There’s a perception out there that people with type 2 could control their disease if they just tried hard enough. But self-control and will power are not the whole story. A new study published in this month’s Journal of Nursing and Healthcare of Chronic Illness includes “eating out, lack of social support and high-risk lifestyles” as just a few of the roadblocks that stop patients with type 2 diabetes from controlling their condition.
The research reviewed information from 8,900 patients and 4,550 healthcare providers from 28 countries.
Major barriers identified by the review included:
- Financial. Even if healthcare was free or funded by insurance, patients still had to spend more money on healthy food, home glucose monitoring kits and transport to and from healthcare appointments.
- Social support. Patients who received support from family, friends and diabetes clinics appeared to handle self-care better than those who did not
- Patient provider gaps. Care was more effective when patients and healthcare providers worked together to devise treatment plans that patients could stick to.
- Meals out. Eating out in restaurants was a frequently mentioned problem and being offered inappropriate food when visiting others was also an issue.
- Favorite foods. Healthcare professionals did not always appreciate that patients disliked being denied their favorite foods and would cope better if they were incorporated in eating plans.
- Exercise. Attitudes toward exercise, physical limitations and discomfort prevented people from taking regular exercise. These need to be taken into account when devising exercise programs.
- High-risk lifestyles. Behavioral and psychiatric disorders and cultural and language barriers, among both patients and family members, can impede effective treatment.
- Medication. Some patients forgot to take their medication and others ran out. Others were also reluctant to carry out regular glucose tests.
- Psychological wellbeing. Psychological problems are common among people with diabetes, but providers don’t always have the resources to manage this aspect of their patient’s care.
- Understanding. Patients often lack knowledge about their condition and don’t always understand the relevance of diet and care plans.
- Frustration. Being unable to maintain good glucose control can cause helplessness and frustration, as can the progression of the disease
“There are various barriers to achieving optimal self-care in type 2 diabetes,” said co-author Professor Vivien Coates, from the Institute of Nursing Research at the University of Ulster, UK in a press release. “Some stem from limitations within the healthcare team, some from ineffective communication between providers and patients and some from the patient’s lack of empowerment, motivation and involvement in their treatment.
Researchers from Hong Kong and Northern Ireland studied research carried out between 1986 and 2007 to try and identify what could be improved. They developed a three-point plan for nurses involved in diabetes care:
- Nurses should provide patients with enough information about their condition and its treatment to enable them to make informed decisions about their care.
- Patients need to be motivated to take action to ensure that they manage their diabetes and prevent complications.
- Nurses need to approach diabetes care in a holistic way that takes account of a wide range of physical, psychosocial, cultural, financial and environmental factors.
Sources: EurekAlert, Journal of Nursing and Healthcare of Chronic Illness