TY - JOUR
T1 - Lay perceptions of type 2 diabetes in Scotland
T2 - Bringing health services back in
AU - Lawton, Julia
AU - Peel, Elizabeth
AU - Parry, Odette
AU - Araoz, Gonzalo
AU - Douglas, Margaret
N1 - Funding Information:
This study was funded by the Chief Scientist Office, Scottish Executive Health Department. The research was undertaken in the Research Unit in Health, Behaviour and Change, which is jointly funded by the Scottish Executive Health Department and NHS Health Scotland. The opinions expressed in this paper are those of the authors, not necessarily those of the funding bodies. The authors would like to thank the healthcare professionals who assisted with recruitment and the patients who took part. Additional thanks goes to Margaret MacPhee for excellent secretarial support and to Nina Hallowell and Steve Plat for their constructive and helpful comments on a draft of this paper.
PY - 2004/11/17
Y1 - 2004/11/17
N2 - The growing prevalence of type 2 diabetes is placing Scottish health services under considerable strain. Consequently, diabetes services are undergoing a major process of reorganisation, including the devolvement of routine diabetes care/diabetic review from secondary to primary healthcare settings. This qualitative study was devised to explore newly diagnosed type 2 diabetes patients' perceptions of their disease and the health services they receive at a time when this restructuring of services is taking place. The sample comprised 40 patients resident in Lothian, Scotland, who had diverse experiences of services, some receiving GP-based care only, others having varying contact with hospital diabetes clinics. In-depth interviews were undertaken with patients, three times at six monthly intervals over 1 year, enabling their experiences to be tracked at critical junctures during the post-diagnostic period. Disease perceptions and health service delivery were found to be mutually informing and effecting. Not only did (different types of) health service delivery influence the ways in which patients thought about and self-managed their disease, over time patients' disease perceptions also informed their expectations of, and preferences for, diabetes services. We thus argue that there is a need for a reconceptualisation within the medical social sciences to take into account the context of healthcare and the economic/policy factors that inform health service delivery when looking at patients' disease perceptions. We also discuss the logistical and ethical challenges of drawing upon patients' perspectives, preferences and views in the design and delivery of future health services.
AB - The growing prevalence of type 2 diabetes is placing Scottish health services under considerable strain. Consequently, diabetes services are undergoing a major process of reorganisation, including the devolvement of routine diabetes care/diabetic review from secondary to primary healthcare settings. This qualitative study was devised to explore newly diagnosed type 2 diabetes patients' perceptions of their disease and the health services they receive at a time when this restructuring of services is taking place. The sample comprised 40 patients resident in Lothian, Scotland, who had diverse experiences of services, some receiving GP-based care only, others having varying contact with hospital diabetes clinics. In-depth interviews were undertaken with patients, three times at six monthly intervals over 1 year, enabling their experiences to be tracked at critical junctures during the post-diagnostic period. Disease perceptions and health service delivery were found to be mutually informing and effecting. Not only did (different types of) health service delivery influence the ways in which patients thought about and self-managed their disease, over time patients' disease perceptions also informed their expectations of, and preferences for, diabetes services. We thus argue that there is a need for a reconceptualisation within the medical social sciences to take into account the context of healthcare and the economic/policy factors that inform health service delivery when looking at patients' disease perceptions. We also discuss the logistical and ethical challenges of drawing upon patients' perspectives, preferences and views in the design and delivery of future health services.
KW - Diabetes
KW - Health service delivery
KW - Lay understandings
KW - Scotland
KW - Self-management
KW - UK
UR - http://www.scopus.com/inward/record.url?scp=12344308193&partnerID=8YFLogxK
U2 - 10.1016/j.socscimed.2004.08.013
DO - 10.1016/j.socscimed.2004.08.013
M3 - Article
C2 - 15652676
AN - SCOPUS:12344308193
SN - 0277-9536
VL - 60
SP - 1423
EP - 1435
JO - Social Science and Medicine
JF - Social Science and Medicine
IS - 7
ER -