Unsuccessful diabetes management: a qualitative study

Introduction. Understanding the experiences of diabetes of unsuccessful management will help the treatment team to plan appropriate interventions to solve the problems they face. The aim of this study was to explore the experiences of unsuccessful diabetes management in people with diabetes.Methods. A hermeneutic phenomenological method was used to gain the experience of subjects. Participants were selected through purposive sampling. The data were collected through in-depth interviews and analyzed based on Dickman’s method.Results. Data analysis revealed the following three categories: missed care, extreme poverty, and the recurrence of diabetes.Conclusion. Findings indicated the missed care due to laziness in care, inadequate knowledge, negligence in prevention and not giving up the pleasure, and the scary nightmare that was associated with grief and insolvency. This phenomenon is a recurrent mani-festation of the disease and may result in incurable illness and cripple. This in-depth understanding demonstrates the importance of patients’ emotional and informational support depending on their inadequate knowledge and altered mental status, which should be considered by health care providers in designing appropriate programs to improve diabetes manage-ment.

Unsuccessful diabetes management: a qualitative study

WSTĘP: Poznanie doświadczeń związanych z niepowodzeniami leczenia cukrzycy ułatwi zespołowi leczącemu zaplanowanie odpowiednich interwencji w celu rozwiązania napotkanych problemów. Celem tego badania było przeanalizowanie doświadczeń związanych z niepowodzeniami leczenia cukrzycy u osób z tą chorobą. METODY: W celu zyskania wglądu w doświadczenia osób uczestniczących w badaniu posłużono się metodą fenomenologiczno-hermeneutyczną. Uczestników dobrano metodą doboru celowego. Dane zebrano, przeprowadzając dogłębne rozmowy z uczestnikami, a następnie przeanalizowano je metodą Dickmana. WYNIKI: Analiza danych ujawniła następujące trzy kategorie problemów: niewykorzystane możliwości leczenia, skrajną bezradność oraz nawracanie problemów związanych z cukrzycą. WNIOSKI: Uzyskane dane wskazały na niewykorzystane możliwości leczenia wynikające z lenistwa w leczeniu, niedostatecznej wiedzy, zaniedbywania prewencji oraz nierezygnowania z przyjemności, a także koszmary senne związane ze smutkiem i poczuciem niemożności rozwiązania problemów. Z kolei nawracające przejawy choroby mogą prowadzić do jej nieuleczalności i inwalidztwa. To dogłębne poznanie doświadczeń pacjentów dowodzi znaczenia ich emocjonalnego i informacyjnego wsparcia w przypadkach niedostatecznej wiedzy i zmian stanu psychicznego, co powinno być brane pod uwagę przez świadczeniodawców w opiece zdrowotnej, kiedy projektuje się odpowiednie programy w celu poprawy jakości leczenia cukrzycy.BACKGROUND: Understanding the experiences of diabetes of unsuccessful management will help the treatment team to plan appropriate interventions to solve the problems they face. The aim of this study was to explore the experiences of unsuccessful diabetes management in people with diabetes. METHODS: A hermeneutic phenomenological method was used to gain the experience of subjects. Participants were selected through purposive sampling. The data were collected through in-depth interviews and analyzed based on Dickman’s method. RESULTS: Data analysis revealed the following three categories: missed care, extreme poverty, and the recurrence of diabetes. CONCLUSION: Findings indicated the missed care due to laziness in care, inadequate knowledge, negligence in prevention and not giving up the pleasure, and the scary nightmare that was associated with grief and insolvency. This phenomenon is a recurrent manifestation of the disease and may result in incurable illness and cripple. This in-depth understanding demonstrates the importance of patients’ emotional and informational support depending on their inadequate knowledge and altered mental status, which should be considered by health care providers in designing appropriate programs to improve diabetes management

The Effect of Designed Transitional Care Program on Anxiety and General Comfort of the Patients Undergoing Coronary Artery Bypass Graft during Transfer from Open Heart Surgery Intensive Care Unit to General Ward: A Clinical Trial

Background and Aim: Transferring a patient from the intensive care unit to the general ward is an anxiety-inducing process that is associated with feelings of insecurity, discomfort, dependency, and increased need. The most important goal of any care program is to satisfy the patient's needs and create a feeling of comfort. The aim of this study was to determine the effect of designed transitional care program on anxiety and general comfort of the patients undergoing coronary artery bypass graft during transfer from open-heart surgery intensive care unit to general ward. Materials and Methods: This study was a non-randomized clinical trial with a control group which included 62 patients who were candidates for transfer from the open-heart surgery intensive care unit of Imam Khomeini Hospital in Tehran to the general ward in 2021. The patients were selected by convenient method. The control group received the routine care and were followed up. The experimental group pursued the designed transitional care program in addition to routine care. This program had 4 dimensions: 1-waiting for transfer, 2-support, gradually reducing dependence and increasing independence, 3-communication and strengthening the care triad, and 4-continuity of integrated and need-based care which was implemented by selected and trained nurses in cooperation with the researcher, physician, patients and families for 5-7 days.  Spielberger's anxiety Questionnaires and general comfort scale were completed before the transfer and on the day of the patient's discharge. Using SPSS version 26, the results were analyzed by Fisher's exact, Chi-square, paired and independent t-tests at a significance level of 0.05. Results: The results showed that the designed transitional care program could significantly reduce anxiety and increase the general comfort of the patients undergoing coronary artery bypass graft (p≤0.000). Conclusion: Considering the impact of the intervention on the variables under study, use of the designed program as a suitable care program during patient transfer can be suggested