Are patients with type 2 diabetes in the Waikato District provided with adequate education and support in primary care to self-manage their condition? A qualitative study

Rebekah Crosswell; Kimberley Norman; Shemana Cassim; Valentina Papa; Rawiri Keenan; Ryan Paul; Lynne Chepulis

doi:10.1071/HC23141

RESEARCH ARTICLE (Open Access)

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Are patients with type 2 diabetes in the Waikato District provided with adequate education and support in primary care to self-manage their condition? A qualitative study

Rebekah Crosswell

¹ ^* , Kimberley Norman ¹ , Shemana Cassim ¹ ² , Valentina Papa ³ , Rawiri Keenan

¹ , Ryan Paul ⁴ , Lynne Chepulis ¹

+ Author Affiliations

- Author Affiliations

¹ Waikato Medical Research Centre, University of Waikato, Te Huataki Waiora, School of Health, Private Bag 3105, Hamilton 3240, New Zealand.

² School of Psychology, Massey University, Auckland, New Zealand.

³ Department of Nursing, University of Waikato, Hamilton, New Zealand.

⁴ Te Whatu Ora Waikato, Hamilton, New Zealand.

^* Correspondence to: rebekah.crosswell@waikato.ac.nz

Handling Editor: Tim Stokes

Journal of Primary Health Care 16(1) 61-69 https://doi.org/10.1071/HC23141

Submitted: 1 November 2023 Accepted: 2 February 2024 Published: 4 March 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of The Royal New Zealand College of General Practitioners. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Introduction

In Aotearoa New Zealand (NZ), type 2 diabetes (T2D) is predominantly managed in primary care. Despite established guidelines, patients are often suboptimally managed, with inequitable health outcomes. To date, few NZ studies have evaluated the primary care management of T2D at the time of diagnosis.

Aim

This study aims to explore the provision of education and delivery of care to patients at the time of diagnosis, which is a crucial time in the disease trajectory.

Methods

Participants were recruited from a Māori health provider in the Waikato District, and diagnosed with T2D after January 2020. Patients were texted a link to opt into a survey (larger study) and then registered interest by providing contact details for an interview (current study). Semi-structured interviews were conducted and were audio recorded, transcribed, and thematically analysed.

Results

In total, 11 participants aged 19–65 years completed the interviews (female n = 9 and male n = 20); the comprised Māori (n = 5), NZ European (n = 5) and Asian (n = 1) participants. Three overarching themes were identified, including: (1) ineffective provision of resources and education methods; (2) poor communication from healthcare practitioners; and (3) health system barriers.

Discussion

Evidently, there are difficulties in primary care diabetes mellitus diagnosis and management. Improvements could include locally relevant resources tailored to patients’ experiences and cultural identities. Utilising whānau support and a non-clinical workforce, such as health navigators/kaiāwhina, will drastically address current workforce issues and assist patient self-management. This will allow improved diagnosis experiences and better health outcomes for patients and whānau.

Keywords: communication, diagnosis, healthcare education, primary health care, self-management, type 2 diabetes.

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