Chronic conditions and their management have become a major global public health problem which poses a serious challenge for both health care systems and affected individuals. Type 2 diabetes is one such condition affecting almost 200 million people around the world, a number that is expected to double by 2020. As with most chronic conditions its management requires significant and permanent changes in people???s daily life practices as well as a strict medication regimen. Recent research demonstrates that it is possible to control the complications of diabetes, and even to prevent its development in predisposed individuals by following recommended treatments. Yet studies show that only 2% of people living with diabetes heed their treating team???s advice. This signals a serious discordance between scientifically generated information and its place in the daily lives of people living with diabetes. This study sought to discover how to change the factors that prevent people with type 2 diabetes from following their recommended treatments. Firstly a participant observation process in four diabetes education centres was used to define the characteristics of the context in which people with diabetes and their treating teams interacted. This was followed by a nine-month participatory action process in two of the four centres in which participants defined the problematic areas in the management of their diabetes and devised plans to tackle these problems. They then attempted to implement these plans while exploring how and why their plans did or did not work. The findings indicate that the decision to follow recommended treatments is far from being a matter of individual choice. Rather it is heavily influenced by a complex interaction of numerous factors that people with diabetes have limited power to change. This study reveals that the management of chronic conditions such as diabetes could be enhanced where operational and practical knowledge about the condition is provided to people living with the disorder by health care providers responsive to patients??? perspectives, and where patients, providers and policy-makers recognise that health is a resource constructed in the wider social context, whose every element needs to be harnessed in encouraging people to make healthier life decisions.
|Demirkol, Abdullah, Public Health & Community Medicine, Faculty of Medicine, UNSW
|Awarded by:University of New South Wales. School of Public Health and Community Medicine
|Australiasian Digital Theses Program
|Copyright Abdullah Demirkol, http://unsworks.unsw.edu.au/copyright
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