Barriers to Diabetes Patients’ Self-Care Practices in Eastern Ethiopia: A Qualitative Study from the Health Care Providers Perspective

Abstract

Background All types of diabetes can damage the heart, blood vessels, eyes, kidneys, nerves and increase the overall risk of disability and premature death. Diabetes mellitus requires a range of self-care practices, scientifically recommended to control the glycemic level and maintain the patient’s health. However, perceived barriers that hinder patients from fully implementing these diabetes self-care practices and obstacles have not been thoroughly explored. Therefore, this study aimed to explore the barriers to diabetes patients’ self-care practices from the perspective of health care providers in two public hospitals in Harar City, Eastern Ethiopia. Methods Researchers conducted an exploratory qualitative study among 26 health care providers working in two public hospitals from March to June 2021. The study participants were recruited from different disciplines working on diabetes care. Interviews were conducted in the Amharic language until the saturation point was reached. The interviews were tape-recorded, transcribed, and translated to English. Each transcript was read, re-read, and then exported to ATLAS.ti 7 software for coding. Field notes were used to supplement verbatim transcriptions. Initial codes were generated. The consistency between the two coders and their alignment with research questions were checked and applied to all subsequent transcripts after reached on consensus. The thematic analysis was employed in line with the primary set research question. Results Researchers identified barriers to diabetes patients’ self-care practices such as system, health care providers, and patient-level. These barriers were categorized under three main themes: lack of organized diabetes care services, limited collaborative care practices, and perceived lack of knowledge on self-care practices. In addition, the lack of multidisciplinary team care, lack of training for health care providers on diabetes self-care practices, and availability of laboratory tests and diabetes medication were prominent barriers. Conclusion Multi-level barriers to diabetes patients’ self-care practices such as system, health care providers, and patients were identified. Therefore, interventions targeting proper service integration, building providers’ and patients’ capacity on diabetes self-care practices, and ensuring the sustainability of laboratory tests and medication supplies are essential. These interventions need to be accomplished through multi-level stakeholders’ engagement and one-to-one or group interventions covering the multi-level challenges.

Glycaemic control among type 2 diabetes patients in sub-Saharan Africa from 2012 to 2022: a systematic review and meta-analysis

“…Nevertheless, the full integration of exercise into routine healthcare in Africa is challenged by poor knowledge and attitudes of patients and healthcare providers [ 127 ]. In the same way, self-management of diabetes is poor in Africa as it faces numerous barriers [ 128 , 129 ]. Peer-support interventions have been increasingly recognized worldwide, but one may note that the transferability of interventions across different cultures might be difficult [ 24 ].…”

Level of dietary adherence and determinants among type 2 diabetes population in Ethiopian: A systemic review with meta-analysis

“…Evidence shows that when people were more educated improves people’s dietary adherence [ 65 ], and low educated level linked with inadequate glycemic controls [ 66 ]. Scholars identified that people with lower levels of education consume sugar- and fat-rich foods more often and fruit and vegetables less often than adults with a high education level [ 67 ].…”

Patients’ and Nurses’ Perceptions of Diabetes Self-Management in Oman: A Qualitative Study

“…Otter and colleagues described how nurses with a limited understanding of the self-management concept attempted to persuade patients to follow their advice [ 27 ]. Traditionally, the medical model of care was founded upon patient compliance [ 28 ] rather than patient adherence to a collaborative plan of action [ 29 ]. Our nurses did not discuss approaches central to the nurses’ role in supporting DSM behaviors, such as assessing patient motivations [ 26 ], forming a nurse–patient relationship with empathetic and purposeful communications, or partnering with patients to meet specific goals [ 30 ].…”