Use this URL to cite or link to this record in EThOS:
Title: An investigation of barriers to optimal care in type 2 diabetes mellitus : a mixed methods study
Author: Pun, Sandra P. Y.
ISNI:       0000 0004 2717 5839
Awarding Body: University of Ulster
Current Institution: Ulster University
Date of Award: 2010
Availability of Full Text:
Access from EThOS:
Diabetes Mellitus (DM) is a global health problem with a rapidly increasing prevalence. Despite the provision of comprehensive diabetes management programmes, patients are often not able to achieve the desired outcomes. The aims of the study were to investigate factors affecting self-care behaviours of patients with Type 2 DM among Hong Kong Chinese people and to explore barriers to self-care and strategies to overcome barriers from patients' and nurses' perspectives. The conceptual framework was developed from the Health Belief Model and the Theory of Planned Behaviour. A sequential explanatory mixed methods design was adopted. Structured questionnaires were used to investigate key variables for predicting self-care for 183 patients with Type 2 DM. Subsequently, 22 patients and 17 nurses were selected for focus group interviews. The quantitative findings showed that both attitudes and modifying factors (knowledge, demographics, socio-economic factors, insulin therapy) had a significant effect on self- care behaviours. They showed that older patients, those of lower socio-economic status, being treated with insulin, having better knowledge about DM, and with positive attitudes reported better adherence to self-care. The qualitative findings indicated that the patients and nurses perceived barriers to self-care were consistent including physical, psychological, socio-economic, environmental and cultural factors. The focus group interviews revealed that nurses understood most of the barriers to self- care perceived by their patients. The Diabetes Self-care Model was developed in the study to inform and guide healthcare professionals when designing diabetes management programmes by addressing key variables affecting self-care behaviours and patient outcomes. The unique position of nurses and their understanding of patients' needs are essential for improving patient outcomes. Therefore, the roles of nurses should be reinforced and further developed to address the needs of the patients through improving the effectiveness of diabetes management programmes and patient empowerment.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available