The Needs for effective communication to support self management for reducing blood glucose in type 2 diabetes patients with hypertension

Abstract

This qualitative research aimed to explore patients’ self-perception and communication needs, and to identify mutual goal setting between patients and nurses. The key informants consisted of two nurses working in a diabetes clinic and 20 patients with type 2 diabetes and comorbid hypertension were: aged 35–65 years, having HbA1c > 7%, and being able to perform daily self-care activities independently. Data were collected via focus group interview using a semi‑structured interview guide. The instruments were validated by 3 experts, with an Item-Objective Congruence (IOC) index ranging from .67 to 1.00 Data was analyzed using content analysis and descriptive statistics.

The findings revealed eight themes regarding patients’ self-perception: 1) perceiving diabetes as more severe than hypertension, thus requiring greater caution; 2) practicing intermittent self-management primarily to avoid blame and medication escalation; 3) believing that daily living activities constitute sufficient exercise; 4) prioritizing diet as the most critical factor; 5) identifying hunger and food cravings as major barriers to self-control; 6) lacking practical nutritional knowledge for daily application; 7) lacking clear goals and motivation for self-care; and 8) viewing health as a personal responsibility and declining family assistance to avoid being a burden. Regarding support and communication needs, five themes emerged: 1) need for educational support and a handbook as a memory aid; 2) preference for small group learning in a non-threatening atmosphere using simple, practical language;3) content focusing on diet, medication, and exercise; 4) tangible instructional media; and 5) continuous education during follow-up visits. The mutual goal established between patients and nurses was the reduction of blood sugar levels.