Integrated person- and people-centred primary care for diabetes in low- and middle-income countries: The nurses' perspective on patient needs

Abstract

Aims: The aim of this study was to identify what nurses working in primary care settings perceive as necessary to support the life needs of people with type 2 diabetes. Articulate these needs with the needs expressed by people with diabetes in a previous study. Finally, illustrate the potential of the used method.

Design: A highly structured qualitative group method for brainstorming and idea sharing was used to generate a participant-owned concept map that can support and evaluate practice change.

Methods: Data were collected between April and May 2022 in two public primary healthcare centres in Sacaba, Bolivia, with 33 professional nurses, technical nurses, nurse trainees and one physician. The concept mapping process by Trochim was used to generate, share and structure ideas, maximizing equality of input.

Results: The nurses identified 73 unique needs that were structured in 11 conceptual clusters related to four different stakeholders or domains: organization of care and health policy, strengthening knowledge, skills and attitudes of healthcare providers, empower people living with diabetes and their family, and community-level health promotion and diabetes education.

Conclusion: The needs and domains identified by nurses and people with type 2 diabetes are very similar and inform a multisectoral and transdisciplinary action plan to jointly monitor and evaluate progress towards people-centred care for people with diabetes.

Impact: This study demonstrates nurses' important contribution to analysing and designing people-centred care in their community. They identify and act upon social determinants of health related to schools, safety and legislation. Besides global relevance, results inform the municipal health plan and an ongoing research project on cardiometabolic health.

Patient or public contribution: Data from prior patient consultations were included in the study design, and study results inform the municipal health plan.

Keywords: Bolivia; community participation; diabetes mellitus; health services needs and demand; nursing; patient-centred care; primary health care; public health; social determinants of health; traditional medicine.