Psychosocial health care needs of people with type 2 diabetes in primary care

This study examined (a) psychosocial health care needs of people with type 2 diabetes from the perspective of patients and diabetes healthcare providers in primary care, in terms of topics, attention in diabetes care and preferences and (b) factors associated with a positive attitude towards specialized psychosocial health care.Qualitative focus group study.Using purposive sampling, participants were selected from general practices. In 2012-2013, three focus groups were conducted in people with type 2 diabetes (N = 20) and three with healthcare providers (N = 18).Opinions differed considerably on whether there was a need for psychosocial health care. Topics focused mainly on diabetes-specific issues ranging from a need for additional diabetes education to attention and support in regular diabetes care. However, not all healthcare providers felt competent enough to address psychosocial problems. Some participants reported a need for specialized psychosocial help. A positive attitude towards specialized psychosocial health care appeared to be influenced by care setting (e.g., in the primary care practice or 'outside' mental health care), care accessibility, proactive discussion of psychosocial issues with and referral by healthcare providers and previous experiences with psychosocial health care.Although only few participants expressed a need for specialized psychosocial care, attention for psychosocial well-being in regular diabetes care was generally appreciated.People with type 2 diabetes generally felt psychosocial care could be provided as part of regular diabetes care. Suggestions for healthcare providers to meet psychosocial health care needs include training and discussion tools.目的: 本研究从初级保健中的患者和糖尿病医疗保健提供者的角度,从话题、对糖尿病护理的关注和偏好方面,审查了(a)II型糖尿病患者的心理社会医疗保健需求,以及(b)与对专业心理社会医疗保健的积极态度相关因素。 设计: 定性焦点小组研究。 方法: 通过采用有目的抽样,从 全科医生中选取了参与者。 在2012至2013年间,对II型糖尿病患者(20名)和医疗保健提供者(18名)进行了三次分组座谈会。 结果: 关于是否需要心理社会医疗保健,意见分歧很大。话题主要关注糖尿病特有的问题,从需要额外的糖尿病教育到常规糖尿病护理的关注和支持。然而,并不是所有的医疗保健提供者都觉得能够解决心理社会问题。一些参与者报告说需要专门的心理社会帮助。对专门心理社会医疗保健的积极态度似乎受到保健环境(例如,初级保健实践或‘外部’心理健康护理)、保健可及性、与医疗保健提供者积极讨论心理社会问题和通过他们进行转诊以及以往心理社会医疗保健经验的影响。 结论: 尽管只有少数参与者表示需要专门的心理社会护理,但在常规糖尿病护理中对心理社会健康的关注还是得到了普遍认可。 影响: II型糖尿病患者通常认为心理社会护理可以作为常规糖尿病护理的一部分。医疗保健提供者满足心理社会医疗保健需求的建议包括培训工具和讨论工具。.