Patients’ and Nurses’ Perceptions of Diabetes Self-Management in Oman: A Qualitative Study
Abstract
:- Patient-centered care enhances diabetes self-management.
- Patient-centered care studies have focused on how physician–patient relationships affect health outcomes.
- Scant literature describes the primary care nurse’s role in promoting diabetes self-management within a patient-centered care model.
- Patient perceptions that nurses have a limited role in diabetes management may alert managers to ineffective clinical encounters that lack patient engagement, collaboration, and problem solving.
- Primary care nurses need to assess patient beliefs and self-management behaviors to develop individual plans for achieving optimal health outcomes.
- Task-oriented nurses with little understanding of patient-centered principles may fail to educate and motivate patients to adopt effective diabetes self-management behaviors.
1. Introduction and Background
Study Purpose and Questions
2. Methods
2.1. Research Design
2.2. Sample and Setting
2.3. Data Collection
2.4. Data Analysis
3. Results
3.1. Sample Demographics
3.2. Findings
The person should be responsible for his life and should not be careless about his life.
I started to read about diabetes either through… alternative medicine, and I have some experience in this area. I started taking warm [tap] water, and my blood sugar readings improved. Today, my fasting blood sugar was 126 [mg/dL], which is rare. I also use a mixture of sea salt, lemon, water, and a small amount of natural apple vinegar.
I became not concerned about my food; I became bored and tiresome from following the same regimen. It was a period, then I resumed the same routine. I stopped visiting the diabetes clinic for almost one year and doing lab investigations.[blood glucose tests]
Sometimes I mess up, especially in the gathering with others; I eat from this and that. As you know, my blood sugar control becomes messy, and I have a stomach upset.
I climb the stairs back and forth. I have work in the kitchen, clean the house...
I do not have a chance to have a conversation with nurses; I only see doctors.
I did not interact with nurses too much…when I come here, they do the [blood tests] and the rest of things with doctors. However, the interaction of nurses is kind.
Indeed, nurses do nothing; only they check blood sugar and measure blood pressure. The doctor is the basis for this clinic, whereas the nurse does not have a role only taking [blood tests], and they do not provide any advice. The doctor has a significant role.(P14)
I found that nurses give good health care, and we are not complaining. This is their work.
I do not feel they have a role in diabetes care. Maybe the nature of their work does not require them to guide you. Their role is to perform what doctors delegate them to do.
[If] they find high blood sugar? They [should] ask the patient what he has eaten lately?
Nurses provide us with some advice about food, be away from sugary food, do physical activity whenever possible, and follow diet control.
Nurses advise you…inform you regarding the complications of diabetes and the preventive measures to avoid these complications.(P21)
My role in the diabetes clinic is to receive patients, check their blood sugar, guide them to their responsible doctor. I also provide any help, instruct them on the importance of taking care of their health and maintaining [a healthy] blood sugar level.
We question the patient about his eating habits and lifestyle to know how he spends his life. We are trying to know what the problem is. If we find the problem, the problem is that eating, lifestyle, life circumstances, or psychological factors impact him. Based on the problem, we will try to find the right way to help the patient.
We sit and listen to the patient “Why is his blood sugar like this?” We see his nutritional history, what he likes to eat. “I like to eat dates.” It is okay, we do not like to deprive him of eating dates, but we ration the amount he can eat per day. The first point is to ration his food. The second point is not only telling him and leaving, but to follow-up with him.
Involving patients’ families may support patients at home because, after a time, the patient may not follow the required treatment plan by himself. If the family does not eat a healthy diet, the patient eats what they want. We encourage families to follow a healthy lifestyle to encourage patients to do the same.
Honestly, I do not know about it, unless there is another name. I have no background about it unless someone has explained it to me in another way.
The healthcare that depends on the patient by himself, in the way he interacts with the disease, as he is the cornerstone of the treatment plan.
Maybe you mean that each patient is an individual? Meaning that each patient has his treatment plan that differs from another patient?
It means the patient is the [focus of] healthcare and we care for the patient as a whole. We work, develop ourselves, and improve healthcare services. Why? Only for patients. When we study the patient from all aspects, we will know the deficits or shortcomings to improve them, potentially affecting the patient’s quality of care that is provided.
Engage patients with suggestions and the methods of treatment that they need to follow. Give [them] the priorities to choose their treatment and provide an in-depth explanation about the chosen treatment, such as medication side effects and the best for them.
We do not force and impose our opinions on the patients’ treatment plan. For example, we do not give patients instructions or orders (“Do this and that, take this” and “You must take this”). Even in diet control, we give patients choices from their daily meal plan, but we reorganize the diet for them (“take this, instead of that”). We do not want the patient to reach the stage of refusal, and we lost the patient.
4. Discussion
4.1. Limitations
4.2. Implications of the Findings
4.3. Relevance to Clinical Practice
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
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Demographics | Patients (n = 24) | Nurses (n = 21) |
---|---|---|
M ± (SD) | ||
Age (years) | 41.2 ± 9.2 | 37.1 (5.4) |
range: 25–60 | range: 28–49 | |
Years of experience | - | 16 ± 5.0 |
n (%) | n (%) | |
Male | 13 (54.20) | 19 (90.5) |
Female | 11 (45.80) | 2 (9.5) |
Did not complete 12th grade | 4 (16.7) | - |
Completed 12th grade | 9 (37.5) | - |
Diploma | 4 (16.7) | 17 (81.0) |
Bachelor | 2 (8.3) | 3 (14.3) |
Post-graduate | 5 (20.8) | 1 (4.7) |
Marital Status | 4 (16.7) 17 (70.80) 2 (8.3) 1 (4.2) | - |
Unmarried | ||
Married | ||
Widowed | ||
Divorced | ||
Medication Type | - | |
No medication | 2 (8.3) | |
Pills only | 8 (33.3) | |
Insulin only | 5 (20.8) | |
Pills and insulin | 9 (37.5) | |
Monthly Income (OMR) | - | |
Below 500 | 7 (29.2) | |
501–1000 | 10 (41.7) | |
1001–1500 | 5 (20.8) | |
More than 2000 | 2 (8.3) | |
PHC site of care | ||
Al-Dhahira | 5 (20.8) | 4 (19.0) |
North Al-Batinah | 6 (25.0) | 4 (19.0) |
Dhofar | 4 (16.7) | 4 (19.0) |
South Ash Sharqiyah | 5 (20.8) | 4 (19.0) |
Muscat | 4 (16.7) | 5 (24.0) |
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Al Mahrouqi, A.S.; Mallinson, R.K.; Oh, K.M.; Weinstein, A.A. Patients’ and Nurses’ Perceptions of Diabetes Self-Management in Oman: A Qualitative Study. Int. J. Environ. Res. Public Health 2022, 19, 6929. https://doi.org/10.3390/ijerph19116929
Al Mahrouqi AS, Mallinson RK, Oh KM, Weinstein AA. Patients’ and Nurses’ Perceptions of Diabetes Self-Management in Oman: A Qualitative Study. International Journal of Environmental Research and Public Health. 2022; 19(11):6929. https://doi.org/10.3390/ijerph19116929
Chicago/Turabian StyleAl Mahrouqi, Abdullah Salim, Robert Kevin Mallinson, Kyeung Mi Oh, and Ali A. Weinstein. 2022. "Patients’ and Nurses’ Perceptions of Diabetes Self-Management in Oman: A Qualitative Study" International Journal of Environmental Research and Public Health 19, no. 11: 6929. https://doi.org/10.3390/ijerph19116929