The experiences of Chinese general practitioners in communicating with people with type 2 diabetes-a focus group study.

Publisher: BioMed Central Country of Publication: England NLM ID: 100967792 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2296 (Electronic) Linking ISSN: 14712296 NLM ISO Abbreviation: BMC Fam Pract Subsets: MEDLINE

Original Publication: London : BioMed Central, [2000-2021]

Diabetes Mellitus, Type 2*/therapy ; General Practitioners*; Adult ; Attitude of Health Personnel ; Blood Glucose ; Blood Glucose Self-Monitoring ; China ; Female ; Focus Groups ; Humans ; Male ; Qualitative Research

Background: China has more ascertained cases of diabetes than any other country. Much of the care of people with type 2 diabetes (T2DM) in China is managed by GPs and this will increase with the implementation of health care reforms aimed at strengthening China's primary health care system. Diabetes care requires effective communication between physicians and patients, yet little is known about this area in China. We aimed to explore the experiences of Chinese GPs in communicating with diabetes patients and how this may relate to communication skills training.
Methods: Focus groups with Chinese GPs were undertaken. Purposive sampling was used to recruit 15 GPs from Guangzhou city in China. All data were audio-recorded and transcribed. A thematic analysis using the Framework Method was applied to code the data and identify themes.
Results: Seven males and 8 females from 12 general practices attended 4 focus groups with a mean age of 37.6 years and 7.5 years' work experience. Four major themes were identified: diversity in diabetic patients, communication with patients, patient-doctor relationship, and communication skills training. GPs reported facing a wide variety of diabetes patients in their daily practice. They believed insufficient knowledge and misunderstanding of diabetes was common among patients. They highlighted several challenges in communicating with diabetes patients, such as insufficient consultation time, poor communication regarding blood glucose monitoring and misunderstanding the risk of complications. They used terms such as "blind spot" or "not on the same channel" to describe gaps in their patients' understanding of diabetes and its management, and cited this as a cause of ineffective patient-doctor communication. Mutual understanding of diabetes was perceived to be an important factor towards building positive patient-doctor relationships. Although GPs believed communication skills training was necessary, they reported rarely received this.
Conclusions: Chinese GPs reported facing challenges in communicating with diabetes patients. Some of these were perceived as being due to the patients themselves, others were attributed to system constraints, and some were seen as related to a lack of clinician training. The study identified key issues for the development of primary care-based management of diabetes in China, and for developing appropriate communication skills training programs for the primary care workforce.
(© 2021. The Author(s).)

BMJ. 2003 Jun 14;326(7402):1276-7. (PMID: 12805126)
Am J Med. 2013 Oct;126(10):925.e11-22. (PMID: 23810406)
Lancet. 2020 Jun 6;395(10239):1802-1812. (PMID: 32505251)
BMC Fam Pract. 2009 Jun 06;10:39. (PMID: 19500397)
J Gen Intern Med. 2012 Oct;27(10):1361-7. (PMID: 22618581)
Patient Educ Couns. 2016 Mar;99(3):364-369. (PMID: 26776708)
Med Care. 2009 Aug;47(8):826-34. (PMID: 19584762)
Lancet. 2017 Dec 9;390(10112):2584-2594. (PMID: 29231837)
Am J Manag Care. 2009 Sep;15(9):593-601. (PMID: 19747024)
Adm Policy Ment Health. 2015 Sep;42(5):533-44. (PMID: 24193818)
BMJ. 2018 Oct 26;363:k4015. (PMID: 30366963)
Patient Educ Couns. 2018 Jul;101(7):1193-1206. (PMID: 29422231)
BMC Med Res Methodol. 2013 Sep 18;13:117. (PMID: 24047204)
BMJ. 1995 Jul 29;311(7000):299-302. (PMID: 7633241)
Lancet. 2015 Oct 10;386(10002):1484-92. (PMID: 26466052)
Camb Q Healthc Ethics. 2011 Jul;20(3):458-65. (PMID: 21676333)
Chronic Illn. 2020 Mar;16(1):3-22. (PMID: 29895167)
JAMA. 2017 Jun 27;317(24):2515-2523. (PMID: 28655017)
J Gen Intern Med. 2012 Sep;27(9):1180-7. (PMID: 22549299)
Fam Med. 2019 Mar;51(3):262-270. (PMID: 30861081)
BMC Med. 2014 Oct 23;12:188. (PMID: 25338506)
Diabetes Metab Res Rev. 2019 Sep;35(6):e3158. (PMID: 30908791)
Int J Qual Health Care. 2007 Dec;19(6):349-57. (PMID: 17872937)
Circulation. 2008 Mar 18;117(11):1361-8. (PMID: 18316489)
Patient Educ Couns. 2015 Jan;98(1):3-14. (PMID: 25308954)
Diabetes Educ. 2012 May-Jun;38(3):397-408. (PMID: 22446035)
J Gen Intern Med. 2007 Apr;22(4):459-63. (PMID: 17372793)

Keywords: Communication; Experiences; General practitioner; Type 2 diabetes mellitus

0 (Blood Glucose)

Date Created: 20210719 Date Completed: 20210924 Latest Revision: 20210924

20231215

PMC8287665

10.1186/s12875-021-01506-9

34275440