BackgroundThe aim of this study was to understand the perceptions and experiences of health education and self-management practices on Malamulo Adventist Hospital type 2 diabetic patients.
MethodsIn this qualitative study, key informant interviews (KIIs; n=4) and focus group discussions (3 FGDs; n=16) were conducted amongst type 2 diabetes patients who had been treated at Malamulo Adventist Hospital in southern Malawi at least once. Key informant interviews and focus group discussions were audio recorded, transcribed verbatim and translated for analysis. Grounded theory methods were used to identify line-by-line emerging codes and were categorized and examined in Atlas.ti. The data was analyzed for emergent themes and supported by critical quotes. Results Content analysis revealed participants had a positive regard for the diabetes education classes and had satisfactory health literacy. Participants expressed their ability to integrate diabetes education, such as exercise into their lifestyle. Due to financial constraints subjects experienced trouble maintaining their medication regimen, and had difficulty adopting healthier nutritional alternatives. Although patients expressed efficacy in controlling their blood sugar they subsequently expressed having limited knowledge when dealing with diabetes complications. Conclusions Diabetes self-management is comprised of a complex set of processes. Patients with type 2 diabetes at Malamulo Adventist Hospital are deeply impacted by these processes which includes their understanding of the disease process, effects of medication, economic challenges to acquiring health care services and medications, and one's unique life experience. For all patients with type 2 diabetes to successfully manage their condition, support from their family, the medical community, and health policies must be readily available.
Smoking during pregnancy remains one of the most significant risk factors for poor birth outcomes. The Loma Linda University Health Comprehensive Tobacco Treatment Program (CTTP) is the largest maternal tobacco cessation program in San Bernardino County – the largest county in the contiguous US. CTTP is an eight week, incentivized, behavioral intervention for tobacco cessation for pregnant smokers. As part of program evaluation, we used a retrospective cohort design to assess smoking abstinence and to identify predictors of relapse/smoking after enrollment. Among CTTP cohort enrollees (n=233) from 2012-2013 we found: 1) a 28.4% 8 week point prevalence abstinence (PPA), and at a median of 9 months of follow-up after the PPA, 81.6% continued to indicate tobacco cessation, and 2) a high rate of relapse or loss to follow-up (56%). Our modeling of relapse/smoking after enrollment indicated that this was higher in young mothers, non-Hispanic mothers (White, Black), first/third trimester mothers, and rural mothers. The evaluation identified efficacy of the behavioral model at 8 weeks, but that relapse/smoking was occurring in disparity populations. Formative research is needed to expand the programmatic outreach and enrollment of mothers wanting to quit smoking.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.