Open AccessMaking sense of change: patients’ views of diabetes and GP ‐led integrated diabetes care
Author(s) -
Burridge Letitia H.,
Foster Michele M.,
Donald Maria,
Zhang Jianzhen,
Russell Anthony W.,
Jackson Claire L.
Publication year - 2016
Publication title -
health expectations
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.314
H-Index - 74
eISSN - 1369-7625
pISSN - 1369-6513
DOI - 10.1111/hex.12331
Subject(s) - thematic analysis , diabetes management , medicine , qualitative research , diabetes mellitus , context (archaeology) , nursing , health care , psychology , gerontology , type 2 diabetes , paleontology , social science , sociology , economic growth , economics , biology , endocrinology
Background Health system reform is directed towards better management of diabetes. However, change can be difficult, and patients’ perspectives are a key aspect of implementing change. Objective This study investigated patients’ perceptions and experiences of type 2 diabetes (T2 DM ), self‐care and engagement with GP ‐led integrated diabetes care. Design Qualitative interviews were conducted with purposively selected patients with T2 DM following their initial medical appointment in the new model of care. Normalization process theory was used to orientate the thematic analysis, to explain the work of implementing change. Setting Two specialist GP ‐based complex diabetes services in primary care in Brisbane, Australia. Participants Intervention group patients ( n = 30) in a randomized controlled trial to evaluate a model of GP ‐led integrated care for complex T2 DM . Main outcome measures Participants’ experiences and perceptions of diabetes management and a GP ‐led model of care. Results Three themes were identified: sensibility of change, ‘diabetic life’ and diabetes care alliance. The imperative of change made sense, but some participants experienced dissonance between this rational view and their lived reality. Diabetes invaded life, revealing incongruities between participants’ values and living with diabetes. They appreciated a flexible and personalized approach to care. Discussion Participants responded to advice in ways that seemed rational within the complexities of their life context. Their diabetes partnerships with health professionals coupled providers’ biomedical expertise with patients’ contextual expertise. Conclusions Learning to manage relationships with various health professionals adds to patients’ diabetes‐related work. Providers need to adopt a flexible, interactive approach and foster trust, to enable better diabetes care.