Examining policy implementation for type 2 diabetes: exploring barriers and enablers associated with uptake of structured patient education

Lawal, Muili (2015) Examining policy implementation for type 2 diabetes: exploring barriers and enablers associated with uptake of structured patient education. Doctoral thesis, University of West London.


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Background: Diabetes remains an incurable disease and as the search for a
cure continues, the need to minimise complications and enhance the quality of
life of patients is essential. A key UK policy initiative in the management of
diabetes is empowerment through education. However, implementation of policy
in the context of healthcare delivery in general may be challenging at times and
the provision and uptake of diabetes education is not an exception.
Aims: This thesis aims to examine the barriers and enhancing factors that are
associated with the uptake of structured patient education for patients newly
diagnosed with type 2 diabetes.
Methods: The study used a sequential mixed methods approach. The data
were collected using a focus group and face-to-face individual interviews of
multiprofessionals delivering the education, a questionnaire/survey of patients and
individual face-to-face interviews of referring practitioners working in GP
surgeries within a PCT.
Findings: Factors influencing non-attendance at diabetes education centres
relate to barriers associated with the patients, practitioners and government
regulations. The patients were affected by their healthcare beliefs and personal circumstances such as work patterns, childcare problems, forgetfulness, bad
weather and ill health. The practitioners’ barriers were mainly around patient
versus practitioner communication, inter-professional collaboration and
administrative protocols. The barriers associated with the government directives
relate to government regulations and funding issues. In contrast to barriers, the
predictors of attendance are personal motivation, individual perceptions and
beliefs coupled with the guidance given by the practitioners. Whilst it may be
difficult to avoid non-attendance completely, positive steps to reduce nonattendance
include enhanced communication, a positive pay-for-performance
system and adequate support to develop a positive attitude towards diabetes
Conclusion: The results indicate that barriers to attendance are multifactorial
and complex; therefore, response to improve uptake requires diverse

Item Type: Thesis (Doctoral)
Subjects: Education
Medicine and health > Primary health
Depositing User: Marzena Dybkowska
Date Deposited: 17 Sep 2015 12:14
Last Modified: 24 Oct 2016 14:10
URI: http://repository.uwl.ac.uk/id/eprint/1272


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