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      Understanding the diabetes self-care behaviour in rural areas: Perspective of patients with type 2 diabetes mellitus and healthcare professionals

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          Abstract

          Background

          Diabetes self-care behaviour plays a crucial role in managing the diabetes effectively and preventing complications. Patients with type 2 diabetes mellitus (T2DM) and health care professionals (HCPs) of rural areas often face unique challenges when it comes to diabetes self-care practices (SCPs). Therefore, this study aim to explore the perspectives of patients with T2DM and HCPs on diabetes SCPs.

          Methods

          Eight focus group discussions (FGDs) among individuals with T2DM and In-depth interviews (IDIs) with 15 HCPs were conducted in rural areas of Punjab, North India. Capability, Opportunity, Motivation, and Behaviour model (COM-B) was employed for thematic framework analyses.

          Results

          The study participants perceived that a limited understanding of diabetes mellitus (DM), beliefs in alternative therapies, drug side effects, attitudes towards DM (psychological capability), comorbidities (physical capability), family support (social opportunity), financial and time constraints, and weather conditions (physical opportunity) contributed to lack of DM SCPs. Physicians’ guidance and support were motivating them to adhere to SCPs, especially when aligned with their sense of self-efficacy ( reflective motivation). HCPs constraints in providing patient-centred care are due to training limitations (psychological capability) and a lack of essential resources (physical opportunities). Participants expressed need for comprehensive diabetes care (automatic motivation) through structured diabetes education intervention to improve diabetes SCPs.

          Conclusions

          The study findings indicate that various factors influence diabetes SCPs from the perspectives of both patients with T2DM and HCPs and emphasizes the need for a multi-faceted approach to improve diabetes SCPs in rural areas. Implementing a structured diabetes self-care intervention strategy in rural areas may help for preventing and mitigating the impact of diabetes-related complications in rural areas.

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          Most cited references51

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          Qualitative research in health care. Analysing qualitative data.

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            Social Determinants of Health and Diabetes: A Scientific Review

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              Prevalence of diabetes and prediabetes in 15 states of India: results from the ICMR–INDIAB population-based cross-sectional study

              Previous studies have not adequately captured the heterogeneous nature of the diabetes epidemic in India. The aim of the ongoing national Indian Council of Medical Research-INdia DIABetes study is to estimate the national prevalence of diabetes and prediabetes in India by estimating the prevalence by state.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: MethodologyRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SupervisionRole: ValidationRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: MethodologyRole: SoftwareRole: ValidationRole: Writing – review & editing
                Role: Formal analysisRole: InvestigationRole: ResourcesRole: SupervisionRole: ValidationRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: MethodologyRole: ResourcesRole: SupervisionRole: ValidationRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                PLOS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                8 February 2024
                2024
                : 19
                : 2
                : e0297132
                Affiliations
                [1 ] Department of Community Medicine and School of Public Health, Post-Graduate Institute of Medical Education and Research, Chandigarh, India
                [2 ] Centre for Sexuality and Health Research and Policy (C-SHaRP), Chennai, India
                [3 ] Department of Endocrinology, Post-Graduate Institute of Medical Education and Research, Chandigarh, India
                [4 ] HEAL Foundation, Chandigarh, India
                Rural Women’s Social Education Centre, INDIA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                https://orcid.org/0000-0003-4671-9144
                https://orcid.org/0000-0002-6921-9794
                https://orcid.org/0000-0001-9998-9135
                https://orcid.org/0000-0002-9375-3102
                https://orcid.org/0000-0003-2450-3115
                Article
                PONE-D-23-21411
                10.1371/journal.pone.0297132
                10852243
                38330094
                836d8752-02a7-431d-ba2f-2208992942e0
                © 2024 Gupta et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 11 July 2023
                : 28 December 2023
                Page count
                Figures: 2, Tables: 1, Pages: 21
                Funding
                Funded by: Indian Council of Medical Research – JRF/SRF Fellowship Scheme
                Award ID: 3/1/3/JRF-2016/HRD-90
                Award Recipient :
                The first (SKG) author was a recipient of Indian Council of Medical Research – JRF/SRF Fellowship Scheme [No. 3/1/3/JRF-2016/HRD-90)] for pursuing his Ph.D.. However, The ICMR-JRF/SRF scheme had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors did not receive any specific funding for this work.
                Categories
                Research Article
                Medicine and Health Sciences
                Endocrinology
                Endocrine Disorders
                Diabetes Mellitus
                Medicine and Health Sciences
                Medical Conditions
                Metabolic Disorders
                Diabetes Mellitus
                Medicine and Health Sciences
                Health Care
                Patients
                Earth Sciences
                Geography
                Geographic Areas
                Rural Areas
                Biology and Life Sciences
                Nutrition
                Diet
                Medicine and Health Sciences
                Nutrition
                Diet
                Biology and Life Sciences
                Anatomy
                Body Fluids
                Blood
                Blood Sugar
                Medicine and Health Sciences
                Anatomy
                Body Fluids
                Blood
                Blood Sugar
                Biology and Life Sciences
                Physiology
                Body Fluids
                Blood
                Blood Sugar
                Research and Analysis Methods
                Research Design
                Qualitative Studies
                Medicine and Health Sciences
                Public and Occupational Health
                Physical Activity
                Medicine and Health Sciences
                Endocrinology
                Endocrine Disorders
                Diabetes Mellitus
                Type 2 Diabetes
                Medicine and Health Sciences
                Medical Conditions
                Metabolic Disorders
                Diabetes Mellitus
                Type 2 Diabetes
                Custom metadata
                Data cannot be shared publicly because, during the informed consent process, participants did not provide permission for the public use of their data. The authors will make the anonymized data sets available for other researchers upon request, after receiving a permission from the institutional ethics committee of PGIMER, Chandigarh. Data requests can be directed to the corresponding author of the manuscript (email: mini.manmeet@ 123456gmail.com ) or to the ethics committee directly (email: iecpgi@ 123456gmail.com ).

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