Diabetes service provision: a qualitative study of newly diagnosed Type 2 diabetes patients' experiences and views.
OBJECTIVE
To explore newly diagnosed Type 2 diabetes patients' views about Scottish diabetes services at a time when these services are undergoing a major reorganization. To provide recommendations to maximize opportunities brought by the devolvement of services from secondary to primary healthcare settings.


METHODS
Qualitative panel study with 40 patients newly diagnosed with Type 2 diabetes, recruited from hospital clinics and general practices in Lothian, Scotland. Patients were interviewed three times over 1 year. The study was informed by grounded theory, which involves concurrent data collection and analysis.


RESULTS
Patients were generally satisfied with diabetes services irrespective of the types of care received. Most wanted their future care/review to be based in general practice for reasons of convenience and accessibility, although they disliked it when appointments were scheduled for different days. Many said they lacked the knowledge/confidence to know how to manage their diabetes in particular situations, and needed access to healthcare professionals who could answer their questions promptly. Patients expressed a need for primary care professionals who had diabetes expertise, but who had more time and were more accessible than general practitioners. Patients who had encountered practice lead nurses for diabetes spoke particularly positively of these professionals.


CONCLUSIONS
Nurses with diabetes training are particularly well placed to provide information and support to patients in primary care. Ideally, practices should run 'one-stop' diabetes clinics to provide structured care, with easily accessible dietetics, podiatry and retinopathy screening. Newly diagnosed patients may benefit from being made more aware of specific services provided by charitable organizations such as Diabetes UK.
Lawton
J
J
Research Unit in Health, Behaviour and Change, School of Clinical Sciences and Community Health, The University of Edinburgh, Edinburgh, UK. j.lawton@ed.ac.uk
Parry
O
O
Peel
E
E
Douglas
M
M
D000328:Adult; D000368:Aged; D001071:Appointments and Schedules; D001294:Attitude to Health; D003695:Delivery of Health Care / Q000379:methods*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000523:psychology*; D005194:Family Practice; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D009722:Nurse Practitioners; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D011369:Professional-Patient Relations; D012606:Scotland / Q000453:epidemiology