JMIR Publications

ABSTRACT

Background:

Type 2 diabetes mellitus (T2DM) face significant challenges in the treatment process, which can have a negative impact on disease management. Proper management of the disease can reduce symptoms and complications, improve glycemic indices, and reduce mortality and readmission.

Objective:

Given the influential role of patients in prevention and self-care, this study was conducted to explore the challenges of diabetes management from the perspective of patients.

Methods:

Two rounds of focus group discussions (FGDs) with T2DM patients were conducted. The principal investigator (PI) of the study, with research assistant, compiled a list of volunteer patients with their names and contact information and selected participants based on their medical information. The participants were chosen via a purposive sampling technique. The questions were designed to encourage patients to share their views on how the treatment team communicates, participates in treatment, how they are trained, and the health care system. The discussion continued until data saturation. During two rounds of FGDs, the voices of the participants were recorded by two voice recorders, and one of the team members was a transcriber. After discussion, participants' views were transcribed and common issues were identified, and categorized and reported as categories and subcategories.

Results:

According to the conventional content analysis, eighty-eight primary codes were extracted from the detailed and in-depth description of the participants. The codes were summarized after repeated readings and classified based on their similarities and semantic relevance. Through analysis and comparison, four categories and seven subcategories were identified. The categories were including “communication challenges” (sub-categories: "poor medical staff communication ", " lack of psychological support"), “challenges of participation in treatment” (sub-categories: "lack of patient participation”), “educational challenges” (sub-categories: “Training program bugs” and " inadequate training”) and “challenges of the health care system” (sub-categories: “inefficiency of the care system”, “caregiver inefficiency”).

Conclusions:

This study showed that the treatment team members should pay more attention to the challenges of care and treatment from the perspective of patients with T2DM. Therefore, there are recommendations for the policy of future plans to overcome the obstacles, including establishing a multidisciplinary health care team, using trained health care workers to provide organized treatment and care services, holding individual counseling sessions with patients in need of counseling and providing counseling services and involving patients in the treatment and self-care process and designing a comprehensive diabetes education program with an emphasis on education. Necessary information should be provided to the patients, and how to communicate appropriately will eliminate the patients` concerns.