Making sense of change: patients' views of diabetes and GP-led integrated diabetes care

Burridge, Letitia H., Foster, Michele M., Donald, Maria, Zhang, Jianzhen, Russell, Anthony W. and Jackson, Claire L. (2015) Making sense of change: patients' views of diabetes and GP-led integrated diabetes care. Health Expectations, 19 1: 74-86. doi:10.1111/hex.12331

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Author Burridge, Letitia H.
Foster, Michele M.
Donald, Maria
Zhang, Jianzhen
Russell, Anthony W.
Jackson, Claire L.
Title Making sense of change: patients' views of diabetes and GP-led integrated diabetes care
Journal name Health Expectations   Check publisher's open access policy
ISSN 1369-6513
Publication date 2015-01-05
Year available 2015
Sub-type Article (original research)
DOI 10.1111/hex.12331
Open Access Status DOI
Volume 19
Issue 1
Start page 74
End page 86
Total pages 13
Place of publication Chichester, West Sussex, United Kingdom
Publisher Wiley-Blackwell Publishing
Collection year 2016
Language eng
Formatted abstract
Background Health system reform is directed towards better management of diabetes. However, change can be difficult, and patients’ perspectives are a key aspect of implementing change.

Objective This study investigated patients’ perceptions and experiences of type 2 diabetes (T2DM), self-care and engagement with GP-led integrated diabetes care.

Design Qualitative interviews were conducted with purposively selected patients with T2DM following their initial medical appointment in the new model of care. Normalization process theory was used to orientate the thematic analysis, to explain the work of implementing change.

Setting Two specialist GP-based complex diabetes services in primary care in Brisbane, Australia.

Participants Intervention group patients (n = 30) in a randomized controlled trial to evaluate a model of GP-led integrated care for complex T2DM.

Main outcome measures Participants’ experiences and perceptions of diabetes management and a GP-led model of care.

Results Three themes were identified: sensibility of change, ‘diabetic life’ and diabetes care alliance. The imperative of change made sense, but some participants experienced dissonance between this rational view and their lived reality. Diabetes invaded life, revealing incongruities between participants’ values and living with diabetes. They appreciated a flexible and personalized approach to care.

Discussion Participants responded to advice in ways that seemed rational within the complexities of their life context. Their diabetes partnerships with health professionals coupled providers’ biomedical expertise with patients’ contextual expertise.

Conclusions Learning to manage relationships with various health professionals adds to patients’ diabetes-related work. Providers need to adopt a flexible, interactive approach and foster trust, to enable better diabetes care.
Keyword General practitioners
GP-led integrated care
Normalization process theory
Primary care
Type 2 diabetes
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Article first published online: 7 JAN 2015

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Medicine Publications
School of Nursing, Midwifery and Social Work Publications
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Created: Thu, 08 Jan 2015, 11:04:43 EST by Dr Letitia Burridge on behalf of Discipline of General Practice