BACKGROUND: A key step for improving the effectiveness of diabetes self-management education (DSME) is to identify its restrictors. OBJECTIVES: The aim of this study was to explore the restrictors of the effectiveness of DSME. METHODS: This descriptive qualitative study was conducted in March 2016–2017. Participants were 16 DSME providers (viz., physicians, nurses, nutritionists, and psychologists) and nine DSME receivers (viz., patients and their family members) – 25 in total. Semi-structured interviews were held for data collection. Interviews were transcribed word by word and analyzed through conventional content analysis approach proposed by Graneheim and Lundman. RESULTS: The restrictors of the effectiveness of DSME were categorized into three main categories and 11 subcategories, namely patients' limited welcoming of DSME classes (allocating limited time for participation in DSME classes, inadequate knowledge about diabetes mellitus [DM] importance, inappropriate educational environment, and financial problems), unfavorable adherence to treatments: serious challenge (inattention to educations, poor motivation for adherence to medical recommendations, and inattention to the psychological aspects of DM), and the difficulty of adult education (the difficulty of changing health-related attitudes and behaviors, mere information delivery during education, adults' physical and perceptual limitations, and diabetes educators' limited competence in adult education). CONCLUSION: The findings of the present study provide an in-depth understanding about the restrictors of the effectiveness of DSME. DM management authorities and policymakers can use these findings to develop strategies for improving the effectiveness of DSME.
BACKGROUND: Education in vulnerable communities can be a health affordable strategy to promote patient empowerment. Recognition and understanding the problems of diabetes education are of significance to overcome the barriers and advance the educational and care services to control diabetes and promotion of society health. The aim of this study was to explore participants’ perspectives, experiences, and preferences, regarding diabetes education problems. MATERIALS AND METHODS: This descriptive, qualitative study was conducted from March 2016 to September 2017. The participants were 23 people including nine patients with diabetes and their family members and 14 members of diabetes healthcare team (physicians, nurses, and nutritionists). The data were collected through individual semi-structured interviews and analyzed through conventional content analysis approach proposed by Graneheim and Lundman. Some main categories and subcategories emerged. RESULTS: Three main categories showed the most prominent problems of diabetes education, namely, inadequate infrastructure for diabetes education, insufficient defined and de facto position for the role of diabetes nurse educator, and the failure in patient-oriented team approach in diabetes education. CONCLUSION: This article addresses the most important problems of diabetes education. The fundamental strategy to overcome these problems seems to be the planning and management of diabetes education as a high priority in the noncommunicable disease management policies of the Ministry of Health and Medical Education.
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