An Exploration of Knowledge and Themes on Diabetes during Outpatient Consultation in a Tertiary Referral Hospital
Objectives. Effective communication has been correlated with improved outcomes in diabetes mellitus. Patient comprehension bears an effect on understanding, improving healthcare access and utilization, interaction with healthcare providers, caring for one’s own health, and shared decision making. Currently, there is a gamut of information on diabetes-related terms from various sources. However, no material has yet been available for clinical use in the third world setting. Hence, we explored the most common themes discussed during an outpatient diabetes consult in our hospital.
Methodology. Consultation audio recordings (N = 96) and focus group discussions (N = 32) were conducted among adults with diabetes. Transcribed results underwent qualitative content and thematic analyses to develop the conceptual framework.
Results. The study generated the following themes: diabetes mellitus diagnosis, lifestyle modification, treatment targets, hypoglycemia precautions, diabetes complications, and medication safety. There was a good understanding of these themes among patients with a higher educational attainment, however, among those with lower educational attainment, the attitude of patients toward diabetes care is paternalistic.
Conclusion. The themes discussed in outpatient diabetes consult reflects the dimensions of diabetes care mainly influenced by socio-cultural factors, patient-doctor relationships and adaptability to limitations of resources. The results will be used to develop and validate a culturally appropriate diabetes health literacy tool.
Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). UK Prsopective Diabetes Study (UKPDS) Group. Lancet. 1998;352(9131):854–65. https://pubmed.ncbi.nlm.nih.gov/9742977.
Saaddine JB, Cadwell B, Gregg EW, et al. Improvements in Diabetes Processes of Care and Intermediate. Ann Intern Med. 2011;334(Suppl 1):S89-96. https://pubmed.ncbi.nlm.nih.gov/21193633. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3006053. https://doi.org/10.2337/dc11-S089.
Funnell MM, Brown TL, Childs BP, et al. National standards for diabetes self-management education. Diabetes Educ. 2007;33(4):599–614.
Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Viera A, Crotty K, et al. Health literacy interventions and outcomes: An updated systematic review. Evidence report/technology assessment number 199. Search. 2011;941. https://www.ahrq.gov/downloads/pub/evidence/pdf/literacy/literacyup.pdf.
Ishikawa H, Yano E. The relationship of patient participation and diabetes outcomes for patients with high vs. low health literacy. Patient Educ Couns. 2011;84(3):393–7. https://pubmed.ncbi.nlm.nih.gov/21388773. https://doi.org/10.1016/j.pec.2011.01.029.
van der Heide I, Poureslami I, Mitic W, Shum J, Rootman I, Fitzgerald JM. Health literacy in chronic disease management: A matter of interaction. J Clin Epidemiol. 2018;102:134–8. https://pubmed.ncbi.nlm.nih.gov/ 29793001. https://doi.org/10.1016/j.jclinepi.2018.05.010.
Brach C, Keller D, Hernandez LM, et al. Ten attributes of health literate health care organizations. Participants in the workgroup on attributes of a health literate organization of the IOM Roundtable on health literacy. NAM Perspectives. National Academy of Medicine, Washington, DC; 2012. https://nam.edu/wp-content/uploads/2015/06/BPH_Ten_HLit_Attributes.pdf.
Kim SH, Lee A. Health-literacy-sensitive diabetes self-management interventions : A systematic review and meta-analysis. Worldviews Evid Based Nurs. 2016;13(4):324–33. https://pubmed.ncbi.nlm.nih.gov/27104337. https://doi.org/10.1111/wvn.12157.
Rozier RG, Horowitz AM, Podschun G. Dentist-patient communication techniques used in the United States: The results of a national survey. J Am Dent Assoc. 2011;142(5):518–30. https://pubmed.ncbi.nlm.nih.gov/21531934. https://doi.org/10.14219/jada.archive.2011.0222.
Howe CJ, Walker D. 002-Pediatric Diabetes Educators' use of recommended health literacy communication techniques. J Pediatr Nurs. 2017;34(4):101–2. https://doi.org/10.1016/j.pedn.2017.02.011.
Travis LB. Youth education: diabetes dictionary. Diab Care. 1978;1(5):311-3. https://doi: 10.2337/diacare.1.5.311.
Ley P. Communicating with patients: Improving communication, satisfaction and compliance. New York, NY, US: Croom Helm: Nelson Thornes; 1988.
Blackman J, Sahebjalal M. Patient understanding of frequently used cardiology terminology - The British Journal of Cardiology. Br J Cardiol. 2014;21:39.
Zeng QT, Tse T. Exploring and developing consumer health vocabularies. J Am Med Inform Assoc. 2006;13(1):24–9. https://pubmed.ncbi.nlm.nih.gov/16221948. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1380193. https://doi.org/10.1197/jamia.M1761.
Chapman K, Abraham C, Jenkins V, Fallowfield L. Lay understanding of terms used in cancer consultations. Psychooncology. 2003;12(6):557–66. https://pubmed.ncbi.nlm.nih.gov/12923796. https://doi.org/10.1002/pon.673.
Adams A, Cox AL. Questionnaires, in-depth interviews and focus groups. In: Research Methods for Human Computer Interaction. Cambridge, UK: Cambridge University Press; 2008.
Douglas D. A comparative study of the effectiveness of decision making processes which utilize the Delphi and leaderless group methodologies. Vol. 12, Practical Assessment Research and Evaluation. Ohio State University. Columbus: Unpublished doctoral dissertation; 1983.
Jacobs JM. Essential assessment criteria for physical education teacher education programs: A Delphi study. West Virginia University. Morgantown; 1996.
Hsu CC, Sandford BA. The Delphi technique: Making sense of the consensus. Pract Assessment, Res Eval. 2007;12(10):1–8. https://scholarworks.umass.edu/cgi/viewcontent.cgi?article=1177&context=pare.
Copyright (c) 2021 Angelique Bea Uy, Harold Henrison Chiu, Ramon Larrazabal Jr., Cecilia jimeno
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Journal of the ASEAN Federation of Endocrine Societies is licensed under a Creative Commons Attribution-NonCommercial 4.0 International. (full license at this link: http://creativecommons.org/licenses/by-nc/3.0/legalcode).
To obtain permission to translate/reproduce or download articles or use images FOR COMMERCIAL REUSE/BUSINESS PURPOSES from the Journal of the ASEAN Federation of Endocrine Societies, kindly fill in the Permission Request for Use of Copyrighted Material and return as PDF file to email@example.com or firstname.lastname@example.org.
A written agreement shall be emailed to the requester should permission be granted.