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Contents

Introduction 

1. Qualitative article

2. Qualitative article

3. Qualitative article

1. Quantitative article

2. Quantitative article

3. Quantitative article

Comparison

Conclusion

References

Introduction

Self monitoring of diabetes is very important for people suffering with diabetes as it can help them monitor their blood sugar levels and overall health. Additionally enhanced knowledge of diabetes helps in the self-management of the disease by maintaining an improved and overall disciplined diet as well as recommended physical activity. To achieve the associated benefits with managing oneself, there is always a requirement in favour of required resources that needs to be incorporated in a particular order. This particular study is going to review the quantitative along with qualitative articles in context to self-monitoring of diabetes. This study will also try to make a comparison between the articles based on qualitative and quantitative terms.

1. Qualitative Article

As stated by Tewahido and Berhane (2017), the foundation stone of diabetes management refers to the self-care practices which involve oneself in the blood sugar level monitoring, exercise daily, management of diet, and medication adherence. With the increase in diabetes prevalence, the notion of self-care in context to developing countries is a little known fact. Individuals diagnosed with type II diabetes along with their self-care practices based in Addis Ababa, Ethiopia form the main objective of this study and the data was collected from them using the qualitative method. Data was collected from diabetes outpatient clinics from 2 major public hospitals using semi-structured guided interview going further this data was analysed using a thematic analysis approach. The findings suggest that most patients reported irregular blood sugar levels and also revealed that proper self care was not adhered.

The participants included did not follow the recommended dietary as well as the exercise regimens adequately instead tendencies to adhere to prescription drugs were also observed by the author. Patients generally need appropriate information/data regarding the criticality of self-care and how to achieve it. By considering point by point directly, the author perceived three key orders of patients; who are those "complaining", "confused" as well as "being negligent". The centrality of real practices of self-care for the effective organization of diabetes is not sufficiently demonstrated in diabetes care centres and healthcare users need satisfactory data/knowledge base for appropriate self-care.

2. Qualitative Article

As stated by pal et al. (2018), globally type 2 diabetes is increasing in vivid terms. This is often a long term complication which is a reason for the degradation of health quality. There are several nations who are struggling due to increase in the level of type 2 diabetes. Aiming to reduce the complications and improving glycolic control behavioural support, known as DSME, or Diabetes self-management education is instrumental in reducing associated diabetic risks. Aiming for overcoming challenges in attending diabetic self-management sessions, sustained support can be provided by digital health interventions (DHI). They possess convenient multiple locations delivery at scheduled times, along with the maintaining of anonymity, as well as presenting the content in an attractive yet customized form.

This article examines the needs and requirements of type 2 diabetic patients to shed light on the improvement concerning nearby advanced self-management advice. The purpose of this review was to seek perspectives on rejected needs for self-management in type 2 diabetic patients and to support nearby DHI activity. This assessment used a qualitative method that was based on data that was generated from meetings with 20 patients in the focus group of 4. The data generated by the focus group depicts the enormous diagnosis burden on various type 2 diabetic patients along with the negative consequences on their daily work-life culture, their psychological behaviours, and aspects of their socio-economical prosperity. Regardless of how patient experiences of welfare varied, one could not expect to locate all of the clients' problems to support their physical, emotional and socio-economic conditions to manage changes and to implement self-management successfully.

By concentrating on medical care close to the informational provisions, existing therapeutic administration organizations and their associated task preparation may not meet all the needs of type 2 diabetes patients. These characteristics could help DHI to respond to a segment of the ignored needs portrayed by the individuals in this evaluation. Agreeably, DHI can improve access to DSME near social assistance and increase the breadth of stuff offered by prosperity organizations to accommodate an ever-widening range of patient needs. Certain features helping DHIs to address the unfulfilled participants' needs described were included. It emphasized on emotional as well as role management, making it all time available, possessing an evidence-based up-to-date patient's guideline for providing peer-generated as well as professional access advice.

3. Qualitative Article

As stated by Laranjo et al. (2015), the effective self-management behaviours with its adoption are frequently challenging the patients diagnosed with type 2 diabetes mellitus (DM) who possess a fundamental role in management of disease. The self-monitoring associated with type 2 diabetes mellitus, are perceived by the patients forms the main study objective. The study also subjected to understand the need to assess facilitators, contextual barriers and expectations of self management of DM type 2. The healthcare users with type 2 DM was subjected at the Portuguese Diabetes Association maintained outpatient clinic using an effective technique of sampling. Using the video-recording facilities all the Qualitative data was obtained. Each of the sessions followed a pre-tested questioning route including a moderator along with observer. The aspects of diet, exercises, along with glycaemic control were identified as 3 important themes.

There were difficulties in changing dietary habits and they were grouped in 4 main categories: decisional, food quality, quantity of food and dietary schedule formed the 4 main categories. The application of information and knowledge, in context to family and social ties, is explored as an aspect of the three themes, considered to be a facilitator in some situations and hindered in others. A number of decisional aspects, including fatigue, along with other co-morbidities, joint and muscle pain, were also included as the barriers to physical exercising. For this reason the importance of customized guidance of this study was instrumental in providing new barrier's insight thus facilitating expectations of the efficient management of type 2 diabetes mellitus. To promote as well as facilitate the population's behavioural changes future research should be conducted to explore design interventions.

1. Quantitative Article

As stated by Captieux et al. (2018), it was conferred that self management gives a kind of confidence that is very much necessary to deal with their disease be it chronic or not. This particular article comprehended that a meta review is very much vital in this context as it can help to inform policy makers and managers of healthcare about the effectiveness of self monitoring support strategies. This study also subjects that it is significant to be noted that which interventions work best and for whom it works. There was a total of eight databases that was searched for systematic review in context to RCTs ranging from Jan'93 to Oct'16, in regards to an updation before its publication in Apr'17.

The study revealed that forward citation was subjected on the reviews of The Institute for Scientific Information (ISI) proceedings. The Revised-Assessment of Multiple Systematic Reviews (R-AMSTAR) was put into use while assessing the extracted data’s quality. Interventions in regard to self management use a variety of approaches. It can help in the control of short term glycamin in individuals with type 2 diabetes. Going further it helps in reassess the routine care on self-management in diverse culturally enriched populations. It has been subjected that the results of the study can let researchers, policymakers, and health care professionals gain knowledge of the surroundings. The concepts of implementation and sustainability are needed to be considered in further researches.

2. Quantitative Article

From the study led by Berard et al. (2020) it can be stated that Basal Insulin treatment initiation and dose titration in context to type 2 diabetes also known as (T2DM ) is frequently delayed. In this study it has been subjected that an online survey was held. An online survey ranging from Jul to Aug’15 determined the HCP and attitudes of the healthcare users in the context of Bi titration ad initiation. This study was conducted on patients with T2DM in the United States, France, including Germany. This study had conferred that there was long‐term complications risk due to "clinical inertia" and it resulted in reduced glycogenic control. Determining patient attitudes to BI initiation as well as titration considering the healthcare professional (HCP) formed the main aim of this survey. Considered patients who have been on BI form 6-36 months, contrarily have discontinued BI within the last 12 months and were greater than equal to 18 years old. As observed that 318 people were diagnosed with T2DM from the total number of 386 HCP's participants.

Greater than 75 percent of HCP's reported discussing titration at the initiation visits while only 16-28 percent of patients recalled those discussions. It was even observed that only 28-39 percent of respondents recalled the mentioning of time that is needed to reach glycaemic goals. Even many was ranging from 32-42 percent were unaware of titrating BI, as well. Many of the HCP and healthcare users subjected that more support tools are required to assist Bi titration and initiation. There were several healthcare users who indicated that provision of such support tools will increase confidence in their self titration. Important titration barriers that were identified in this study were low motivation among the patients, failure to titrate in context to symptom absence and fear of HCP's hypoglycemia. The study also revealed that the titration signified the worsening of the disease, on the other hand, identifies patients' weight gain and address the frustration of objectives associated with HbA1c. The HCPs along with patient barriers for effective BI titration refer to a gap that lies in between them. Further it was concluded that HCP-patient communication as well as providing support through educational tools helps in the optimization of the titration and improved targeted strategies.

3. Quantitative Article

As stated by Ansari et al. (2017), for diabetes patients to lead a better as well as a healthy lifestyle, the self-management associated with type 2 diabetes is to be considered as an essential part. Enhanced diabetes knowledge, overall behaviour improvement, dietary discipline as well as physical activity refer to diabetes self-management that can result in a better outcome. To achieve self-management benefits, resources integration in proper order is needed. Ansari et al. in this article have found that, a contextual chronic care model that includes the framework for resource integration supports self-management. It also includes key clinical care components. The major aim of this study was to use quantitative approach and methodology to comprehend the relationship amid illness, cultural beliefs and social support in context to the population ranging from 40-60 years of age in rural Pakistan.

The article is instrumental in indicating a fact that the contextual quantitative research that was carried put would help in self-management particularly in context to type 2 diabetes patients. This study conferred that it carried out a research that was connected to culturally associated beliefs, including the family and professional health care giver’s support. The study was subjected in rural Pakistan. From the research it was comprehended that better understanding of the appropriate determinant of behaviour was entailed at the end of the study. It was done so as it could confer the growth of interventions reflecting the needs of culture by the integration of other instruments like the 9-item Brief illness perceptions questionnaire. RSSM scale and DFSC scale was also imparted in the study as it helped the participants share their experiences and conflict related to their self management of diabetes in context to their families.

Comparison

From article 1 of Qualitative research it can be seen that healthcare users need satisfactory data/knowledge base for appropriate self-care. Self management is only possible when appropriate knowledge of the disease is adhered. In comparison the first article of quantitative study reveals that concepts of implementation and sustainability are needed in self management of diabetes. Article 2 of qualitative study subjects that DHI can improve access to DSME near social assistance and increase the breadth of stuff offered by prosperity organizations to accommodate an ever-widening range of patient needs. On the other hand quantitative article 2 concluded that HCP-patient communication as well as providing support through educational tools helps in the optimization of the titration of self monitoring strategies. The third article of qualitative study reveals that physical exercising is a very important element that is needed to be adhered by the patients of type 2 DM. On comparison it can be subjected that quantitative article 3 subjects that enhanced diabetes knowledge, overall behaviour improvement, dietary discipline as well as physical activity refer to diabetes self-management that can result in a better outcome.

It can be subjected that qualitative research was more particular in identifying barriers or issues in self monitoring of diabetes. In terms of data collection, evaluation methods, ontology, and epistemology, there is a difference between qualitative researchers. This paper subjected that qualitative research methods are used to establish the grounds for understanding the self monitoring of diabetes as well as their respective uses in research of healthcare. In this particular study, it can be seen that qualitative research is more effective.

Conclusion

In conclusion, it can be conferred that qualitative research was more effective in this regard. Based on the articles and evidences of the qualitative study it can be comprehended that the studies were more effective and showed more positive results than the qualitative studies. Qualitative research provides more useful evidence in clinical practice, health service management, or public health as it can be seen from the studies of Tewahido and Berhane, pal et al. and Laranjo et al. Thematic analysis that was used for a qualitative study that revealed that most healthcare users reported irregular self-monitoring of blood sugar. Systematic reviews also revealed very vital results in this context. However, it can be concluded that qualitative research in clinical terms is getting more appreciation in today's times.

References

Ansari, R. M., Harris, M. F., Zwar, N. A., & Hosseinzadeh, H. (2017). A Quantitative Research on Self-management of Type 2 Diabetes, DOI: 10.4172/2167-1079.1000273

Berard, L., Bonnemaire, M., Mical, M., & Edelman, S. (2018). Insights into optimal basal insulin titration in type 2 diabetes: Results of a quantitative survey. Diabetes, Obesity and Metabolism, 20(2), 301-308, https://doi.org/10.1111/dom.13064

Captieux, M., Pearce, G., Parke, H. L., Epiphaniou, E., Wild, S., Taylor, S. J., & Pinnock, H. (2018). Supported self-management for people with type 2 diabetes: a meta-review of quantitative systematic reviews. BMJ Open, 8(12), e024262, DOI: http://dx.doi.org/10.1136/bmjopen-2018-024262

Laranjo, L., Neves, A. L., Costa, A., Ribeiro, R. T., Couto, L., & Sá, A. B. (2015). Facilitators, barriers and expectations in the self-management of type 2 diabetes—a qualitative study from Portugal. European Journal of General Practice, 21(2), 103-110, DOI: https://doi.org/10.3109/13814788.2014.1000855

Pal, K., Dack, C., Ross, J., Michie, S., May, C., Stevenson, F., ... & Murray, E. (2018). Digital health interventions for adults with type 2 diabetes: Qualitative study of patient perspectives on diabetes self-management education and support. Journal of medical Internet research, 20(2), e40, DOI: 10.2196/jmir.8439.

Tewahido, D., & Berhane, Y. (2017). Self-care practices among diabetes patients in Addis Ababa: a qualitative study. PloS One, 12(1), DOI:10.1371/journal.pone.0169062

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