Factors influencing self-management in patients with type 2 diabetes in general practice: a qualitative study
Julie Dao A C , Catherine Spooner A , Winston Lo B and Mark F. Harris A
+ Author Affiliations
- Author Affiliations
A UNSW Sydney, Centre for Primary Health Care and Equity, Level 3, AGSM Building, Botany Street, Sydney, NSW 2052, Australia.
B Western Sydney University, School of Medicine, Building 30, Narellan Road & Gilchrist Drive, Campbelltown, Sydney, NSW 2560, Australia.
C Corresponding author. Email: julie.dao96@gmail.com
Australian Journal of Primary Health 25(2) 176-184 https://doi.org/10.1071/PY18095
Submitted: 22 June 2018 Accepted: 12 January 2019 Published: 20 March 2019
Journal Compilation © La Trobe University 2019 Open Access CC BY-NC-ND
Abstract
Many Australian adults with type 2 diabetes mellitus (T2DM) do not follow recommended self-management behaviours that could prevent or delay complications. This exploratory study aimed to investigate the factors influencing self-management of T2DM in general practice. Semi-structured qualitative interviews were conducted with patients with T2DM (n = 10) and their GPs (n = 4) and practice nurses (n = 3) in a low socioeconomic area of Sydney, New South Wales, Australia. The interviews were analysed thematically using the socio-ecological model as a framework for coding. Additional themes were derived inductively based on the explicitly stated meaning of the text. Factors influencing self-management occurred on four levels of the socio-ecological model: individual (e-health literacy, motivation, time constraints); interpersonal (family and friends, T2DM education, patient-provider relationship); organisational (affordability, multidisciplinary care); and community levels (culture, self-management resources). Multi-level strategies are needed to address this wide range of factors that are beyond the scope of single services or organisations. These could include tailoring health education and resources to e-health literacy and culture; attention to social networks and the patient–provider relationship; and facilitating access to affordable on-site allied health services.
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