Perspectives On Lifestyle Counselling For Type 2 Diabetes Patients

T2DM and Lifestyle Counselling

Discuss about the Perspectives on Lifestyle Counselling.

Diabetes is a significant problem facing the world today. There is type 1 and type 2 diabetes. This research focusses on type 2 diabetes due to its implications on the life of patients. Type 2 diabetes (T2DM) is a progressive condition that requires continuous education, interventions, risk identification, evaluation, and assessment to reduce stigma and complications associated with the disease (ADA, 2014). According to WHO (2015) reports, the number of people diagnosed with T2DM is estimated to increase to 350 million people from the current 18.8 million diagnosed patients by the year 2030. The disease is mainly caused by genetic factors and inactive lifestyle behaviour (ADA, 2014). Due to the increased prevalence of the disease as a result of urbanization, obesity, and physical inactivity, T2DM is often considered a poor lifestyle disease (Browne et al., 2013). The increased prevalence of the disease is aggravated further by socio-cultural and demographic factors. In particular, there are difficulties in health care accessibility by minority groups in Australia and New Zealand such as Pacific Island and the Maori people leading to higher diabetes-related risks (Harding et al., 2014). To prevent and manage T2DM, it is important to facilitate lifestyle interventions. The public and diabetes patients must be sensitized on nutritional and lifestyle habits to alleviate the onset and complications of T2DM (Burke, Sherr and Lipman, 2014). This research project recognises the importance of preventive measures and lifestyle adjustment between both patients of T2DM and healthcare providers. According to a study conducted by the US Department of Health and Human Services (2013), participants claimed that they desired to improve their lifestyle and reduce the economic burden caused by T2DM. In support of these findings, Hussain and Kumari (2015) suggested that costs and complications associated with diabetes may be delayed by managing the levels of blood glucose.

There are various studies about the issue of diabetes and its effect on the lifestyle of patients (Thorne, Nyhlin and Paterson, 2000). These studies however mostly focus on the lifestyle habits and factors that lead to the development of T2DM (Wändell, 2005). The studies dwell on preventive measures and clinical measures to manage the disease. Although these studies provide valuable information on managing the disease and empowering the patients to improve their lifestyle, they fail to address implementation of the tools into the daily practice and life of both the patients and their healthcare providers (Elissen et al., 2013). This research study seeks to utilize a personalized approach to tacking the T2DM menace. This will be achieved by taking a person-centred approach to understanding what goes through the minds and lives of T2DM patients as they struggle to integrate the challenges brought by the disease into their everyday life. By looking at the issue from the patients’ point of view, more effective measures and intervention strategies can be formulated to mitigate the growing number of diabetes cases all over the world.

Research Objectives

Diabetes is associated with stigmatization by the media, healthcare practitioners, and peers (Schabert et al., 2013). Because of the stigmatization, patients often experience reduced quality of life. Healthcare providers are unable to reconcile the challenges experienced by their patients because they are not aware of what the patients go through. T2DM patients are often forced to change their normal eating and lifestyle habits. They have to practice abstention from their favourite dishes and sweets. From this problem statement, the research study aims to understand how people with T2DM cope with such pressures in their life and the role of lifestyle counselling. The research seeks to answers question on how to abstain, moral pressure and challenges faced by patients, the pain of abstaining, and the role of healthcare providers in supporting the patients. Therefore, the study looks at the experience of T2DM patients including the role of healthcare providers from the perspective of the patients.

When conducting a qualitative research study, it is important to consider to the ethical implication of the process to the participants and community. Due to the person-centred approach utilised by the study, it is important to consider the ethical context of the research. Throughout the research process and activities, the research team will make ethical considerations and reflect on the possible impact on the community and participants in the study. Ethics-related risks include misrepresentation of the study, exploitation of the participants, distress, and anxiety (Oftedal, Karlsen and Bru, 2010). The study will ensure that the interests of the participants are prioritized. These considerations include confidentiality of data, anonymity assurance, and the informed consent of the participants. The findings of the study shall also be appropriately communicated to the participants.

Since the research study touches on a sensitive and emotional aspect of the participants’ lives, it is necessary to keep their well-being in mind. Diabetes type 2 affects the entire community in one way or another (Yannakoulia, 2006). All members of the society are therefore invested in the management of the disease. Another ethical issue to consider is the association of T2DM with poor lifestyle habits.

Before conducting the research, approval from the Human resources Ethics Committee (HREC) of Australia will be ensured. The research will fully comply with all the relevant guidelines and standards set by HREC.

The research study is designed to investigate the issues surrounding diabetes types two management and lifestyle counselling from the patients’ perspective. In particular, the study looks into the lifestyle and eating challenges faced by diabetes patients as they strive to manage the disease.

Research Methodology

The research study aims to answer the following questions:

1. What kind of lifestyle challenges do patients of T2DM face?
2. How do they cope and manage these challenges?
3. What kind of pain and pressure do the patients face in their daily lives?

The main aim of the study is to provide insight on how people with T2DM and their healthcare providers make sense of and cope with the challenges and pressure from diabetes type 2. This will provide useful information for managing the disease. The objectives of this study therefore are:

1. To understand the pain patients of diabetes two go through as they abstain from previous eating habits.
2. To determine the moral pressure patients face in their efforts to manage T2DM.
3. How to abstain from lifestyle habits that cause diabetes.
4. To determine the role of doctors in enforcing a person-centred diabetes management and lifestyle counselling strategy.

These objectives lead to the hypothesis that healthcare providers and the perspective of patients are important in managing T2DM lifestyle challenges such as abstinence from previous eating habits

The research will utilise a qualitative study method to collect, analyse, measure, and interpret the findings. Data will be collected using in-depth semi-structured interviews to understand the experiences of the participants. The main body of the study will be comprised of these in-depth interviews. The interviews will be conducted on both diabetes type 2 patients and healthcare providers. Research data will be collected using questionnaires and face to face interviews

Purposive sampling will be used to select participants for the research study. The healthcare providers will be medical practitioners dealing with the prevention and management of diabetes type 2 in various healthcare facilities in Australia. In addition, the selection criteria will only include healthcare professionals engaged in lifestyle counselling of diabetes type 2 patients. The criteria for selecting patients will consist of patients who are above eighteen years of age and are under life counselling interventions from healthcare providers. Selection of patients above the age of eighteen will be due to potential legal and ethical constraints likely to be faced in a sample below the age of eighteen. The sampling technique only narrows out patients and healthcare providers with a life counselling history in order to efficiently collect data that outlines their experiences and perspective.

In particular, the study will sample twenty patients and ten healthcare providers from ten healthcare facilities located in different regions of Australia. The criteria will consider demographic factors that may affect the findings of the research such as age and gender. The study will interview an equal number men and women from eighteen years to sixty-five years of age. The sampling criteria will also include patients in minority communities and regions. This will ensure the data and findings from the research are generalizable and representative of the population of Australia.

Research data will be collected by means of questionnaires and in-depth interviews. The questionnaires will be distributed to the different hospitals all over Australia before in-depth interviews are employed. This will enable the selected participants to gain a general view of what the study entails and prepare them both mentally and emotionally. Different questionnaires will be developed for T2DM patients and healthcare providers. Patient questionnaires will include questions regarding their experiences, their previous lifestyle habits, their new lifestyle habits, the pain of abstaining, pressures they experience because of abstinence, and the role of lifestyle counselling from healthcare professionals in managing T2DM. These questions will be simple and straightforward to ensure the wilful compliance of the participants with the study. Likewise, questionnaires distributed to the healthcare providers will detail questions related to their lifestyle counselling activities and their experiences with diabetes type 2 patients. In-depth interviews which form the main body of the research will be conducted in the respective hospitals. The interviews will be recorded in video and audio formats for transcription. The interviewers will be keen to foster a comfortable atmosphere and personal relationship with the participants to ensure they give a detailed and personal account of their experiences.

Sampling Technique

Researchers will make written transcripts to record the in-depth interviews. The transcripts will then be analysed using content analysis. This analysis will include both and non-verbal communication portrayed by the participants. This will enable interviewers to translate the underlying implications of the content effectively.

The study will utilize a qualitative research design for various reasons. In the subject of diabetes and healthcare maximization, a qualitative study is a useful method to collect information from different groups (Smith, 2015). Since the study seeks to understand the different experiences patients and healthcare provider undergo in their lifestyle, a qualitative study will enable the researchers to develop a deep understanding of the topic. This will facilitate the formulation of relevant and practical interventions from the findings of the study. The research will use an in-depth interview qualitative methodology to enable a personal connection with the patients.

The sampling technique will provide a general representation of diabetes healthcare in Australia. This will ensure the findings of the research are applicable over a wide range of scenarios. In addition, the generalizability of the study will provide insights that can be applied in future research projects on related topics. In-depth interviews help in the facilitation of a comfortable atmosphere. This ensures participants are relaxed and free as they interact with the interviewers.

Qualitative studies are meant to ensure trustworthiness of the findings. To ensure proper interpretation, interviews will be peer-reviewed. Furthermore, the period of the study is carefully determined to ensure credible research and outcomes. Rigour will be guaranteed by maintaining in-depth discussions among the research team during data analysis and collection. The generalizability of the research will ensure the findings can be transferred to other settings and used for future research.

1. To understand the pain patients of diabetes two go through as they abstain from previous eating habits.
2. To determine the moral pressure patients face in their efforts to manage T2DM.
3. How to abstain from lifestyle habits that cause diabetes.
4. To determine the role of doctors in enforcing a person-centered diabetes management and lifestyle counselling strategy.

The findings of the study will help both healthcare providers and T2DM patients in managing diabetes. Insight from the patients’ experience will enable the relevant authorities in the health care system of Australia to implement the measures in the changes for better T2DM management. This will improve the patients’ quality of life and sensitize the community on diabetes management. The research will require an estimated budget of $2000 to cover transportation, data collection, interviewer remuneration, and other relevant miscellaneous expenses. The study is scheduled run for approximately one year. All research planning, sampling, data collection, data analysis and interpretation of the finding will be conducted within the period as shown below.

Research Activity	Duration
Planning and preparation (Field study and procurement of resources)	November 2017 – January 2018
Sampling	January 2018 – February 2018
Distribution of Questionnaires	April 2018 – May 2018
In-depth Interviews	May 2018- August 2018
Data analysis	September 2018- October 2018
Final Report	November 2018

References

American Diabetes Association, 2014. Diagnosis and classification of diabetes mellitus. Diabetes care, 37(Supplement 1), pp.S81-S90.

Browne, J.L., Ventura, A., Mosely, K. and Speight, J., 2013. ‘I call it the blame and shame disease’: a qualitative study about perceptions of social stigma surrounding type 2 diabetes. BMJ open, 3(11), p.e003384.

Burke, S.D., Sherr, D. and Lipman, R.D., 2014. Partnering with diabetes educators to improve patient outcomes. Diabetes, metabolic syndrome and obesity: targets and therapy, 7, p.45.

Colagiuri, S., Dickinson, S., Girgis, S. and Colagiuri, R., 2017. National Evidence Based Guideline for Blood Glucose Control in Type 2 Diabetes. Canberra: Diabetes Australia and the NHMRC, 2009.

Elissen, A., Nolte, E., Knai, C., Brunn, M., Chevreul, K., Conklin, A., Durand-Zaleski, I., Erler, A., Flamm, M., Frølich, A. and Fullerton, B., 2013. Is Europe putting theory into practice? A qualitative study of the level of self-management support in chronic care management approaches. BMC Health Services Research, 13(1), p.117.

Harding, J.L., Shaw, J.E., Peeters, A., Guiver, T., Davidson, S. and Magliano, D.J., 2014. Mortality trends among people with type 1 and type 2 diabetes in Australia: 1997–2010. Diabetes Care, 37(9), pp.2579-2586.

Hussain, S. and Kumari, S., 2015. Evaluation of The Annual Cost of Medicines used In treatment of Type 2 diabetes Mellitus In India. Value in Health, 18(3), p.A59.

Oftedal, B., Karlsen, B. and Bru, E., 2010. Life values and self?regulation behaviours among adults with type 2 diabetes. Journal of clinical nursing, 19(17?18), pp.2548-2556.

Schabert, J., Browne, J.L., Mosely, K. and Speight, J., 2013. Social stigma in diabetes. The Patient-Patient-Centered Outcomes Research, 6(1), pp.1-10.

Smith, J.A. ed., 2015. Qualitative psychology: A practical guide to research methods. Sage.

Thorne, S.E., Nyhlin, K.T. and Paterson, B.L., 2000. Attitudes toward patient expertise in chronic illness. International journal of nursing studies, 37(4), pp.303-311.

US Department of Health and Human Services, 2013. Health resources and services administration. Critical Care Workforce Report. Requested by Senate Report, pp.108-91.

Wändell, P.E., 2005. Quality of life of patients with diabetes mellitus an overview of research in primary health care in the Nordic countries. Scandinavian journal of primary health care, 23(2), pp.68-74.

Wermeling, M., Thiele-Manjali, U., Koschack, J., Lucius-Hoene, G. and Himmel, W., 2014. Type 2 diabetes patients’ perspectives on lifestyle counselling and weight management in general practice: a qualitative study. BMC family practice, 15(1), p.97.

World Health Organization, 2015. Diabetes: Fact sheet N 312. 2011. URL: https://www. who. int/mediacentre/factsheets/fs312/en/(Accessed on 3 November 2015).

Yannakoulia, M., 2006. Eating behavior among type 2 diabetic patients: a poorly recognized aspect in a poorly controlled disease. The Review of Diabetic Studies, 3(1), p.11.