title: What follow-up care and self-management support do patients with type 2 diabetes want after their first acute coronary event? A qualitative study.
abstract: OBJECTIVE
  Despite diabetes patients' efforts to control their disease, many of them are confronted with an acute coronary event. This may evoke depressive feelings and self-management may be complicated. According to the American Diabetes Association, the transition from hospital to home after an acute coronary event (ACE) is a high-risk time for diabetes patients; it should be improved. Before developing an intervention for diabetes patients with an ACE in the period after discharge from hospital, we want to gain a detailed understanding of patients' views, perceptions and feelings in this respect.
  
  
  METHODS
  Qualitative design. Two semi-structured focus groups were conducted with 14 T2DM patients (71% male, aged 61-77 years) with a recent ACE. One focus group with partners (67% male, aged 64-75 years) was held. All interviews were transcribed verbatim and analyzed by two independent researchers.
  
  
  RESULTS
  Patients believed that coping with an ACE differs between patients with and without T2DM. They had problems with physical exercise, sexuality and pharmacotherapy. Patients and partners were neither satisfied with the amount of information, especially on the combination of T2DM and ACE, nor with the support offered by healthcare professionals after discharge. Participants would appreciate tailored self-management support after discharge from hospital.
  
  
  CONCLUSIONS
  Patients with T2DM and their partners lack tailored support after a first ACE. Our findings underpin the ADA recommendations to improve the transition from hospital to home. The results of our study will help to determine the exact content of a self-management support program delivered at home to help this specific group of patients to cope with both conditions.
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands. Electronic address: m.j.kasteleyn@umcutrecht.nl.
authors.forename: Marise J
authors.initials: MJ
authors.lastname: Kasteleyn
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.
authors.forename: Kees J
authors.initials: KJ
authors.lastname: Gorter
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands.
authors.forename: Anne L
authors.initials: AL
authors.lastname: van Puffelen
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands.
authors.forename: Monique
authors.initials: M
authors.lastname: Heijmans
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.
authors.forename: Rimke C
authors.initials: RC
authors.lastname: Vos
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.
authors.forename: Hanneke
authors.initials: H
authors.lastname: Jansen
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.
authors.forename: Guy E H M
authors.initials: GE
authors.lastname: Rutten
mesh_terms: D022126:Access to Information; D000223:Adaptation, Psychological; D000368:Aged; D003327:Coronary Disease / Q000175:diagnosis / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D017281:Cost of Illness; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005260:Female; D017144:Focus Groups; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006699:Home Care Services; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009426:Netherlands; D017060:Patient Satisfaction; D010361:Patients / Q000523:psychology*; D010465:Perception; D036301:Qualitative Research; D012648:Self Care; D018454:Spouses / Q000523:psychology; D013997:Time Factors
keywords: Acute coronary event; Focus group; Hospital discharge; Patients’ perspectives; Type 2 diabetes