Preprint Article Version 1 This version is not peer-reviewed

Patient and Provider Dilemmas of type 2 Diabetes Self-Management: a Qualitative Study in Socioeconomically Disadvantaged Communities in Stockholm

Version 1 : Received: 18 July 2018 / Approved: 19 July 2018 / Online: 19 July 2018 (00:44:34 CEST)

A peer-reviewed article of this Preprint also exists.

Aweko, J.; De Man, J.; Absetz, P.; Östenson, C.-G.; Swartling Peterson, S.; Mölsted Alvesson, H.; Daivadanam, M. Patient and Provider Dilemmas of Type 2 Diabetes Self-Management: A Qualitative Study in Socioeconomically Disadvantaged Communities in Stockholm. Int. J. Environ. Res. Public Health 2018, 15, 1810. Aweko, J.; De Man, J.; Absetz, P.; Östenson, C.-G.; Swartling Peterson, S.; Mölsted Alvesson, H.; Daivadanam, M. Patient and Provider Dilemmas of Type 2 Diabetes Self-Management: A Qualitative Study in Socioeconomically Disadvantaged Communities in Stockholm. Int. J. Environ. Res. Public Health 2018, 15, 1810.

Journal reference: Int. J. Environ. Res. Public Health 2018, 15, 1810
DOI: 10.3390/ijerph15091810

Abstract

Studies comparing provider and patient views and experiences of self-management within primary healthcare are particularly scarce in disadvantaged settings. In this qualitative study, patient and provider perceptions of self-management were investigated in five socio-economically disadvantaged communities in Stockholm. Twelve individual interviews and three group interviews were conducted. Semi-structured interview guides included questions on perceptions of diabetes diagnosis, diabetes care services available at primary health care centers, patient and provider interactions, and self-management support. Data was analysed using thematic analysis. Two overarching themes were identified. These were characterized by inherent dilemmas representing confusions and conflicts that patients and providers experienced in their daily life or practice respectively: adopting and maintaining new routines through practical and appropriate lifestyle choices (patients); and balancing expectations and pre-conceptions of self-management (providers). Patients found it difficult to tailor information and lifestyle advice to fit their daily life. Healthcare providers recognized that patients were in need of support to change behavior, but saw themselves as inadequately equipped to deal with the different cultural and social aspects of self-management. This study highlights patient and provider dilemmas that influence the interaction and collaboration between patients and providers with respect to communication and uptake of self-management advice.

Subject Areas

Self-management, type 2 diabetes, immigrants, health systems, chronic diseases, qualitative study, lifestyle change, thematic analysis, socioeconomically disadvantaged, Stockholm

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