Do people with diabetes who need to talk want to talk?

Modelling the factors affecting Quality of Life among Indian police officers: a novel ISM and DEMATEL approach

Background

This study examines quality of life (QOL) of a sample of police officers in India. The concept of QOL includes well-being, social obligations, relationships of a person, and his association with environment. The study examines the factors on which QOL of police officers depend and their relationships with each other. The issues linked with QOL are important because they directly affect the individual's ability to maintain a healthy lifestyle and affect organizational performance in the long run. This study explores relevant factors that have an impact on the QOL of the employees of police department in India.

Method

In this paper, literatures review, ISM, MICMAC, and DEMATEL methodology have established eleven factors that impact the QOL of police officers in India. Mutual relations between factors have been established using the ISM approach to develop a model to represent these relationships. DEMATEL methodologies were used to analyze these factors.

Results

Results indicate that "fair compensation, work overload, workplace safety, and job stress" are the top-level factors that affect QOL of police officers.

Conclusion

The identification of factors and their mutual relationships that affect QOL are important for police officers and have to be dealt with according to their order of importance. The research model developed in this study shows how the factors of police officers' QOL are interrelated and presents the interrelationships among these factors. A comprehensive model depicting the relationships among these factors has been established, so that the QOL of police officers can be improved.

Achieving a useful and person-centred diabetes consultation is a shared responsibility between diabetologists and people with diabetes: a qualitative study of perspectives from people with type 1 diabetes

AIMS

To explore perceptions of useful routine consultations with diabetologists from the perspective of adults with type 1 diabetes, including preferences for discussing psychosocial issues.

METHODS

We conducted semi-structured interviews in 2018/2019 with 33 people with type 1 diabetes (age 22-75 years, 20 men and 13 women, median diabetes duration 25 years) recruited from two diabetes clinics in the capital region of Denmark. Interviews were audio recorded, transcribed verbatim and analysed using thematic text condensation.

RESULTS

Achieving a useful consultation was perceived as a shared responsibility between people with diabetes and diabetologists. Participants' perspectives of what constitutes a useful consultation and expectations for both consultation and diabetologist varied in relation to perceptions of (1) the interaction between the person with diabetes and diabetologist, including being prepared, being honest, experiencing good rapport and preferring a partnership with the diabetologist or 'keeping it clinical' and (2) the diabetologist's approach to diabetes care, including providing up-to-date knowledge and listening and showing understanding.

CONCLUSIONS

Both content and style of diabetes consultations need to be adapted to the individual person with type 1 diabetes. People with diabetes have an important role in expressing their needs and preferences related to both content and style. Diabetologists need to be aware of and attentive to the many individual needs and expectations among people with diabetes, including the desire and need to discuss psychosocial issues. Dialogue tools for preparation and in consultations may enable people with diabetes to voice their needs and expectations and diabetologists to juggle these diversities.

Modeling the factors affecting the quality of life in diabetic patients in India using total interpretive structural modeling

Purpose

Diabetes mellitus has become a major world health problem that has unenviable impacts on health of the people including quality of life (QOL) also and in which person’s physical and psychological state, social commitments and relationships and his interaction with the environment is affected. This shows that there is an urgent need for behavior change and considerable educational strategies for proper management and rehabilitation (Reddy, 2000). This research has identified and ranked the significant factors which affect the QOL in diabetic patients in India. The paper aims to discuss these issues.

Design/methodology/approach

In this paper, nine factors which affect the QOL in diabetic patients in India have been identified through review of the literature and evaluated by total interpretive structural modeling (TISM) approach, i.e. an extended version of ISM. In this approach, interpretations of the interrelationship among factors have been discussed. Therefore, TISM approach has been used to develop the model and the mutual interactions among these factors.

Findings

The results of the model and MICMAC analysis indicate that diet restriction, body pain and satisfaction with treatment are the top-level factors.

Practical implications

Identification of the factors that have a remarkable effect on the QOL in diabetic patients is very important so that the doctors and other healthcare professionals may handle these factors efficiently and proper rehabilitation can be provided to such patients.

Originality/value

This paper has used an application of the TISM approach to interpret the mutual relationship by using the tool of interpretive matrix and has developed a framework to calculate the drive and the dependence power of factors using MICMAC analysis. The issues related to QOL are extremely important, as they can strongly anticipate a person’s capability to govern his lifestyle with disease like diabetes mellitus and maintain good health in the long run. This shows the urgent requirement of an optimized model which can predict and interpret the relationships among these factors. In this research, the interrelationships among these factors have been developed and interpretations of these interactions have been given to develop a comprehensive model so that QOL of diabetic patients may be improved.

Patient Experience in a Coordinated Care Model Featuring Diabetes Self-management Education Integrated Into the Patient-Centered Medical Home

Purpose

The purpose of this study is to gain insight about patient experience of diabetes self-management education in a patient-centered medical home.

Methods

Six focus groups consisting of 37 people with diabetes, diverse in race and ethnicity, were conducted at 3 sites. Participants described their experience in the program and their challenges in diabetes self-management; they also suggested services to meet their diabetes care needs.

Results

The most common theme was ongoing concerns about care and support. There was much discussion about the value of the support provided by health navigators integrated in the diabetes health care team. Frequent concerns expressed by participants centered on personal challenges in engaging in healthy lifestyle behaviors. Ongoing programmatic support of self-management goals was widely valued.

Conclusions

Individuals who received health care in a patient-centered medical home and could participate in diabetes self-management education with integrated support valued both activities. The qualitative results from this study suggest need for more formalized exploration of effective means to meet the ongoing support needs of people with diabetes.

Do physicians understand Type 2 diabetes patients' perceptions of seriousness; the emotional impact and needs for care improvement? A cross-national survey

OBJECTIVE

To explore across countries the extent to which physicians understand Type 2 diabetes patients' perceptions of seriousness, worries about complications, emotional distress, and needs for care improvement.

METHODS

Cross-sectional data were collected in a multinational survey (SHARED). Type 2 diabetes patients (n=1609), general practitioners (n=818) and diabetes specialists (n=697) from eight countries were included. Data were gathered online and via telephone interviews. Responses from patients and professionals were compared using descriptive statistics and multilevel analyses.

RESULTS

Patients generally perceived diabetes as a serious condition and reported moderate distress. Physicians tended to underestimate patients' perceived seriousness, while overestimating their level of distress. Physicians had difficulty estimating which diabetes complications concerned patients most, and what they needed to feel more confident about their diabetes. Patients did not wish for more consultation time, but rather active involvement, information and easy access to their physician.

CONCLUSION

Results of this large survey highlight the importance of patient involvement and shared decision making.

PRACTICE IMPLICATIONS

Further improvement of patient-provider communication as a basis for shared responsibilities and achieving optimal treatment outcomes is needed. With the growing numbers of diabetes patients worldwide, task delegation should be considered, in the framework of a multidisciplinary diabetes care model.

Monitoring of Individual Needs in Diabetes (MIND): baseline data from the Cross-National Diabetes Attitudes, Wishes, and Needs (DAWN) MIND study

OBJECTIVE

To test the feasibility and impact of implementing the computer-assisted Monitoring of Individual Needs in Diabetes (MIND) procedure, which is aimed at improving recognition and management of the psychological needs of diabetic patients in routine care.

RESEARCH DESIGN AND METHODS

The MIND study was implemented in diabetes clinics across eight countries as part of the annual review. The computerized assessment covered emotional well-being (World Health Organization 5 Well-Being Index), diabetes-related distress (Problem Areas in Diabetes), life events, and the patient's agenda. Medical data were retrieved from the charts, and agreed-upon actions were recorded.

RESULTS

Of 1,567 patients monitored using the MIND, 24.9% had either likely depression or high diabetes-related distress; 5.4% had both. Over 80% of these patients were newly identified cases, and 41% of patients with depression were referred to a mental health professional.

CONCLUSIONS

Monitoring of well-being and diabetes-related distress as part of routine diabetes care is feasible and helps to identify and discuss unmet psychosocial needs.

Overcoming barriers to diabetes care: Perceived communication issues of healthcare professionals attending a pilot Diabetes UK training programme

As part of our evaluation of the Diabetes UK Careline workshop "Overcoming barriers to diabetes care", we received feedback from 18 healthcare professionals. Generally, they felt competent in identifying patients' psychosocial issues but less knowledgeable/skilled in handling them. Lack of time, privacy and support were barriers to addressing patients' psychosocial concerns.