Selection of Treatment Strategies among Patients with Type 2 Diabetes Mellitus in Malaysia: A Grounded Theory Approach

被引:23
|
作者
Low, Lee Lan [1 ,2 ]
Tong, Seng Fah [3 ]
Low, Wah Yun [4 ]
机构
[1] Univ Malaya, Fac Med, Med Educ & Res Dev Unit, Kuala Lumpur, Malaysia
[2] Minist Hlth Malaysia, Inst Hlth Syst Res, Shah Alam, Selangor, Malaysia
[3] Univ Kebangsaan Malaysia, Fac Med, Dept Family Med, Kuala Lumpur, Malaysia
[4] Univ Malaya, Fac Med, Res & Management Ctr, Kuala Lumpur, Malaysia
来源
PLOS ONE | 2016年 / 11卷 / 01期
基金
美国国家卫生研究院;
关键词
SEEKING BEHAVIOR; HEALTH-CARE; ILLNESS; PEOPLE;
D O I
10.1371/journal.pone.0147127
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background Diabetes Mellitus is a multifaceted chronic illness and its life-long treatment process requires patients to continuously engage with the healthcare system. The understanding of how patients manoeuvre through the healthcare system for treatment is crucial in assisting them to optimise their disease management. This study aims to explore issues determining patients' treatment strategies and the process of patients manoeuvring through the current healthcare system in selecting their choice of treatment for T2DM. Methods The Grounded Theory methodology was used. Twelve patients with Type 2 Diabetes Mellitus, nine family members and five healthcare providers from the primary care clinics were interviewed using a semi-structured interview guide. Three focus group discussions were conducted among thirteen healthcare providers from public primary care clinics. Both purposive and theoretical samplings were used for data collection. The interviews were audio-taped and transcribed verbatim, followed by line-by-line coding and constant comparison to identify the categories and core category. Results The concept of "experimentation" was observed in patients' help-seeking behaviour. The "experimentation" process required triggers, followed by information seeking related to treatment characteristics from trusted family members, friends and healthcare providers to enable decisions to be made on the choice of treatment modalities. The whole process was dynamic and iterative through interaction with the healthcare system. The decision-making process in choosing the types of treatment was complex with an element of trial-and-error. The anchor of this process was the desire to fulfil the patient's expected outcome. Conclusion Patients with Type 2 Diabetes Mellitus continuously used "experimentation" in their treatment strategies and help-seeking process. The "experimentation" process was experiential, with continuous evaluation, information seeking and decision-making tinged with the element of trial-and-error. The theoretical model generated from this study is abstract, is believed to have a broad applicability to other diseases, may be applied at varying stages of disease development and is non-context specific.
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页数:15
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