Barriers and facilitators to effective type 2 diabetes management in a rural context: a qualitative study with diabetic patients and health professionals

J Health Psychol. 2014 Mar;19(3):441-53. doi: 10.1177/1359105312473786. Epub 2013 Mar 14.

Abstract

Although effective type 2 diabetes management is essential for the prevention of complications, it is rarely carried out. Type 2 diabetes deaths in rural areas are higher than in metropolitan areas. A focus group (n = 8) and telephone interviews with patients (n = 10), and telephone interviews with health professionals (n = 18) in rural areas were conducted to examine this issue in a rural context. Inductive thematic analysis was used to generate 13 themes of barriers and facilitators to type 2 diabetes management at intrapersonal (denial of the illness, motivation, knowledge and skills and lack of time), interpersonal (stress and relationships), organisational (access to recommended foods, transport, health professionals, and exercise options) and societal (engagement and societal attitudes) levels of influence. Across all themes, participants highlighted the difficulty of maintaining management behaviours.

Keywords: adherence; chronic illness; health behaviour; public health psychology; qualitative methods.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Diabetes Mellitus, Type 2 / therapy*
  • Disease Management*
  • Female
  • Focus Groups
  • Health Personnel / psychology
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance / psychology*
  • Qualitative Research
  • Rural Health Services / standards
  • Rural Population