Structured care of diabetes in general practice: a qualitative study of the barriers and facilitators.
This qualitative study explored general practitioner's and practice nurse's perceptions of barriers and facilitators to the proposed transfer of diabetes care to general practice. Qualitative data were collected through five focus groups. Participants included GPs (n = 55) and practice nurses (n = 11) representing urban (44%), rural (29%) and mixed (27%) practices, in the Irish Mid-West region. Barriers and facilitators were mentioned 631 times (100%). Barriers were mentioned 461 times (73%), facilitators 170 times (27%). The most frequently identified barriers were lack of financial incentive (119/631; 19%), lack of access to secondary resources (93/631; 15%), lack of staff and increased workload (59/631; 9%) and time constraints (52/631; 8%). Identified facilitators were access to secondary care (49/631;7.8%), the holistic nature of general practice and continuity of care (48/631;7.6%). Although many are enthusiastic, there remains significant reluctance among GPs and practice nurses to take responsibility for diabetes care without addressing these barriers.
Graduate Entry Medical School, Mid-West Specialist Training Programme in General Practice, University of Limerick, Limerick. rocthedoc@eircom.net
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O'Connor
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Mannix
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Mullen
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Powys
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Mannion
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HA
Nolan
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Kearney
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Cullen
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Griffin
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Saunders
D000328:Adult; D000368:Aged; D003920:Diabetes Mellitus / Q000628:therapy*; D005260:Female; D017144:Focus Groups; D058006:General Practice / Q000458:organization & administration*; D058005:General Practitioners / Q000523:psychology* / Q000706:statistics & numerical data; D006295:Health Resources / Q000706:statistics & numerical data; D006801:Humans; D007494:Ireland; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009726:Nurses / Q000523:psychology* / Q000706:statistics & numerical data; D036301:Qualitative Research; D011785:Quality Assurance, Health Care / Q000191:economics / Q000592:standards; D012424:Rural Population; D011795:Surveys and Questionnaires; D013997:Time Factors; D014505:Urban Population; D016526:Workload / Q000706:statistics & numerical data