본 연구는 당뇨병 환자를 대상으로 인슐린 치료에 대한 문화적 관점과 경험을 탐색하기 위해 19명의 제1형과 2형 당뇨병 환자를 대상으로 포커스 그룹 인터뷰를 실시하였다. 인터뷰 내용을 기록하고 녹취한 후 내용분석을 통해 당뇨병 환자들이 경험하는 인슐린 치료에 대한 사전인식요인과 장애요인 및 촉진요인을 목록화하였으며 이들 3가지 목록에 포함되는 주요어를 도출하였다. 그 결과 인슐린에 대한 막연한 두려움이 사전인식요인의 주요어로 확인되었고 장애요인으로는 인슐린과 관련된 걱정(통증, 낮은 지식과 문해력, 자가 주사에 대한 낮은 자신감, 경제적 부담, 저혈당에 대한 두려움)과 의료진에 대한 양가감정, 의지하게 된 삶, 친구, 친척과 가족에 대한 감정, 불편감, 과거에 대한 후회, 부끄러움이 주요어로 도출되었다. 촉진요인으로는 깨달음과 신체적 회복 및 혈당조절에 대한 자신감이 확인되었다. 본 연구결과를 토대로 국내 당뇨병 환자의 인슐린 치료에 대한 경험과 지각에 대한 의료인의 이해가 필요하며 당뇨병 환자의 이러한 경험은 존중되어야 할 것으로 사료된다.
본 연구는 당뇨병 환자를 대상으로 인슐린 치료에 대한 문화적 관점과 경험을 탐색하기 위해 19명의 제1형과 2형 당뇨병 환자를 대상으로 포커스 그룹 인터뷰를 실시하였다. 인터뷰 내용을 기록하고 녹취한 후 내용분석을 통해 당뇨병 환자들이 경험하는 인슐린 치료에 대한 사전인식요인과 장애요인 및 촉진요인을 목록화하였으며 이들 3가지 목록에 포함되는 주요어를 도출하였다. 그 결과 인슐린에 대한 막연한 두려움이 사전인식요인의 주요어로 확인되었고 장애요인으로는 인슐린과 관련된 걱정(통증, 낮은 지식과 문해력, 자가 주사에 대한 낮은 자신감, 경제적 부담, 저혈당에 대한 두려움)과 의료진에 대한 양가감정, 의지하게 된 삶, 친구, 친척과 가족에 대한 감정, 불편감, 과거에 대한 후회, 부끄러움이 주요어로 도출되었다. 촉진요인으로는 깨달음과 신체적 회복 및 혈당조절에 대한 자신감이 확인되었다. 본 연구결과를 토대로 국내 당뇨병 환자의 인슐린 치료에 대한 경험과 지각에 대한 의료인의 이해가 필요하며 당뇨병 환자의 이러한 경험은 존중되어야 할 것으로 사료된다.
The purpose of this study was to explore the cultural perspectives and experiences relating to insulin therapy among the diabetes. The authors conducted four semi-structured focus groups and individual interviews with 19 adults with type 1 and 2 diabetes, focusing on the personal experiences and tho...
The purpose of this study was to explore the cultural perspectives and experiences relating to insulin therapy among the diabetes. The authors conducted four semi-structured focus groups and individual interviews with 19 adults with type 1 and 2 diabetes, focusing on the personal experiences and thoughts regarding insulin therapy. Patients' perspectives and experiences relating to taking insulin formed three categories of themes: preoccupations about insulin, barriers to taking insulin, and benefits to taking insulin. The theme for preoccupations about insulin was "vague fear," while the theme of barriers to taking insulin were "worrisome insulin-related issues", "ambivalent feelings (trust/mistrust) about healthcare providers," "dependent life," "feeling about supporters(family, friends, and religion)," "inconvenience," "regret about the past," and "embarrassment." The theme of benefits to taking insulin were "recognition" and "physical recovery and confidence in regulating blood glucose". Based on this study, patients' feelings about their insulin should be respected by healthcare providers.
The purpose of this study was to explore the cultural perspectives and experiences relating to insulin therapy among the diabetes. The authors conducted four semi-structured focus groups and individual interviews with 19 adults with type 1 and 2 diabetes, focusing on the personal experiences and thoughts regarding insulin therapy. Patients' perspectives and experiences relating to taking insulin formed three categories of themes: preoccupations about insulin, barriers to taking insulin, and benefits to taking insulin. The theme for preoccupations about insulin was "vague fear," while the theme of barriers to taking insulin were "worrisome insulin-related issues", "ambivalent feelings (trust/mistrust) about healthcare providers," "dependent life," "feeling about supporters(family, friends, and religion)," "inconvenience," "regret about the past," and "embarrassment." The theme of benefits to taking insulin were "recognition" and "physical recovery and confidence in regulating blood glucose". Based on this study, patients' feelings about their insulin should be respected by healthcare providers.
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문제 정의
For instance, the generalizability of these results can be limited because of convenience and small sample size. However, this study was the first attempt to explore the perspectives and experiences of patients about taking insulin therapy in Korea.
The purpose of this study was to clarify the experiences and perspectives related to insulin therapy among Korean people with diabetes using qualitative methods. The research questions and topics were as follows: (1) Preoccupations about insulin: “How would you feel when you are recommended to take insulin by your doctor?” (2) Barriers to taking insulin: “What are the difficulties related to your insulin therapy that you have perceived? (3) Benefits to taking insulin: “What are the benefits of insulin therapy that you have perceived?”
To the best of the authors’ knowledge, this is the first attempt to explore the perspectives and experiences related to insulin therapy among individuals with diabetes in South Korea.
제안 방법
A FGI guide was developed according to the studied concepts, a literature review, and the research team’s experiences in working with diabetes patients. After discussions among the research team, which included clinicians and nurses, the FGI guide questions were revised to increase their understandability to laypersons; all alterations were reviewed together by the research team. The primary investigator, who was experienced FGIs and has used them in several prior studies, facilitated conversation as a moderator while a co-author took field notes.
Each FGI lasted approximately one hour. All interviews were recorded using an electronic recording device and transcribed verbatim. All participants received gifts (about $50) for their time.
First, research team members discussed and reached a consensus regarding the research questions before conducting any interviews. Second, after all of the interviews, research members debriefed and discussed the interactions between FGI participants using verbatim transcripts and relevant quotes. Both the verbal and non-verbal behaviors of participants were recorded by a note-taker.
After discussions among the research team, which included clinicians and nurses, the FGI guide questions were revised to increase their understandability to laypersons; all alterations were reviewed together by the research team. The primary investigator, who was experienced FGIs and has used them in several prior studies, facilitated conversation as a moderator while a co-author took field notes. Each FGI lasted approximately one hour.
대상 데이터
Among them, 13 participants who took part in the FGIs had been hospitalized because they had been unable to control their blood glucose levels and thus developed complications. Four different FGIs with the 13 participants were conducted, with each group comprising two to four participants. The 6 participants who took part in the individual interviews could not take part in an FGI due to their busy schedules, and were interviewed in outpatient departments at the university hospitals where they received their care.
Nineteen individuals with type 1 or type 2 DM were recruited, with 13 and 6 participating in the FGI and individual interviews, respectively, from June to September in 2015. Participants were recruited using convenience sampling from outpatients clinics and university hospitals located in a metropolitan area of South Korea.
Of the 19 participants, 11 were female and 18 were married. The mean age of participants was 59.
Nineteen individuals with type 1 or type 2 DM were recruited, with 13 and 6 participating in the FGI and individual interviews, respectively, from June to September in 2015. Participants were recruited using convenience sampling from outpatients clinics and university hospitals located in a metropolitan area of South Korea. Among them, 13 participants who took part in the FGIs had been hospitalized because they had been unable to control their blood glucose levels and thus developed complications.
Four different FGIs with the 13 participants were conducted, with each group comprising two to four participants. The 6 participants who took part in the individual interviews could not take part in an FGI due to their busy schedules, and were interviewed in outpatient departments at the university hospitals where they received their care. A FGI guide was developed according to the studied concepts, a literature review, and the research team’s experiences in working with diabetes patients.
성능/효과
The findings revealed that Korean participants with diabetes had both positive and negative perceptions of insulin therapy. In particular, they experienced feelings of shock and fear when they were recommended insulin therapy by their physicians.
후속연구
Based on those assessments, individualized education and counseling early on may help to minimize or prevent PIR and insulin therapy delay. Second, more research on the most effective intervention times and methods should be performed. Although healthcare providers have also been found to show PIR, which makes them less likely to prescribe insulin, little is known about this phenomenon in healthcare providers in South Korea.
To the best of the authors’ knowledge, this is the first attempt to explore the perspectives and experiences related to insulin therapy among individuals with diabetes in South Korea. Ultimately, this study provides evidence that will help in developing culturally appropriate instruments that can measure behaviors and attitudes related to insulin therapy for Koreans with diabetes.
참고문헌 (29)
Reach G, Le Pautremat V, Gupta S, "Determinants and consequences of insulin initiation for type 2 diabetes in France: analysis of the National Health and Wellness Survey", Patient Prefer Adherence, Vol. 7, pp. 1007-1023, 2013.
M. Lee, Y. Kim, Y. Seo, M. Lee, S. Jung, Utilization and Awareness of Complementary and Alternative Medicine (CAM) in Rural Hypertension or Diabetes Patients Journal of Digital Convergence, Vol. 12, No. 1, pp.457-466, 2014.
K. Jung, A Study on Implementation of Medical for Elderly Inpatients -Through Compared with Non-elderly Patients-, Journal of Digital Convergence, Vol. 10, No. 3, pp.219-225, 2012.
Machinani S, Bazargan-Hejazi S, Hsia S H. "Psychological insulin resistance among low-income U.S. racial minority patients with type 2 diabetes", Prim Care Diabetes, Vol. 7, No. 1, pp. 51-55, 2013.
Brod M, Kongso JH, Lessard S, Christensen TL, "Psychological insulin resistance: patient beliefs and implications for diabetes management", Qual Life Res, Vol. 18. No. 1, pp. 23-32, 2013.
Polonsky WH, Fisher L, Guzman S, Villa-Caballero L, Edelman SV, "Psychological insulin resistance in patients with type 2 diabetes: The scope of the problem", Diabetes Care, Vol. 28, No. 10, pp. 2543-2545, 2005.
Fu SN, Chin WY, Wong CKH, et al. "Development and validation of the Chinese Attitudes to Starting Insulin Questionnaire(Ch-ASIQ) for primary care patients with type 2 diabetes", PLoS One, Vol. 8, No. 11, pp. e78933, 2013.
Jenkins N, Hallowell N, Farmer AJ, Holman RR, Lawton J, "Initiating insulin as part of the Treating To Target in Type 2 Diabetes(4-T) trial: an interview study of patients' and health professionals' experiences", Diabetes Care, Vol. 33, No. 10, pp, 2178-2180, 2010.
Korean Diabetes Research Foundation. "Korean Diabetes Association. Diabetes fact sheet in Korea 201", Seoul, 2013, Accessed August 2015. www.diabetes.or.kr/temp/diabetes_factsheet_2013111.pdf
Choi YJ, Kim HC, Kim HM, Park SW, Kim J, Kim DJ, "Prevalence and management of diabetes in Korean adults: Korea National Health and Nutrition Examination Surveys 1998-2000", Diabetes Care, Vol. 32, No. 11, pp. 2016-2020, 2009.
Hong S H, Kim M J, Noh S G, et al. "A study on resistance in type 2 diabetic patient against commencement of insulin treatment", Korean Diabetes J, Vol. 32, pp. 269-279, 2008.
Lee S. "A study on the knowledge, self-care practice level and accuracy, and barriers of insulin injection behavior in elderly patients with diabetes mellitus", Jinju: Gyeongsang National University, 2012.
Lee E. "Self-injection related anxiety, fear and self-care compliance in insulin-treated diabetes patients", Seoul: Ewha Womans University, 2002.
Nam S, Song H J, Park S Y, Song Y, "Challenges of diabetes management in immigrant Korean Americans", Diabetes Educ, Vol. 39, No. 2, pp. 213-221, 2013.
Halcomb EJ, Gholizadeh L, DiGiacomo M, Phillips J, Davidson PM, "Literature review: considerations in undertaking focus group research with culturally and linguistically diverse groups", J Clin Nurs, Vol. 16, No. 6, pp. 1000-1011, 2007.
Karter AJ, Subramanian U, Saha C, et al, "Barriers to insulin initiation: the translating research into action for diabetes insulin starts project", Diabetes Care, Vol. 33, No. 4, pp. 733-735, 2010.
Ligthelm R, Davidson J, "Initiating insulin in primary care - the role of modern premixed formulations", Prim Care Diabetes, Vol. 2, No. 1, pp. 9-16, 2008.
G. Song, H. Kim, J. Jun, Analysis of Reported Study on Intervention Programs for Patients with Diabetes Mellitus, Journal of Digital Convergence, Vol. 13, No. 9, pp.541-551, 2015.
M. Hwang, J Park, Lexical and Phrasal Analysis of Online Discourse of Type 2 Diabetes Patients based on Text-Mining, Journal of Digital Convergence, Vol. 12, No. 6, pp.655-667, 2014.
Y. Kim, S. Kang, Changes and determinants affecting on geographic variations in health behavior, prevalence of hypertension and diabetes in Korean, Journal of Digital Convergence, Vol. 13, No. 11, pp.241-254, 2013.
Diamond SA, Matok I, "Pharmacists' anticipated pain compared to experienced pain associated with insulin pen injection and fingertip lancing", Can J Diabetes , Vol. 35, No. 3, pp. 282-286, 2011.
Farsaei S, Radfar M, Heydari Z, Abbasi F, Qorbani M, "Insulin adherence in patients with diabetes: Risk factors for injection omission", Prim Care Diabetes, Vol. 8, No. 4, pp. 338-345, 2014.
Song Y, Song H J, Han H R, Park S Y, Nam S, Kim M T, "Unmet needs for social support and effects on diabetes self-care activities in Korean Americans with type 2 diabetes", Diabetes Educ, Vol. 38, No. 1, pp. 77-85, 2012.
Makine C, Karsidag C, Kadioglu P, et al, "Symptoms of depression and diabetes-specific emotional distress are associated with a negative appraisal of insulin therapy in insulin-naive patients with Type 2 diabetes mellitus. A study from the European Depression in Diabetes[EDID] Research Consortium", Diabet Med, Vol. 26, No. 1, pp. 28-33, 2009.
D. Park, E. Jang, "Convergence Factors Related to Glycemic Control in Workers with Diabetes Mellitus : using the Korean National Health and Nutrition Examination Survey, 2009-2013", Journal of the Korea Convergence Society, Vol. 6, No. 6, pp. 95-103, 2015.
J. Lim, C. Oh, Medical care utilization status and quality of life in diabetes mellitus patients, Journal of Digital Convergence, Vol. 11, No. 10, pp.609-618, 2013.
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