PMID- 24164794
OWN - NLM
STAT- MEDLINE
DCOM- 20140709
LR  - 20220408
IS  - 1471-2296 (Electronic)
IS  - 1471-2296 (Linking)
VI  - 14
DP  - 2013 Oct 29
TI  - Factors influencing insulin acceptance among type 2 diabetes mellitus patients in 
      a primary care clinic: a qualitative exploration.
PG  - 164
LID - 10.1186/1471-2296-14-164 [doi]
AB  - BACKGROUND: Many Type 2 Diabetes Mellitus (T2DM) patients refuse insulin therapy 
      even when they require this modality of treatment. However, some eventually 
      accept insulin. This study aimed to explore the T2DM patients' reasons for 
      accepting insulin therapy and their initial barriers to use insulin. METHODS: 
      This qualitative study interviewed twenty-one T2DM patients at a primary care 
      clinic who had been on insulin for more than a year through three in-depth 
      interviews and three focus group discussions. A semi structured interview 
      protocol was used and the sessions were audio-recorded. Subsequently, thematic 
      analysis was conducted to identify major themes. RESULTS: The participants' 
      acceptance of insulin was influenced by their concerns and beliefs about diabetes 
      and insulin. Concerns about complications of poorly controlled diabetes and side 
      effects of other treatment regime had resulted in insulin acceptance among the 
      participants. They also had a strong belief in insulin benefits and 
      effectiveness. These concerns and beliefs were the results of having good 
      knowledge about the diabetes and insulin, experiential learning, as well as 
      doctors' practical and emotional support that helped them to accept insulin 
      therapy and become efficient in self-care management. These factors also allayed 
      their negative concerns and beliefs towards diabetes and insulin, which were 
      their barriers for insulin acceptance as it caused fear to use insulin. These 
      negative concerns were related to injection (self-injection, needle phobia, 
      injection pain), and insulin use (inconvenience, embarrassment, lifestyle 
      restriction, negative social stigma, and poor self-efficacy), whereas the 
      negative beliefs were 'insulin could cause organ damage', 'their diabetes was not 
      serious enough', 'insulin is for life-long', and 'insulin is for more severe 
      disease only'. CONCLUSIONS: Exploring patients' concerns and beliefs about 
      diabetes and insulin is crucial to assist physicians in delivering 
      patient-centered care. By understanding this, physicians could address their 
      concerns with aim to modify their patients' misconceptions towards insulin 
      therapy. In addition, continuous educations as well as practical and emotional 
      support from others were found to be valuable for insulin acceptance. TRIAL 
      REGISTRATION: Universiti Kebangsaan Malaysia FF-214-2009.
FAU - Abu Hassan, Hasliza
AU  - Abu Hassan H
FAU - Tohid, Hizlinda
AU  - Tohid H
AD  - Department of Family Medicine, Universiti Kebangsaan Malaysia Medical Centre, 
      JalanYaacob Latiff, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia. 
      hizlinda2202@gmail.com.
FAU - Mohd Amin, Rahmah
AU  - Mohd Amin R
FAU - Long Bidin, Mohamed Badrulnizam
AU  - Long Bidin MB
FAU - Muthupalaniappen, Leelavathi
AU  - Muthupalaniappen L
FAU - Omar, Khairani
AU  - Omar K
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20131029
PL  - England
TA  - BMC Fam Pract
JT  - BMC family practice
JID - 100967792
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Ambulatory Care Facilities
MH  - *Attitude to Health
MH  - Diabetes Mellitus, Type 2/*drug therapy/psychology
MH  - Female
MH  - Focus Groups
MH  - Humans
MH  - Hypoglycemic Agents/*therapeutic use
MH  - Insulin/*therapeutic use
MH  - Malaysia
MH  - Male
MH  - Middle Aged
MH  - *Patient Acceptance of Health Care
MH  - *Primary Health Care
MH  - Qualitative Research
MH  - Self Care/psychology
MH  - Self Efficacy
MH  - Social Stigma
PMC - PMC4231611
EDAT- 2013/10/30 06:00
MHDA- 2014/07/10 06:00
PMCR- 2013/10/29
CRDT- 2013/10/30 06:00
PHST- 2013/03/23 00:00 [received]
PHST- 2013/10/24 00:00 [accepted]
PHST- 2013/10/30 06:00 [entrez]
PHST- 2013/10/30 06:00 [pubmed]
PHST- 2014/07/10 06:00 [medline]
PHST- 2013/10/29 00:00 [pmc-release]
AID - 1471-2296-14-164 [pii]
AID - 10.1186/1471-2296-14-164 [doi]
PST - epublish
SO  - BMC Fam Pract. 2013 Oct 29;14:164. doi: 10.1186/1471-2296-14-164.