PMID- 25127714
OWN - NLM
STAT- MEDLINE
DCOM- 20150512
LR  - 20220311
IS  - 1472-6963 (Electronic)
IS  - 1472-6963 (Linking)
VI  - 14
DP  - 2014 Aug 16
TI  - A qualitative synthesis of diabetes self-management strategies for long term 
      medical outcomes and quality of life in the UK.
PG  - 348
LID - 10.1186/1472-6963-14-348 [doi]
LID - 348
AB  - BACKGROUND: Qualitative research on self-management for people with Type 2 
      Diabetes Mellitus (T2DM) has typically reported one-off retrospective accounts of 
      individuals' strategies. The aim of this research was to identify the ways in 
      which self-management strategies are perceived by people with T2DM as being 
      either supportive or unsupportive over time, by using qualitative findings from 
      both longitudinal intervention studies and usual care. METHODS: A systematic 
      review of qualitative literature, published between 2000 and 2013, was conducted 
      using a range of searching techniques. 1374 prospective qualitative papers 
      describing patients' experiences of self-management strategies for T2DM were 
      identified and screened. Of the 98 papers describing qualitative research 
      conducted in the UK, we identified 4 longitudinal studies (3 intervention 
      studies, 1 study of usual care). Key concepts and themes were extracted, reviewed 
      and synthesised using meta-ethnography techniques. RESULTS: Aspects of 
      self-management strategies in clinical trials (e.g. supported exercise regimens) 
      can be perceived as enabling the control of biomarkers and facilitative of 
      quality of life. In contrast, aspects of self-management strategies outwith trial 
      conditions (e.g. self-monitoring) can be perceived of as negative influences on 
      quality of life. For self-management strategies to be sustainable in the long 
      term, patients require a sense of having a stake in their management that is 
      appropriate for their beliefs and perceptions, timely information and support, 
      and an overall sense of empowerment in managing their diabetes in relation to 
      other aspects of their life. This enables participants to develop flexible 
      diabetes management strategies that facilitate quality of life and long term 
      medical outcomes. CONCLUSIONS: This synthesis has explored how patients give 
      meaning to the experiences of interventions for T2DM and subsequent attempts to 
      balance biomarkers with quality of life in the long term. People with T2DM both 
      construct and draw upon causal accounts as a resource, and a means to counter 
      their inability to balance medical outcomes and quality of life. These accounts 
      can be mediated by the provision of timely and tailored information and support 
      over time, which can allow people to develop a flexible regimen that can 
      facilitate both quality of life and medical outcomes.
FAU - Frost, Julia
AU  - Frost J
AD  - Institute of Health Research, University of Exeter Medical School, Veysey 
      Building, Salmon Pool Lane, Exeter EX2 4SG, UK. j.frost@exeter.ac.uk.
FAU - Garside, Ruth
AU  - Garside R
FAU - Cooper, Chris
AU  - Cooper C
FAU - Britten, Nicky
AU  - Britten N
LA  - eng
GR  - PB-PG-0909-19257/DH_/Department of Health/United Kingdom
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
DEP - 20140816
PL  - England
TA  - BMC Health Serv Res
JT  - BMC health services research
JID - 101088677
SB  - IM
MH  - Diabetes Mellitus, Type 2/*therapy
MH  - Humans
MH  - *Outcome Assessment, Health Care
MH  - *Quality of Life
MH  - Self Care/*methods
MH  - United Kingdom
PMC - PMC4158039
EDAT- 2014/08/17 06:00
MHDA- 2015/05/13 06:00
PMCR- 2014/08/16
CRDT- 2014/08/17 06:00
PHST- 2013/12/13 00:00 [received]
PHST- 2014/08/04 00:00 [accepted]
PHST- 2014/08/17 06:00 [entrez]
PHST- 2014/08/17 06:00 [pubmed]
PHST- 2015/05/13 06:00 [medline]
PHST- 2014/08/16 00:00 [pmc-release]
AID - 1472-6963-14-348 [pii]
AID - 3458 [pii]
AID - 10.1186/1472-6963-14-348 [doi]
PST - epublish
SO  - BMC Health Serv Res. 2014 Aug 16;14:348. doi: 10.1186/1472-6963-14-348.