Perceptions of a service redesign by adults living with type 2 diabetes.
OBJECTIVE
This article is a report of a study conducted to explore the perceptions of adults with type 2 diabetes towards the service redesign.


BACKGROUND
Diabetes is reaching epidemic proportions and the management of this chronic illness is changing in response to this challenge. In the United Kingdom, there is ongoing restructuring of healthcare services for people with chronic illnesses to ensure that their general health and clinical needs are met predominantly in primary care.


METHODS
An explorative qualitative approach was used. Eight focus groups were conducted with 35 people with type 2 diabetes in one urban location between 2003 and 2004. Five focus groups were conducted with people who had recently experienced the restructured service and three groups with people who had up to 2 years' experience of the new service. Concurrent data collection and thematic analysis were conducted by three researchers and credibility and verification sought by feedback to participants.


RESULTS
Five main themes were identified: impact of living with diabetes; understanding diabetes; drivers for organizational change; care in context and individual concerns. Participants identified issues for ongoing development of the service.


CONCLUSIONS
People with type 2 diabetes appreciate their care management within the primary care setting where there has been investment in staff to deliver this care. Healthcare resources are required to support the development of staff and the necessary infrastructure to undertake management in primary care. Policy makers need to address the balance of resources between primary and secondary care.
McDowell
Joan R S
JR
Division of Nursing & Health Care, University of Glasgow, UK. j.r.mcdowell@clinmed.gla.ac.uk
McPhail
Kathryn
K
Halyburton
Gillian
G
Brown
Malcolm
M
Lindsay
Grace
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003153:Community Health Services / Q000458:organization & administration*; D003695:Delivery of Health Care / Q000458:organization & administration; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D006302:Health Services Research / Q000458:organization & administration; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000592:standards; D017060:Patient Satisfaction; D011320:Primary Health Care / Q000458:organization & administration; D011787:Quality of Health Care / Q000458:organization & administration*; D006113:United Kingdom; D055815:Young Adult