CC BY-NC-ND 4.0 · Journal of Social Health and Diabetes 2019; 7(02): 61-72
DOI: 10.1055/s-0039-3402529
Review Article

Patients’ Experiences of Barriers and Facilitators for Adherence to Type 2 Diabetes Mellitus: A Meta-Ethnography

Subha Gomathy Sridharan
1  Department of Liberal Arts, Indian Institute of Technology Hyderabad, Kandi, Sangareddy District, Telangana, India
,
Mahati Chittem
1  Department of Liberal Arts, Indian Institute of Technology Hyderabad, Kandi, Sangareddy District, Telangana, India
,
Sravannthi Maya
1  Department of Liberal Arts, Indian Institute of Technology Hyderabad, Kandi, Sangareddy District, Telangana, India
› Author Affiliations
Funding This research work was funded through a PhD fellowship awarded to the lead author by the Ministry of Human Resource Development, Government of India.
  

Abstract

Objectives The main purpose of this article is to synthesize qualitative research exploring experiences of the factors that facilitated and hindered adherence among patients with type 2 diabetes mellitus (T2DM).

Methods Twenty-six qualitative studies were purposefully included in the final sample. The Critical Appraisal Skills Program criteria for quality assessment of the studies was conducted. A meta-ethnographic approach proposed by Noblit and Hare (1988) was employed to analyze the studies. Using the “reciprocal translation” process, the authors searched for and consolidated the common themes.

Results Three major themes were observed: (1) psychological determinants comprising illness beliefs, locus of control, and being forgetful; (2) sociocultural determinants of family and community, culture, and financial aspects; and (3) patients’ relationship with their physicians.

Discussion The meta-ethnography underlines the importance of cultural nuances in the subjective experiences of the barriers and enablers of diabetes adherence. The findings support the need to include qualitative research methods to develop and evaluate interventions to improve T2DM adherence in patients. Clinical implications of this meta-ethnography include engaging in psychoeducation sessions for patients and caregivers, helping set reminders for patients, introducing communication skills training for healthcare providers, and including female caregivers/patients actively in diabetes care.

1 Search strategy for WoS: Keywords were used to identify publications from 1998 to 2017 through the WoS database. In this way, 42 studies were obtained from WoS. Of these, 31 studies were excluded as they used quantitative methods, mixed methods, and/or used multiple stakeholders (e.g., family, physician, friends) approach. Consequently, 11 qualitative studies were included in the meta-ethnography that were extracted from WoS as they explored patients’ personal accounts of enablers and barriers of T2DM adherence.




Publication History

Publication Date:
30 March 2020 (online)

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