Why do GPs hesitate to refer diabetes patients to a self-management education program: a qualitative study.
Identifieur interne : 001670 ( Main/Exploration ); précédent : 001669; suivant : 001671Why do GPs hesitate to refer diabetes patients to a self-management education program: a qualitative study.
Auteurs : Patricia Sunaert [Belgique] ; Marie Vandekerckhove ; Hilde Bastiaens ; Luc Feyen ; Piet Vanden Bussche ; Jan De Maeseneer ; An De Sutter ; Sara WillemsSource :
- BMC family practice [ 1471-2296 ] ; 2011.
Descripteurs français
- KwdFr :
- Adulte (MeSH), Adulte d'âge moyen (MeSH), Attitude du personnel soignant (MeSH), Autosoins (méthodes), Autosoins (psychologie), Belgique (MeSH), Charge de travail (MeSH), Diabète de type 2 (psychologie), Diabète de type 2 (thérapie), Entretiens comme sujet (MeSH), Facteurs temps (MeSH), Femelle (MeSH), Humains (MeSH), Mâle (MeSH), Médecins généralistes (normes), Médecins généralistes (psychologie), Orientation vers un spécialiste (statistiques et données numériques), Recherche qualitative (MeSH), Types de pratiques des médecins (MeSH), Éducation du patient comme sujet (MeSH).
- MESH :
- méthodes : Autosoins.
- normes : Médecins généralistes.
- psychologie : Autosoins, Diabète de type 2, Médecins généralistes.
- statistiques et données numériques : Orientation vers un spécialiste.
- thérapie : Diabète de type 2.
- Adulte, Adulte d'âge moyen, Attitude du personnel soignant, Belgique, Charge de travail, Entretiens comme sujet, Facteurs temps, Femelle, Humains, Mâle, Recherche qualitative, Types de pratiques des médecins, Éducation du patient comme sujet.
English descriptors
- KwdEn :
- Adult (MeSH), Attitude of Health Personnel (MeSH), Belgium (MeSH), Diabetes Mellitus, Type 2 (psychology), Diabetes Mellitus, Type 2 (therapy), Female (MeSH), General Practitioners (psychology), General Practitioners (standards), Humans (MeSH), Interviews as Topic (MeSH), Male (MeSH), Middle Aged (MeSH), Patient Education as Topic (MeSH), Practice Patterns, Physicians' (MeSH), Qualitative Research (MeSH), Referral and Consultation (statistics & numerical data), Self Care (methods), Self Care (psychology), Time Factors (MeSH), Workload (MeSH).
- MESH :
- methods : Self Care.
- psychology : Diabetes Mellitus, Type 2, General Practitioners, Self Care.
- standards : General Practitioners.
- statistics & numerical data : Referral and Consultation.
- therapy : Diabetes Mellitus, Type 2.
- Adult, Attitude of Health Personnel, Belgium, Female, Humans, Interviews as Topic, Male, Middle Aged, Patient Education as Topic, Practice Patterns, Physicians', Qualitative Research, Time Factors, Workload.
Abstract
BACKGROUND
Self-management support is seen as a cornerstone of good diabetes care and many countries are currently engaged in initiatives to integrate self-management support in primary care. Concerning the organisation of these programs, evidence is growing that engagement of health care professionals, in particular of GPs, is critical for successful application. This paper reports on a study exploring why a substantial number of GPs was (initially) reluctant to refer patients to a self-management education program in Belgium.
METHODS
Qualitative analysis of semi-structured face-to-face interviews with a purposive sample of 20 GPs who were not regular users of the service. The Greenhalgh diffusion of innovation framework was used as background and organising framework.
RESULTS
Several barriers, linked to different components of the Greenhalgh model, emerged from the interview data. One of the most striking ones was the limited readiness for innovation among GPs. Feelings of fear of further fragmentation of diabetes care and frustration and insecurity regarding their own role in diabetes care prevented them from engaging in the innovation process. GPs needed time to be reassured that the program respects their role and has an added value to usual care. Once GPs considered referring patients, it was not clear enough which of their patients would benefit from the program. Some GPs expressed the need for training in motivational skills, so that they could better motivate their patients to participate. A practical but often mentioned barrier was the distance to the centre where the program was delivered. Further, uncertainty about continuity interfered with the uptake of the offer.
CONCLUSIONS
The study results contribute to a better understanding of the reasons why GPs hesitate to refer patients to a self-management education program. First of all, the role of GPs and other health care providers in diabetes care needs to be clarified before introducing new functions. Feelings of security and a basic trust of providers in the health system are a prerequisite for participation in care innovation. Moreover, some important lessons regarding the implementation of an education program in primary care have been learned from the study.
DOI: 10.1186/1471-2296-12-94
PubMed: 21902832
PubMed Central: PMC3181200
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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Factors</term><term>Workload</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Attitude du personnel soignant</term><term>Belgique</term><term>Charge de travail</term><term>Entretiens comme sujet</term><term>Facteurs temps</term><term>Femelle</term><term>Humains</term><term>Mâle</term><term>Recherche qualitative</term><term>Types de pratiques des médecins</term><term>Éducation du patient comme sujet</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Self-management support is seen as a cornerstone of good diabetes care and many countries are currently engaged in initiatives to integrate self-management support in primary care. Concerning the organisation of these programs, evidence is growing that engagement of health care professionals, in particular of GPs, is critical for successful application. This paper reports on a study exploring why a substantial number of GPs was (initially) reluctant to refer patients to a self-management education program in Belgium.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>Qualitative analysis of semi-structured face-to-face interviews with a purposive sample of 20 GPs who were not regular users of the service. The Greenhalgh diffusion of innovation framework was used as background and organising framework.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Several barriers, linked to different components of the Greenhalgh model, emerged from the interview data. One of the most striking ones was the limited readiness for innovation among GPs. Feelings of fear of further fragmentation of diabetes care and frustration and insecurity regarding their own role in diabetes care prevented them from engaging in the innovation process. GPs needed time to be reassured that the program respects their role and has an added value to usual care. Once GPs considered referring patients, it was not clear enough which of their patients would benefit from the program. Some GPs expressed the need for training in motivational skills, so that they could better motivate their patients to participate. A practical but often mentioned barrier was the distance to the centre where the program was delivered. Further, uncertainty about continuity interfered with the uptake of the offer.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>The study results contribute to a better understanding of the reasons why GPs hesitate to refer patients to a self-management education program. First of all, the role of GPs and other health care providers in diabetes care needs to be clarified before introducing new functions. Feelings of security and a basic trust of providers in the health system are a prerequisite for participation in care innovation. Moreover, some important lessons regarding the implementation of an education program in primary care have been learned from the study.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">21902832</PMID><DateCompleted><Year>2012</Year><Month>01</Month><Day>31</Day></DateCompleted><DateRevised><Year>2018</Year><Month>12</Month><Day>01</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1471-2296</ISSN><JournalIssue CitedMedium="Internet"><Volume>12</Volume><PubDate><Year>2011</Year><Month>Sep</Month><Day>08</Day></PubDate></JournalIssue><Title>BMC family practice</Title><ISOAbbreviation>BMC Fam Pract</ISOAbbreviation></Journal><ArticleTitle>Why do GPs hesitate to refer diabetes patients to a self-management education program: a qualitative study.</ArticleTitle><Pagination><MedlinePgn>94</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/1471-2296-12-94</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Self-management support is seen as a cornerstone of good diabetes care and many countries are currently engaged in initiatives to integrate self-management support in primary care. Concerning the organisation of these programs, evidence is growing that engagement of health care professionals, in particular of GPs, is critical for successful application. This paper reports on a study exploring why a substantial number of GPs was (initially) reluctant to refer patients to a self-management education program in Belgium.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">Qualitative analysis of semi-structured face-to-face interviews with a purposive sample of 20 GPs who were not regular users of the service. The Greenhalgh diffusion of innovation framework was used as background and organising framework.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Several barriers, linked to different components of the Greenhalgh model, emerged from the interview data. One of the most striking ones was the limited readiness for innovation among GPs. Feelings of fear of further fragmentation of diabetes care and frustration and insecurity regarding their own role in diabetes care prevented them from engaging in the innovation process. GPs needed time to be reassured that the program respects their role and has an added value to usual care. Once GPs considered referring patients, it was not clear enough which of their patients would benefit from the program. Some GPs expressed the need for training in motivational skills, so that they could better motivate their patients to participate. A practical but often mentioned barrier was the distance to the centre where the program was delivered. Further, uncertainty about continuity interfered with the uptake of the offer.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">The study results contribute to a better understanding of the reasons why GPs hesitate to refer patients to a self-management education program. First of all, the role of GPs and other health care providers in diabetes care needs to be clarified before introducing new functions. Feelings of security and a basic trust of providers in the health system are a prerequisite for participation in care innovation. 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Maeseneer</LastName><ForeName>Jan</ForeName><Initials>J</Initials></Author><Author ValidYN="Y"><LastName>De Sutter</LastName><ForeName>An</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Willems</LastName><ForeName>Sara</ForeName><Initials>S</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2011</Year><Month>09</Month><Day>08</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>BMC Fam Pract</MedlineTA><NlmUniqueID>100967792</NlmUniqueID><ISSNLinking>1471-2296</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001291" MajorTopicYN="Y">Attitude of Health Personnel</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001530" MajorTopicYN="N">Belgium</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003924" MajorTopicYN="N">Diabetes Mellitus, Type 2</DescriptorName><QualifierName UI="Q000523" MajorTopicYN="N">psychology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D058005" MajorTopicYN="N">General Practitioners</DescriptorName><QualifierName UI="Q000523" MajorTopicYN="Y">psychology</QualifierName><QualifierName UI="Q000592" MajorTopicYN="N">standards</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007407" MajorTopicYN="N">Interviews as Topic</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010353" MajorTopicYN="N">Patient Education as Topic</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010818" MajorTopicYN="N">Practice Patterns, Physicians'</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D036301" MajorTopicYN="N">Qualitative Research</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012017" MajorTopicYN="N">Referral and Consultation</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012648" MajorTopicYN="N">Self Care</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName><QualifierName UI="Q000523" 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IdType="pubmed">21902832</ArticleId><ArticleId IdType="pii">1471-2296-12-94</ArticleId><ArticleId IdType="doi">10.1186/1471-2296-12-94</ArticleId><ArticleId IdType="pmc">PMC3181200</ArticleId></ArticleIdList><ReferenceList><Reference><Citation>Implement Sci. 2010 Mar 13;5:21</Citation><ArticleIdList><ArticleId IdType="pubmed">20226066</ArticleId></ArticleIdList></Reference><Reference><Citation>BMC Health Serv Res. 2009;9:152</Citation><ArticleIdList><ArticleId IdType="pubmed">19698185</ArticleId></ArticleIdList></Reference><Reference><Citation>Med J Aust. 2007 Jan 15;186(2):84-7</Citation><ArticleIdList><ArticleId IdType="pubmed">17223770</ArticleId></ArticleIdList></Reference><Reference><Citation>Br J Gen Pract. 2006 Jun;56(527):407-14</Citation><ArticleIdList><ArticleId IdType="pubmed">16762121</ArticleId></ArticleIdList></Reference><Reference><Citation>BMJ. 2000 Jan 8;320(7227):114-6</Citation><ArticleIdList><ArticleId IdType="pubmed">10625273</ArticleId></ArticleIdList></Reference><Reference><Citation>JAMA. 2003 Apr 16;289(15):1969-75</Citation><ArticleIdList><ArticleId IdType="pubmed">12697800</ArticleId></ArticleIdList></Reference><Reference><Citation>BMJ. 2008;337:a1786</Citation><ArticleIdList><ArticleId IdType="pubmed">18948344</ArticleId></ArticleIdList></Reference><Reference><Citation>Aust Health Rev. 2007 Nov;31(4):499-509; discussion 498</Citation><ArticleIdList><ArticleId IdType="pubmed">17973606</ArticleId></ArticleIdList></Reference><Reference><Citation>Implement Sci. 2006 Feb 23;1:6</Citation><ArticleIdList><ArticleId IdType="pubmed">16722568</ArticleId></ArticleIdList></Reference><Reference><Citation>Milbank Q. 2004;82(4):581-629</Citation><ArticleIdList><ArticleId IdType="pubmed">15595944</ArticleId></ArticleIdList></Reference><Reference><Citation>BMC Health Serv Res. 2010;10:202</Citation><ArticleIdList><ArticleId IdType="pubmed">20619001</ArticleId></ArticleIdList></Reference><Reference><Citation>Med J Aust. 2008 Nov 17;189(10 Suppl):S17-20</Citation><ArticleIdList><ArticleId IdType="pubmed">19143580</ArticleId></ArticleIdList></Reference><Reference><Citation>Diabetes Care. 2007 Jun;30(6):1630-7</Citation><ArticleIdList><ArticleId IdType="pubmed">17526822</ArticleId></ArticleIdList></Reference><Reference><Citation>JAMA. 2002 Nov 20;288(19):2469-75</Citation><ArticleIdList><ArticleId IdType="pubmed">12435261</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></pubmed><affiliations><list><country><li>Belgique</li></country><region><li>Province de Flandre-Orientale</li><li>Région flamande</li></region><settlement><li>Gand</li></settlement><orgName><li>Université de Gand</li></orgName></list><tree><noCountry><name sortKey="Bastiaens, Hilde" sort="Bastiaens, Hilde" uniqKey="Bastiaens H" first="Hilde" last="Bastiaens">Hilde Bastiaens</name><name sortKey="Bussche, Piet Vanden" sort="Bussche, Piet Vanden" uniqKey="Bussche P" first="Piet Vanden" last="Bussche">Piet Vanden Bussche</name><name sortKey="De Maeseneer, Jan" sort="De Maeseneer, Jan" uniqKey="De Maeseneer J" first="Jan" last="De Maeseneer">Jan De Maeseneer</name><name sortKey="De Sutter, An" sort="De Sutter, An" uniqKey="De Sutter A" first="An" last="De Sutter">An De Sutter</name><name sortKey="Feyen, Luc" sort="Feyen, Luc" uniqKey="Feyen L" first="Luc" last="Feyen">Luc Feyen</name><name sortKey="Vandekerckhove, Marie" sort="Vandekerckhove, Marie" uniqKey="Vandekerckhove M" first="Marie" last="Vandekerckhove">Marie Vandekerckhove</name><name sortKey="Willems, Sara" sort="Willems, Sara" uniqKey="Willems S" first="Sara" last="Willems">Sara Willems</name></noCountry><country name="Belgique"><region name="Région flamande"><name sortKey="Sunaert, Patricia" sort="Sunaert, Patricia" uniqKey="Sunaert P" first="Patricia" last="Sunaert">Patricia 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|texte= Why do GPs hesitate to refer diabetes patients to a self-management education program: a qualitative study.
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