Key factors for overcoming psychological insulin resistance : an examination of patient perspectives through content analysis
Stuckey, Heather (Pennsylvania State University)
Fisher, Lawrence (University of California, San Francisco)
Polonsky, W. H (University of California, San Diego)
Hessler, Danielle (University of California San Francisco)
Snoek, Frank J. (Amsterdam Universitair Medische Centra (Amsterdam, Països Baixos))
Tang, Tricia S.. (University of British Columbia)
Hermanns, Norbert (Diabet Acad Mergentheim FIDAM)
Mundet-Tudurí, Xavier (Universitat Autònoma de Barcelona)
da Silva, Maria Elizabeth Rossi (Hospital das Clínicas da Faculdade de Medicina da USP)
Sturt, Jackie (King's College London)
Okazaki, Kentaro (Nagoya University Graduate School of Medicine)
Cao, Dachuang (Eli Lilly and Company)
Hadjiyianni, Irene (Lilly Deutschland GmbH)
Ivanova, Jasmina I (Analysis Group Inc Boston)
Desai, Urvi (Analysis Group Inc Boston)
Perez-Nieves, Magaly (Eli Lilly and Company)

Fecha:	2019
Resumen:	To understand participant perceptions about insulin and identify key behaviors of healthcare professionals (HCPs) that motivated initially reluctant adults from seven countries (n=40) who had type 2 diabetes (T2D) to start insulin treatment. Telephone interviews were conducted with a subset of participants from an international investigation of adults with T2D who were reluctant to start insulin (EMOTION). Questions related to: (a) participants' thoughts about insulin before and after initiation; (b) reasons behind responses on the survey that were either 'not helpful at all' or 'helped a lot'; (c) actions their HCP may have taken to help start insulin treatment; and (d) advice they would give to others in a similar situation of starting insulin. Responses were coded by two independent reviewers (kappa 0. 992). Starting insulin treatment was perceived as a negative experience that would be painful and would lead down a 'slippery slope' to complications. HCPs engaged in four primary behaviors that helped with insulin acceptance: (1) showed the insulin pen/needle and demonstrated the injection process; (2) explained how insulin could help with diabetes control and reduce risk of complications; (3) used collaborative communication style; and (4) offered support and willingness to answer questions so that participants would not be 'on their own'. Following initiation, most participants noted that insulin was not 'as bad as they thought' and recommended insulin to other adults with T2D. Based on these themes, two actionable strategies are suggested for HCPs to help people with psychological insulin resistance: (1) demonstrate the injection process and discuss negative perceptions of insulin as well as potential benefits; (2) offer autonomy in a person-centred collaborative approach, but provide support and accessibility to address concerns. These findings help HCPs to better understand ways in which they can engage reluctant people with T2D with specific strategies.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Type 2 diabetes ; Psychological insulin resistance ; Patient-provider relationship
Publicado en:	BMJ open diabetes research and care, Vol. 7 (december 2019) , ISSN 2052-4897

DOI: 10.1136/bmjdrc-2019-000723
PMID: 31908792

8 p, 276.2 KB

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