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The purpose of this paper is to test a model in which emotional and work-related conflicts associated with diabetes contribute to health management efficacy and behaviour.

The authors investigated 193 Korean employees with diabetes in a two-phased longitudinal study (101 participants were retained at Time 2).

After controlling for severity of diabetes (HbA_1C), structural equation modelling revealed that higher work-health conflict (a proxy for demand) and higher inauthenticity at work (a proxy for control) were associated with more diabetes-related distress at Time 1. Results also revealed support for longitudinal mediation, such that more diabetes-related distress at Time 1 predicted lower health management efficacy one year later (at Time 2), which was associated with less health management behaviour at Time 2.

Results support the importance of applying the biopsychosocial perspective to diabetes management through the use of subjective measures of demand and control.

Suggestions are provided for occupational programmes for workers with disease, including on-site education, health-management training, and flexible job redesign such as telecommuting.

Research in workers with diabetes for stress relief and disease management.

This paper aims to explicate one of the major findings of a research study seeking to understand how Indonesian people with diabetes learn about their disease. The one key finding discussed in this paper is how families influence the learning and self-management processes adopted by Indonesian people with diabetes.

A grounded theory methodology was adopted to investigate how Indonesian people with diabetes learn about their disease. Twenty-eight semi-structured interviews were undertaken with Indonesian people living with diabetes, families of people living with diabetes, healthcare professionals and other healthcare providers. Data was analysed by using constant comparative analysis during three coding stages.

The study explicated the basic social process of how people with diabetes in Indonesia learn about their disease through a generated theory “Learning, choosing, and acting: self-management of diabetes in Indonesia”. This study found family engagement was integral to Indonesian people living with diabetes who were self-managing their disease. Families assisted with seeking information, providing recommendations, selecting and implementing actions, appraising implemented actions, and informing others about their experiences. By acknowledging that family is involved in this process, the healthcare professional can adequately provide health education to both the person with diabetes and their families. Involving families in health education is crucial as family can influence decision making made by people with diabetes in a proper or improper way. Thus, clinicians need to also skilfully recognise difficulties these people encounter by monitoring their self-management progress and by working closely with them and their family members.

This is the first study conducted in Indonesia that specifically investigates the process of how people with diabetes learn about their disease. The involvement of families in this process is a central finding of the study. Families can enhance the overall health and well-being of the person with diabetes, aid in early recognition of aberration to health status and trigger the initiation of interventions to re-establish homeostasis if they are actively engaged and supported by health professionals.

The aim of this paper is to link complexity theory to the intentional change process by examining the role of emotional attraction. A research study currently underway on intentional change theory (ICT) in a healthcare context is presented.

This paper uses the concept of “attractors” from complexity theory to suggest that emotion affects the process of intentional change in different ways dependent upon whether the emotion is positive or negative. Determination of the emotion in this way proposes the existence of either a positive emotional attractor (PEA) or a negative emotional attractor (NEA). The paper discusses positive psychology's perspective on the differential impacts of positive and negative emotion. The paper also outlines an ongoing research project at a Veterans Affairs Medical Center which examines the concept of PEA and its effect on diabetes self‐management as well as its consequent role in improved health.

A review of the literature and subsequent development of hypotheses and the conceptual model, indicate education for chronically ill adults must be purposeful and directed toward a self‐perceived need for personal change; include their own disease experience; allow them to become active participants in learning; and lastly, the learning process should be considerate of individual cognitive ability.

ICT could address the needs of chronically ill patients as its focus is a self‐directed journey to personal change and learning. The potential of ICT is enormous given that diabetes is a national problem that has reached epidemic proportions.

The purpose of this study is to explore the information culture of people living with Diabetes Mellitus (DM) and how that impacts their self-management practices in Ghana. The study focuses on the information experiences and information cultural patterns and creates awareness of the need for people to be aware of effective information management for sustainable self-management support.

An interpretive qualitative approach was used. A total of 12 interviewees involving 10 diabetes patients and 2 health professionals provided data for the study. Allowing the participants to freely talk about their attitude and behaviour, defining their experiences around information for their self-management was the best approach to achieve an in-depth understanding this study seeks.

The specific elements defining the information of people living with DM in Ghana can be identified. People living with the condition are willing to share information about their condition not only with those within their diabetic community but also with anyone interested. They prefer to use information from sources they find reliable and trust, and they have good information-related competencies that are consistent with diabetic patients in other countries’ contexts to help them identify, access, use and share relevant information. Only a few of the interviewees have difficulty in evaluating the accuracy and currency of some of the information. But they receive a lot of support from experienced people from their community. People also prefer to have information about the condition in their ethnic language. It is important for people living with the condition in Ghana to get involved in the diabetic groups, clubs and community, as members appear to receive the most benefit and support from the community to self-manage the condition alone.

The study is limited by the number of participants and the distances between the researchers and the research context. Also, even though two groups of participants were interviewed (diabetic patients and health professionals), the analysis did not separate the responses of the different groups of study participants. This paper provides a useful insight and understanding of the culture of people living with diabetes in Ghana in terms of how they access, use and share the information they need to support their self-management. It will create awareness of the importance of being mindful of information culture patterns in people in other groups in Ghana and beyond. The research processes and procedures described in the paper can be replicated by other researchers in other contexts.

Although there have been a lot of studies about diabetes and people living with the condition in Ghana, to the best of the authors’ knowledge, this is the first study looking at how people define their need for information, how they identify the source of the information and how they access and use the information, including their general behavioural patterns that influence these information experiences.

The purpose of this paper is to examine how pregnant women with type 1 diabetes integrate new information technology (IT) into their health management activities, using activity theory as an analytical framework.

The research is a multiple case design, based on interviews with 15 women with type 1 diabetes who were pregnant, considering pregnancy, or had recently given birth. A thematic analysis, sensitised by activity theory, was used to analyse the data.

Health management in this setting involves negotiations and contradictions across boundaries of interacting activities. Participants play an active role in managing their health and using new IT tools in particular ways to support their health management. Using new technologies creates both opportunities and challenges. IT-enabled healthcare devices and other information systems open up new treatment possibilities, but also generate new contradictions between interacting activity systems.

The research was conducted with a small sample in a specific context of health management. Further research is needed to extend the findings to other contexts.

Healthcare providers need to accommodate a bottom-up approach to the adoption and use of new technologies in settings where empowered patients play an active role in managing their health.

The findings highlight opportunities to further develop activity theory to accommodate the central role that individuals play in resolving inherent contradictions and achieving alignment between multiple interacting activity systems when incorporating new IT tools into health management activities.

This paper discusses the role played by social determinants of health in the incidence and management of type 2 diabetes mellitus (diabetes) among vulnerable populations. This issue is especially important in light of recent data from Statistics Canada indicating that mortality rates from diabetes have been increasing among Canadians since the mid‐1980s, with increases being especially great among those living in low‐income communities. Diabetes therefore appears – like cardiovascular disease – to be an affliction more common among the poor and excluded. It also appears to be especially likely to afflict poor women. Yet we know little about how these social determinants of health influence diabetes incidence and management. What evidence is available is provided and the case is made that the crisis in diabetes requires new ways of thinking about this disease, its causes, and its management.

This paper explores intensive self‐management of type 1 diabetes with insulin pump therapy as an enabling technology and reports barriers in the communication process with health professionals providing diabetes care who are unfamiliar with this treatment. Questionnaire responses and telephone interviews from a study conducted with 78 people using pump therapy in 2006 showed that individuals attending diabetes centres that were not pump‐trained suffered poor communication and a lack of support for intensive diabetes self‐management. As a result, some pump users did not visit their diabetes centre for care and management of the condition, preferring to communicate with the pump manufacturer and a national insulin pump therapy support organisation because they were familiar with the treatment. Nonetheless, all pump users had a strong sense of self‐efficacy concerning their mastery of the treatment technology to prevent, delay or stabilise the chronic complications of type 1 diabetes. Conclusions are linked to the Insulin Pump Services Report (Department of Health, 2007) and specific guidance on the use of pump therapy with patients by trained health professionals.

Type 2 diabetes mellitus has become a major concern of Australian healthcare providers. From rates of barely more than 1 percent in the mid-90s, diabetes is now the leading cause of morbidity in the country. To combat the growing diabetes epidemic, Western Sydney Local Health District created the Western Sydney Diabetes (WSD) initiative. One of the key components of the WSD initiative since 2014 has been joint specialist case conferencing (JSCC). The purpose of this paper is to evaluate the JSCC service including both individual- and practice-based changes.

The authors evaluated the JSCC program by conducting an analysis of patient-level data in addition to a discrete practice-level study. The study aim was to examine both the effect on individual patients and the practice, as well as acceptability of the program for both doctors and their patients. The evaluation included data collection and analysis of primary patient outcomes, as well as a survey of GPs and patients. Patient data on primary outcomes were obtained by accessing and downloading them through GP practice management software by GP practice staff.

The authors found significant improvements at both the patient levels, with reductions in BMI, HbA1c and blood pressure sustained at three years, and at the practice level with improvements in markers of patient management. The authors also found high acceptability of the program from both patients and GPs.

This paper provides good evidence for the use of a JSCC program to improve diabetes management in primary care through capacity building with GPs.

The purpose of this paper is to explore illness beliefs among adults with type 2 diabetes (T2DM), studied in a clinical setting in the Indian context. Diabetes management lies primarily in the hands of the patient, which signifies the need for understanding the various dimensions of individuals’ illness beliefs. While past research from abroad has stressed the need for understanding the patient’s perspective in effective illness management, the lack of studies in the Indian context calls for further research in this area.

Drawing on the Self-Regulation Model (Leventhal et al., 1980), semi-structured interviews were carried out to understand the beliefs about diabetes among individuals diagnosed to have T2DM. In total, 70 individuals with T2DM were included, taking into account the disease duration, urban-rural, age and gender distinctions. The data were analyzed using content analysis method.

The results of the analysis revealed numerous sub-themes related to the perceived consequences of diabetes, control or cure issues, timeline and emotional issues as experienced by the subjects.

Carrying out a triangulated research with the various stakeholders, namely, diabetologists, general practitioners and other support staff like dieticians could add more value to this exploratory study.

There is a dearth of research work that explores the illness beliefs that patients’ hold about diabetes, as discussed in the Indian context. It is expected that the insight provided by the study can help the government bodies, healthcare organizations and practitioners design and develop interventions from a patient-centric view. Additionally, such a patient-centric approach will enable individuals to achieve their treatment goals.

The purpose of this paper is to learn from participants about their experiences managing type 1 and type 2 diabetes at work.

Longitudinal, qualitative interviews with 45 individuals three times per year over three years focussed on views about disclosure; how they found or created support to manage their diabetes at work; and how they experienced the relationship between health and productivity.

Among participants, the presence of secondary conditions, such as fibromyalgia or vision loss, typically overshadowed the effect of diabetes at work. These conditions were often mentioned as the reason why a participant changed jobs, stopped working, or decreased work hours. Perspectives on disclosure were affected by the perception of stigma and discrimination, as well as the need for workplace accommodations. Overall, participants believed that the routine of a job and feeling useful benefited their health.

The nature of the research was not medical and the paper did not collect participants’ medical records. The paper relied on self-report for diagnoses of diabetes and co-morbidities as well as unrelated health conditions. Although the participants lived in a variety of urban, suburban, and rural settings, the findings do not reflect the ways in which differences in geography may have influenced participants’ experience. A focus of future research might be the role played by geographic location in the experience of managing diabetes at work. Also, the majority of employed participants worked for small employers. Future research might include a focus on participants managing diabetes while working for larger employers, who may have greater resources and staffing to devote toward implementing changes in workplace policy.

The paper considers the preference that many participants have for working and being productive rather than not working, including those with secondary conditions as well as diabetes. The number of participants (n=45) is relatively large for a qualitative interview study. The longitudinal nature of the study allowed for a follow-along opportunity that yielded a rich source of data.