Obstacles to adherence in living with type-2 diabetes: an international qualitative study using meta-ethnography (EUROBSTACLE).
Quantitative studies failed to determine variables which consistently explain adherence or non-adherence to treatment recommendations. Qualitative studies identified issues such as the quality of the health provider-health receiver relationship and the patient's health beliefs. According to these findings, 39 focus groups of 246 people living with type-2 diabetes were conducted in seven European countries, assessing health beliefs, communication with caregivers and problems encountered in adhering to treatment regimens. Meta-ethnography was later applied to make a qualitative meta-analysis. Obstacles to adherence are common across countries, and seem to be related less to issues of the health-care system and more to patient's knowledge about diabetes, beliefs and attitudes and the relationship with health-care professionals. The resulting key themes are course of diabetes, information, person and context, body awareness and relationship with the health care provider. Meta-ethnography is a feasible tool for the meta-analysis of multilingual qualitative data and leads to a richer account.
Vermeire
Etienne
E
Department of General Practice, University of Antwerp, Belgium. etienne.vermeire@ua.ac.be
Hearnshaw
Hilary
H
Rätsep
Anneli
A
Levasseur
Gwenola
G
Petek
Davorina
D
van Dam
Henk
H
van der Horst
Frans
F
Vinter-Repalust
Nevenka
N
Wens
Johan
J
Dale
Jeremy
J
Van Royen
Paul
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000884:Anthropology, Cultural / Q000379:methods; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology / Q000523:psychology* / Q000628:therapy; D005060:Europe / Q000208:ethnology; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000523:psychology*; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D011320:Primary Health Care; D036301:Qualitative Research; D011795:Surveys and Questionnaires