Understanding experiences of diabetes care among patients with diabetic kidney disease
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Authors
Engelbrecht, Rachael
Author ORCID Profiles (clickable)
Degree
Master of Nursing
Grantor
Eastern Institute of Technology (EIT)
Date
2019
Supervisors
Walker, Rachael
Monson, Kathy
Monson, Kathy
Type
Masters Thesis
Ngā Upoko Tukutuku (Māori subject headings)
Keyword
New Zealand
diabetes
diabetic kidney disease
primary care
secondary care
patient experiences
diabetes care
self-management
patient education
outcomes
interviews
diabetes
diabetic kidney disease
primary care
secondary care
patient experiences
diabetes care
self-management
patient education
outcomes
interviews
ANZSRC Field of Research Code (2020)
Citation
Engelbrecht, R. (2019). Understanding experiences of diabetes care among patients with diabetic kidney disease. (Unpublished document submitted in partial fulfilment of the requirements for the degree of Master of Nursing). Eastern Institute of Technology (EIT), New Zealand https://hdl.handle.net/10652/6037
Abstract
This research aimed to explore and understand the experiences and perceptions of diabetes care among patients with diabetic kidney disease and is driven by my research question “what are the experiences of diabetes care among patients with diabetic kidney disease?”. In order to achieve this I interviewed ten patients individually from the Hawke’s Bay area and guided by semi-structured questions, I asked them to describe their experiences about the diabetes care they have received since their diagnosis of diabetes.
The literature review demonstrated that diabetes and diabetic kidney disease is increasing in prevalance in New Zealand and that diabetic kidney disease is preventable. The literature also revealed that there is very little evidence of evaluated models of diabetes care in New Zealand and that currently diabetes care is fragmented in its delivery, not only in geographical location but also in general practice. There are several international studies examining patients’ experience of care involving various models of integrated care in diabetes and one international study exploring patients’ perspectives on health care with diabetes and chronic kidney disease. However, there is no literature in New Zealand specifically exploring patients’ with diabetic kidney disease and their experience of their diabetes care.
This thesis used a qualitative approach by way of semi-structured questions to gain deep insight and rich data from patients’ regarding their experiences of their diabetes care. To analyse the data, a clearly defined method of thematic analysis guided by the general inductive approach was used. The validity of the research was strengthened by applying method triangulation.
This thesis is the first known research in New Zealand to specifically understand patients’ with diabetic kidney disease experience of their diabetes care. The research highlighted the importance of the value of knowledge for patients with diabetes in order to self-manage and improve the quality of their lives. The research also revealed that continuity of care can provide patients with trust and rapport in their health provider which in turn will improve patient outcomes. Coping with a diagnosis of diabetes, including emotional factors such as denial, regret and self-blame were described by participants, as was the importance of whanau involvement in diabetes care.
The findings of this research have implications for the role of healthcare delivery in New Zealand, as well as the future development of nursing roles in primary and specialist nursing care. With the knowledge of diabetic kidney disease numbers on the rise, the recommendations for improving diabetes education, implementing integrated models of diabetes care, addressing the psycho-social needs of patients and health provider recognition and utilisation of Maori models of care, may provide a way forward in the prevention of diabetic kidney disease in New Zealand.
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