| Learning Objective #1: Identify barriers and facilitators of diabetes self-management | |||
| Learning Objective #2: Discuss the process of bringing together diverse groups working to achieve similar outcomes |
Diabetes is a major health problem claiming thousands of lives each year and responsible for innumerable disabilities. Much work has been done with healthcare providers to improve outcomes for patients with diabetes with little improvement noted, especially in the rural areas. Focusing on clients offers a different approach to identifying barriers and facilitators of self-care and enables partnering of statewide groups in efforts to improve the self-management of diabetes.
The purpose of this study was to identify the client-perceived barriers and facilitators of self-management among the population of persons with diabetes in rural South Carolina. The Health Belief Model, used as the framework for this research, helped organize the focus group interviews and to guide interpretation of the patient responses.
This qualitative study used 17 focus groups (N=100) in rural South Carolina to identify barriers and facilitators of self-management. Subjects meeting inclusion criteria were randomly selected from clinic practices. Inclusion criteria were: age greater than 50 years; HgA1c over 9.5 or under 7.2 from 9/1/00 to 8/31/01. Group members reported that the major barriers were feelings of hopelessness and fatalism, lack of clear understanding of the strategies that could work for them, non-supportive attitudes of families and employers, and lack of personal responsibility and motivation. Participants indicated that personal awareness of the complications, will-power, family involvement in managing a schedule for meals, meds, and exercise were the most important success factors. Participants recommended developing group sessions with “buddies” for education and support. They also suggested sessions supplemented with simple written directions specific to the individual and incorporating cultural sensitivities.
The project brought together the SC Diabetes Initiative, SC Diabetes Control Program, SC Peer Review Organization, SC Hospital Association, and the Palmetto Health Community Network. These groups are now moving forward with projects to implement self-management strategies suggested by clients.
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