Self-management practices among type 2 diabetes patients attending physicians and pharmacists: An exploratory study from Lahore, Pakistan

Background: Globally, Pakistan is among the top 10 countries in terms of the proportion of the population living with diabetes. Type 2 diabetes cannot be cured permanently, but complications and premature deaths can be prevented by adopting healthy lifestyles. Self-management is the key to controlling diabetes. Besides rational therapeutic approaches, patient counseling by physicians and pharmacists is crucial because self-management practices are generally influenced by the patient’s knowledge of their disease. Objectives: The objectives of this study were to explore self-management practices among type 2 diabetes patients visiting physicians and pharmacists, and to assess the differences in the self-management practices of patients who visit physicians and those who visit pharmacists concerning type 2 diabetes in the past two years. Methods: This exploratory study recruited 363 established type 2 diabetes patients using a simple random sampling technique. The patients had consulted either a physician or pharmacist (but not both) over the past two years in relation to their type 2 diabetes, and physically visited a branch of a private-chain retail pharmacy in Lahore, Pakistan. Face-to-face interviews and structured questionnaires with a few open-ended questions were adopted as methods of data collection, focusing on socio-demographic and clinical factors, and the standard self-management practices of patients. Data were analyzed using frequencies, percentages, means and standard deviations. The difference between categorical variables, i.e. self-management practices and visits to healthcare professionals, were determined using chi-square tests. Results: The results showed that none of the standard diabetes self-management practices were fully adhered to by the patients. The use of the HbA1C test to monitor diabetes was the least used test among diabetic patients visiting a physician (29.60%) or pharmacist (25.70%). Patients visiting pharmacists adhered to medication use (88.50%, p<0.001), eating a well-balanced diet (75.22%, p=0.050), blood glucose level check (88.50%, p<0.001) and regular blood pressure monitoring (81.42%, p<0.001), whereas patients visiting physicians adhered better to daily feet checking (69.20%, p<0.001) and regular exercise (74.80%, p<0.001). Conclusions: Our study indicates that there is a significant fluctuation in adherence to key self-management practices among type 2 diabetes patients who visit physicians and those who visit pharmacists. Increasing the numbers of pharmacists in the healthcare system who have a special focus on diabetes may improve self-management practices among diabetic patients. [Ethiop. J. Health Dev. 2020; 34(3):165-170] Key words: Pharmacists, physicians, consultation, type 2 diabetes, self-managemen

Liderazgo Dialógico de Mujeres Gitanas: Un Estudio de Caso

Research demonstrates that Roma women can be leaders to support educational processes that contribute to social change and transformation. However, there are few studies addressing the case of the role of Roma women in the learning communities project to show the ways they are committed to education, specially of young Roma women. This article analyses in depth the case of a learning community in which Roma women organize dialogical meetings to share their concerns about education, thus exercising dialogic leadership. Through the communicative methodology, a case study was developed using different techniques. The data analysis and results illustrate the powerful and inspirational narratives of change resonating with the dialogic leadership of the Roma women participating in the school.Las investigaciones demuestran que las mujeres gitanas pueden ser líderes para apoyar procesos educativos que contribuyan al cambio y la transformación social. Sin embargo, existen pocos estudios que aborden el caso del papel de las mujeres gitanas en el proyecto de comunidades de aprendizaje para mostrar las formas en que se comprometen con la educación, especialmente las mujeres jóvenes gitanas. Este artículo analiza en profundidad el caso de una comunidad de aprendizaje en la que mujeres gitanas organizan encuentros dialógicos para compartir sus inquietudes sobre la educación, y por tanto ejerciendo liderazgo dialógico. A través de la metodología comunicativa, se desarrolló un estudio de caso utilizando diferentes técnicas. El análisis de los datos y los resultados ilustran las poderosas e inspiradoras narrativas de cambio que resuenan con el liderazgo dialógico de las mujeres gitanas que participan en la escuela