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Primary care for diabetes mellitus: perspective from older patients

机译：糖尿病的初级保健：老年患者的观点

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Background: Care of diabetes mellitus in the elderly requires an additional perspective to take into account impaired cognitive function, physical function, low level of education, and difficulty making lifestyle changes. Existing services tend to be driven by the views of tertiary and secondary care staff, rather than those of primary care staff and elderly patients. This study aimed to explore the attitudes and preferences of elderly patients with diabetes mellitus towards primary care (clinical care and community program).Method: Elderly patients with diabetes mellitus aged 60 years or above were recruited from governmental diabetes mellitus clinics and diabetes mellitus specific community centers. Three focus group discussions of 14 diabetic elderly patients were conducted and their perspectives on the new service model were assessed. Participants were interviewed according to an open-ended discussion guide which includes the following items: comments on existing clinic follow up and community program, motivation for joining the community program, and suggestions on further clinical services and community service program development.Results: Incapability of the current health service to address their special needs was a common concern in three focus group discussions. The majority highlighted the benefits of the new service program, that is, self-care knowledge and skill, attitudes to living with diabetes mellitus, and supportive network. Key facilitators included experiential learning, a group discussion platform, and goal setting with patients.Conclusions: This study is the first qualitative study to explore the views of elderly diabetic patients’ on their self-care needs. Elderly people with diabetes mellitus in this study identified bad experiences of clinical follow-up; benefit from the community program; and recommendations for the future development of primary care. Study findings revealed a number of discrepancies between elderly diabetic patients’ needs and existing health services in Hong Kong. The study findings provide health practitioners, researchers and educators with an additional perspective on the provision of quality of care for elderly diabetic patients in the community.
机译：背景：老年人的糖尿病护理需要一个新的视角，以考虑到认知功能受损，身体功能受损，教育水平低下以及难以改变生活方式。现有服务往往是由三级和二级护理人员的观点驱动的，而不是初级护理人员和老年患者的观点。本研究旨在探讨老年糖尿病患者对初级保健（临床护理和社区计划）的态度和偏好。方法：从政府糖尿病诊所和糖尿病特定社区招募60岁以上的老年糖尿病患者。中心。对14名糖尿病老年患者进行了3次焦点小组讨论，并评估了他们对新服务模式的看法。根据不限成员名额的讨论指南对参与者进行了采访，其中包括以下项目：对现有诊所随访和社区计划的评论，加入社区计划的动机以及对进一步临床服务和社区服务计划发展的建议。在三个焦点小组讨论中，当前满足他们特殊需求的卫生服务是一个共同关心的问题。多数人强调了新服务计划的好处，即自我保健知识和技能，对糖尿病患者的态度以及支持网络。主要的促进因素包括体验式学习，小组讨论平台和与患者的目标设定。结论：本研究是第一项定性研究，旨在探讨老年糖尿病患者对其自我保健需求的看法。本研究中的老年糖尿病患者发现不良的临床随访经验。从社区计划中受益;以及对基层医疗未来发展的建议。研究结果表明，香港老年糖尿病患者的需求与现有医疗服务之间存在许多差异。该研究结果为卫生从业者，研究人员和教育工作者提供了关于为社区中老年糖尿病患者提供优质医疗服务的其他观点。

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