一项关于改善孟加拉国农村糖尿病自我管理实践的挑战和机遇的保健提供者观点的定性研究

IF 7.4 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice Pub Date : 2025-08-14 DOI:10.1016/j.diabres.2025.112412

Hasina Akhter Chowdhury , Baki Billah , Zobaer Alam , Shamia Akther Dipa , A.K.M. Fazlur Rahman , Liaquat Ali , Anju E. Joham , Cheryce L Harrison

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引用次数: 0

摘要

目的本定性研究探讨了医疗保健专业人员对孟加拉国农村2型糖尿病（T2DM）患者糖尿病自我管理实践的限制和机会的看法。它还审查了对未来干预措施的建议和偏好，以改善糖尿病自我管理实践（DSMP）的依从性和健康结果。方法采用有目的抽样技术，对孟加拉国三级、二级和初级保健机构中为成年T2DM患者提供护理的医疗保健专业人员进行半结构化访谈。使用基于社会生态模型的演绎框架对访谈进行转录和主题分析。结果共有24名卫生专业人员(n = 15，地方一级；（N = 9，国家级）。出现了四个关键主题：医疗保健系统、政府支持和政策、患者因素和社区影响。农村卫生保健系统面临着重大挑战，包括资源不足、劳动力短缺、获得基本药物和设备的机会有限，导致卫生保健提供者负担沉重。此外，由于文化信仰和对疾病管理的宿命论态度，糖尿病治疗融入初级卫生系统的程度很低。医疗保健专业人员建议以小组为基础的dsm为同伴支持，家访为个性化护理。研究结果为全球关于农村地区，特别是孟加拉国和中低收入国家（LMICs）类似地区的农村地区的生活质量问题的讨论提供了有价值的视角，强调了针对具体情况采取具有文化敏感性的干预措施的必要性。

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A qualitative study of healthcare provider perspectives on challenges and opportunities to improve diabetes self-management practices in rural Bangladesh

Aims

This qualitative study explores healthcare professionals’ perspectives on the constraints and opportunities of diabetes self-management practices among rural people with type 2 diabetes mellitus (T2DM) in Bangladesh. It also examines suggestions and preferences for future interventions to improve diabetes self-management practices (DSMP) adherence and health outcomes.

Methods

Semi-structured interviews with healthcare professionals that provide care to adults with T2DM in Bangladesh across tertiary, secondary and primary care settings were conducted using purposive sampling techniques. Interviews were transcribed and thematically analysed using a deductive framework based on the socio-ecological model.

Results

Overall, a total of 24 healthcare professionals (n = 15, local-level; n = 9, national-level) were interviewed. Four key themes emerged: healthcare system, government support and policy, patient factors, and community influences. The rural healthcare system faces major challenges, including inadequate resources, workforce shortages, and limited access to essential medications and equipment, leading to a high burden on healthcare providers. Additionally, diabetes care integration into primary health systems is minimal, compounded by cultural beliefs and fatalistic attitudes toward disease management. Healthcare professionals suggested group-based DSMP for peer support and home visits for personalised care.

Conclusions

The findings contribute valuable perspectives to the global discourse on DSMP in rural settings, particularly in Bangladesh and similar contexts within low- and middle-income countries (LMICs), underscoring the need for context-specific, culturally sensitive interventions.

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来源期刊

Diabetes research and clinical practice 医学-内分泌学与代谢

CiteScore

10.30

自引率

3.90%

发文量

862

审稿时长

32 days

期刊介绍： Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.