全和糖尿病患者的生存方式,以及自我和对自我管理需求的支持。结构性挑战(贫困、社会文化和歧视)被确定为糖尿病患者和粮食不安全患者日常挑战的主要决定因素。这些挑战包括:(i)获得适当食物和食物管理资源的机会有限;(二)压力;(三)贫穷和对糖尿病的耻辱感;(四)非正式支持有限;(五)认为保健从业人员缺乏适当支持,以及知识、信心、理解和获取信息的机会有限。因此,受影响的人的生存方式的特点是生存、避免、平衡和优先考虑。自我和对自我管理需要的支持有两个主题:改进临床对话和保健服务以外的支持。由于经济上的需要,患有糖尿病和粮食不安全的人正在采取自我管理的方法,从保健的角度来看,这可能是不适当的,并可能影响他们的短期和长期健康。在COVID-19大流行后的背景下,迫切需要解决这些问题,以有效预防和管理糖尿病。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Food Insecurity, Diabetes Self-Management and Support for Self-Management in High-Income Countries: A Qualitative Systematic Review and Synthesis (2008 to 2024)

Food Insecurity, Diabetes Self-Management and Support for Self-Management in High-Income Countries: A Qualitative Systematic Review and Synthesis (2008 to 2024)

People living with diabetes and food insecurity in high-income countries have poorer health-related outcomes than those who are food secure. Diabetes is a significant global health challenge. At the same time, the prevalence of household food insecurity continues to increase. This qualitative systematic review and synthesis explored the lived experience of diabetes self-management and support for self-management for people living with diabetes and food insecurity in high-income countries. Keywords and search terms were developed using the PICo framework with searches conducted between January 2008 and August 2024. Titles and abstracts were screened against inclusion and exclusion criteria, and the methodological quality of included papers was assessed using the Critical Appraisal Checklist for Qualitative Research and CERQual. Findings from 18 articles (detailing 17 studies) identified four interlinked themes: structural challenges, day-to-day challenges, ways of being for people living with food insecurity and diabetes, and self and support for self-management needs. Structural challenges (poverty, sociocultural and discrimination) were identified as the main determinants of the day-to-day challenges for people living with diabetes and food insecurity. Those challenges included the following: (i) limited access to suitable foods and food management resources; (ii) stress, (iii) poverty and diabetes stigma, (iv) limited informal support, (v) perceived lack of appropriate support from healthcare practitioners, and limited knowledge, confidence and understanding and access to information. The resulting ways of being for people affected were characterised by experiences of subsisting, avoiding, balancing and prioritising. Self and support for self-management needs were characterised by two themes improve[ing] clinical conversations and, support beyond health services. People living with diabetes and food insecurity are adopting methods of self-management, due to economic necessity, which may not be appropriate from a healthcare perspective, and which may be impacting their short and long-term health. There is an urgent need to address these issues in the post COVID-19 pandemic context for effective diabetes prevention and management.

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来源期刊
CiteScore
4.50
自引率
8.30%
发文量
423
期刊介绍: Health and Social Care in the community is an essential journal for anyone involved in nursing, social work, physiotherapy, occupational therapy, general practice, health psychology, health economy, primary health care and the promotion of health. It is an international peer-reviewed journal supporting interdisciplinary collaboration on policy and practice within health and social care in the community. The journal publishes: - Original research papers in all areas of health and social care - Topical health and social care review articles - Policy and practice evaluations - Book reviews - Special issues
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