Abstract:Objective: To assess the quality of diabetic care provided in primary health care settings in Oman.Methods: This was a cross-sectional study of randomly selected 500 patients with diabetes mellitus (DM) attending 6 primary care diabetic clinics in the north Al-Batinah region of Oman from January to December 2010. Nine standards on the quality of diabetes care were audited.Results: The mean age of the sample was 51±13 years, ranging from 15 to 87 years; the majority (61%) were females. The mean duration of DM w… Show more
“…Approximately 463 million adults in the world live with diabetes mellitus (DM), and the number is estimated to reach 629 million by 2045 [ 1 ]. Diabetes is a rapidly increasing health problem in developing countries such as Oman [ 2 ]; in particular, type 2 diabetes (T2DM) is an emerging public health issue for the country [ 3 ]. The reported prevalence of diabetes among Omanis is 15.7% and, along with other chronic diseases, causes the death of 187.75 people per 100 thousand in Oman each year [ 4 ].…”
Patient-centered care enhances diabetes self-management; however, the primary care nurse’s role in promoting diabetes self-management within a patient-centered care model is unexplored. This study investigated the perceptions of Omani patients with type-2 diabetes and their clinic nurses on the nurses’ role in promoting diabetes self-management within a patient-centered care approach. The thematic analysis of the data from individual interviews with patients (n = 24) revealed two themes: patients experienced “missteps on an unclear path” and “nurses doing their best.” Patients struggled to identify treatment goals and faltered in their attempts to adopt diabetes self-management behaviors. The nurses’ role was perceived as task-oriented. Nurse narratives (n = 21) revealed that very few nurses were aware of the patient-centered care philosophy. A theme emerged of nurses “needing a new perspective” to transition their care delivery to align with the patient-centered care model. Nurses expected patients to comply with their instructions and missed opportunities for assessment, engagement, and collaborative problem-solving during patient encounters. The shift from a physician-based medical model to a patient-centered primary care delivery system may necessitate that nurses engage more effectively with patients, collaborate on an individual treatment plan, and motivate them to adopt self-management behaviors.
“…Approximately 463 million adults in the world live with diabetes mellitus (DM), and the number is estimated to reach 629 million by 2045 [ 1 ]. Diabetes is a rapidly increasing health problem in developing countries such as Oman [ 2 ]; in particular, type 2 diabetes (T2DM) is an emerging public health issue for the country [ 3 ]. The reported prevalence of diabetes among Omanis is 15.7% and, along with other chronic diseases, causes the death of 187.75 people per 100 thousand in Oman each year [ 4 ].…”
Patient-centered care enhances diabetes self-management; however, the primary care nurse’s role in promoting diabetes self-management within a patient-centered care model is unexplored. This study investigated the perceptions of Omani patients with type-2 diabetes and their clinic nurses on the nurses’ role in promoting diabetes self-management within a patient-centered care approach. The thematic analysis of the data from individual interviews with patients (n = 24) revealed two themes: patients experienced “missteps on an unclear path” and “nurses doing their best.” Patients struggled to identify treatment goals and faltered in their attempts to adopt diabetes self-management behaviors. The nurses’ role was perceived as task-oriented. Nurse narratives (n = 21) revealed that very few nurses were aware of the patient-centered care philosophy. A theme emerged of nurses “needing a new perspective” to transition their care delivery to align with the patient-centered care model. Nurses expected patients to comply with their instructions and missed opportunities for assessment, engagement, and collaborative problem-solving during patient encounters. The shift from a physician-based medical model to a patient-centered primary care delivery system may necessitate that nurses engage more effectively with patients, collaborate on an individual treatment plan, and motivate them to adopt self-management behaviors.
“…Also one study in Nigeria showed that 96.4% of symptomatic (neuropathy) and 97.3% of asymptomatic patients with DM had never had foot examination [4]. Al-Shafaee and co-authors assessed nine standards on the quality of diabetes care in primary care diabetic clinics in the north Al--Batinah region of Oman and found that only 39% of the patients had foot examination [5]. Information about quite good implementation of best practice guidelines recommendations comes from Australian podiatrists study [6] but authors mentioned that the character of the study limits its interpretation.…”
Background. The strategy of care for chronic diabetic complications prevention includes appropriate organization and education of healthcare professionals. Despite the availability of skilled medical staff, there is insufficient information about the feet examination in standard practice. We evaluated the personnel's compliance in the context of following the guidelines for foot examination. Materials and methods. We retrospectively analyzed 290 questionnaires from patients with diabetes mellitus (54.13% women) enclosed in the medical records from Diabetic Foot Center. Results. The mean patients' age was 63.24; 7.6% participants suffered from type 1 and 92.4 % from type 2 diabetes; 17.6% patients declared previous foot examination: 31.8% with type 1, 16.4% with type 2 diabetes and it was irrespective from: age, diabetes duration (p = 0.6 and p = 0.37 respectively) and diabetes type (p = 0.068). Conclusion. The foot examination among patients with diabetes, by medical practitioners, is very poor. Neither patient age nor duration or type of diabetes had an influence on the decision for foot examination in our study. Our study has showed that not the guidelines but inadequate foot examination by medical staff could be the main problem of the prevention of diabetic foot. We should stress and re-educate patients but also medical staff about the foot examination.
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