Factors that influence patient empowerment in inpatient chronic care: early thoughts on a diabetes care intervention in South Africa

dc.contributor.authorAbrahams, Nina
dc.contributor.authorGilson, Lucy
dc.contributor.authorLevitt, Naomi S
dc.contributor.authorDave, Joel A
dc.date.accessioned2019-12-10T08:45:43Z
dc.date.available2019-12-10T08:45:43Z
dc.date.issued2019-12-05
dc.date.updated2019-12-08T04:32:44Z
dc.description.abstractAbstract Background The burden of non-communicable diseases is growing rapidly in low- and middle-income countries. Research suggests that health interventions that aim to improve patient self-management and empower patients to care actively for their disease will improve health outcomes over the long-term. There is, however, a gap in the literature about the potential role of the inpatient setting in supporting chronic care. This is particularly important in low-and-middle income countries where hospitals may be a rare prolonged point of contact between patient and health provider. The aim of this small scale, exploratory study was to understand what factors within the inpatient setting may affect patients’ feelings of empowerment in relation to their chronic disease care and provides recommendations for future inpatient-based interventions to support self-management of disease. Methods This study was based in a public, academic hospital in South Africa. Eighteen qualitative, semi-structured interviews were conducted with multiple participants with experience of diabetes care: inpatients and health professionals such as nurses, endocrinologists, and dieticians. Findings were analysed using a broad, exploratory, thematic approach, guided by self-management and chronic care literature. Results Interviews with both patients and providers suggest that patients living in low socio-economic contexts are likely to struggle to access appropriate healthcare information and services, and may often have financial and emotional priorities that take precedence over their chronic illness. Younger people may also be more dependent on their family and community, giving them less ability to take control of their disease care and lifestyle. In addition, hospital care remains bound by an acute care model; and the inpatient setting of focus is characterised by perceived staff shortages and ineffective communication that undermine the implementation of patient empowerment-focused interventions. Conclusions Patient and provider contexts are likely to make supporting patient engagement in long-term chronic care difficult in lower income settings. However, knowledge of these factors can be harnessed to improve chronic care interventions in South Africa and other similar countries.
dc.identifier.apacitationAbrahams, N., Gilson, L., Levitt, N. S., & Dave, J. A. (2019). Factors that influence patient empowerment in inpatient chronic care: early thoughts on a diabetes care intervention in South Africa. http://hdl.handle.net/11427/30661en_ZA
dc.identifier.chicagocitationAbrahams, Nina, Lucy Gilson, Naomi S Levitt, and Joel A Dave "Factors that influence patient empowerment in inpatient chronic care: early thoughts on a diabetes care intervention in South Africa." (2019) http://hdl.handle.net/11427/30661en_ZA
dc.identifier.citationBMC Endocrine Disorders. 2019 Dec 05;19(1):133
dc.identifier.ris TY - Journal Article AU - Abrahams, Nina AU - Gilson, Lucy AU - Levitt, Naomi S AU - Dave, Joel A AB - Abstract Background The burden of non-communicable diseases is growing rapidly in low- and middle-income countries. Research suggests that health interventions that aim to improve patient self-management and empower patients to care actively for their disease will improve health outcomes over the long-term. There is, however, a gap in the literature about the potential role of the inpatient setting in supporting chronic care. This is particularly important in low-and-middle income countries where hospitals may be a rare prolonged point of contact between patient and health provider. The aim of this small scale, exploratory study was to understand what factors within the inpatient setting may affect patients’ feelings of empowerment in relation to their chronic disease care and provides recommendations for future inpatient-based interventions to support self-management of disease. Methods This study was based in a public, academic hospital in South Africa. Eighteen qualitative, semi-structured interviews were conducted with multiple participants with experience of diabetes care: inpatients and health professionals such as nurses, endocrinologists, and dieticians. Findings were analysed using a broad, exploratory, thematic approach, guided by self-management and chronic care literature. Results Interviews with both patients and providers suggest that patients living in low socio-economic contexts are likely to struggle to access appropriate healthcare information and services, and may often have financial and emotional priorities that take precedence over their chronic illness. Younger people may also be more dependent on their family and community, giving them less ability to take control of their disease care and lifestyle. In addition, hospital care remains bound by an acute care model; and the inpatient setting of focus is characterised by perceived staff shortages and ineffective communication that undermine the implementation of patient empowerment-focused interventions. Conclusions Patient and provider contexts are likely to make supporting patient engagement in long-term chronic care difficult in lower income settings. However, knowledge of these factors can be harnessed to improve chronic care interventions in South Africa and other similar countries. DA - 2019-12-05 DB - OpenUCT DP - University of Cape Town KW - Non-communicable disease KW - Inpatient, empowerment KW - Self-management KW - Diabetes KW - South Africa KW - Qualitative methods LK - https://open.uct.ac.za PY - 2019 T1 - Factors that influence patient empowerment in inpatient chronic care: early thoughts on a diabetes care intervention in South Africa TI - Factors that influence patient empowerment in inpatient chronic care: early thoughts on a diabetes care intervention in South Africa UR - http://hdl.handle.net/11427/30661 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s12902-019-0465-1
dc.identifier.urihttp://hdl.handle.net/11427/30661
dc.identifier.vancouvercitationAbrahams N, Gilson L, Levitt NS, Dave JA. Factors that influence patient empowerment in inpatient chronic care: early thoughts on a diabetes care intervention in South Africa. 2019; http://hdl.handle.net/11427/30661.en_ZA
dc.language.rfc3066en
dc.rights.holderThe Author(s).
dc.subjectNon-communicable disease
dc.subjectInpatient, empowerment
dc.subjectSelf-management
dc.subjectDiabetes
dc.subjectSouth Africa
dc.subjectQualitative methods
dc.titleFactors that influence patient empowerment in inpatient chronic care: early thoughts on a diabetes care intervention in South Africa
dc.typeJournal Article
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