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  • Making sense of change: patients' views of diabetes and GP-led integrated diabetes care

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    Author(s)
    Burridge, Letitia H
    Foster, Michele M
    Donald, Maria
    Zhang, Jianzhen
    Russell, Anthony W
    Jackson, Claire L
    Griffith University Author(s)
    Burridge, Letitia H.
    Year published
    2016
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    Abstract
    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 (T2DM), self‐care and engagement with GP‐led integrated diabetes care. Design Qualitative interviews were conducted with purposively selected patients with T2DM 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 ...
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    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 (T2DM), self‐care and engagement with GP‐led integrated diabetes care. Design Qualitative interviews were conducted with purposively selected patients with T2DM 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 T2DM. 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.
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    Journal Title
    Health Expectations
    Volume
    19
    Issue
    1
    DOI
    https://doi.org/10.1111/hex.12331
    Copyright Statement
    © The Author(s) 2015. This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
    Subject
    Nursing
    Health services and systems
    Public health
    Psychology
    Publication URI
    http://hdl.handle.net/10072/173648
    Collection
    • Journal articles

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