학술논문
Social Support for Self-Care: Patient Strategies for Managing Diabetes and Hypertension in Rural Uganda.
Document Type
Academic Journal
Author
Tusubira AK; Uganda Initiative for Integrated Management of Non-Communicable Diseases, Kampala, Uganda.; Nalwadda CK; Department of Community Health and Behavioural Sciences, Makerere University, College of Health Sciences, Kampala, Uganda.; Akiteng AR; Uganda Initiative for Integrated Management of Non-Communicable Diseases, Kampala, Uganda.; Hsieh E; Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.; Yale Network for Global Non-Communicable Diseases, Yale University, New Haven, CT, USA.; Ngaruiya C; Yale Network for Global Non-Communicable Diseases, Yale University, New Haven, CT, USA.; Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, USA.; Rabin TL; Uganda Initiative for Integrated Management of Non-Communicable Diseases, Kampala, Uganda.; Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.; Yale Network for Global Non-Communicable Diseases, Yale University, New Haven, CT, USA.; Katahoire A; Child Health and Development Centre, Makerere University, Kampala, Uganda.; Hawley NL; Yale Network for Global Non-Communicable Diseases, Yale University, New Haven, CT, USA.; Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA.; Kalyesubula R; Departments of Physiology and Internal Medicine, Makerere College of Health Sciences, Kampala, Uganda.; African Community Center for Social Sustainability (ACCESS), Nakaseke, Uganda.; Ssinabulya I; Uganda Initiative for Integrated Management of Non-Communicable Diseases, Kampala, Uganda.; Uganda Heart Institute, Mulago Hospital Complex, Kampala, Uganda.; Department of Internal Medicine, Makerere College of Health Sciences, Kampala, Uganda.; Schwartz JI; Uganda Initiative for Integrated Management of Non-Communicable Diseases, Kampala, Uganda.; Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.; Yale Network for Global Non-Communicable Diseases, Yale University, New Haven, CT, USA.; Armstrong-Hough M; Department of Social & Behavioral Sciences, School of Global Public Health, New York University, New York, NY, USA.; Department of Epidemiology, School of Global Public Health, New York University, New York, NY USA.
Source
Publisher: Ubiquity Press Country of Publication: United States NLM ID: 101620864 Publication Model: eCollection Cited Medium: Internet ISSN: 2214-9996 (Electronic) Linking ISSN: 22149996 NLM ISO Abbreviation: Ann Glob Health Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Low-income countries suffer a growing burden of non-communicable diseases (NCDs). Self-care practices are crucial for successfully managing NCDs to prevent complications. However, little is known about how patients practice self-care in resource-limited settings.
Objective: We sought to understand self-care efforts and their facilitators among patients with diabetes and hypertension in rural Uganda.
Methods: Between April and June 2019, we conducted a cross-sectional qualitative study among adult patients from outpatient NCD clinics at three health facilities in Uganda. We conducted in-depth interviews exploring self-care practices for hypertension and/or diabetes and used content analysis to identify emergent themes.
Results: Nineteen patients participated. Patients said they preferred conventional medicines as their first resort, but often used traditional medicines to mitigate the impact of inconsistent access to prescribed medicines or as a supplement to those medicines. Patients adopted a wide range of vernacular practices to supplement treatment or replace unavailable diagnostic tests, such as tasting urine to gauge blood-sugar level. Finally, patients sought and received both instrumental and emotional support for self-care activities from networks of family and peers. Patients saw their children as their most reliable source of support facilitating self-care, especially as a source of money for medicines, transport and home necessities.
Conclusion: Patients valued conventional medicines but engaged in varied self-care practices. They depended upon networks of social support from family and peers to facilitate self-care. Interventions to improve self-care may be more effective if they improve access to prescribed medicines and engage or enhance patients' social support networks.
Competing Interests: The authors have no competing interests to declare.
(Copyright: © 2021 The Author(s).)
Objective: We sought to understand self-care efforts and their facilitators among patients with diabetes and hypertension in rural Uganda.
Methods: Between April and June 2019, we conducted a cross-sectional qualitative study among adult patients from outpatient NCD clinics at three health facilities in Uganda. We conducted in-depth interviews exploring self-care practices for hypertension and/or diabetes and used content analysis to identify emergent themes.
Results: Nineteen patients participated. Patients said they preferred conventional medicines as their first resort, but often used traditional medicines to mitigate the impact of inconsistent access to prescribed medicines or as a supplement to those medicines. Patients adopted a wide range of vernacular practices to supplement treatment or replace unavailable diagnostic tests, such as tasting urine to gauge blood-sugar level. Finally, patients sought and received both instrumental and emotional support for self-care activities from networks of family and peers. Patients saw their children as their most reliable source of support facilitating self-care, especially as a source of money for medicines, transport and home necessities.
Conclusion: Patients valued conventional medicines but engaged in varied self-care practices. They depended upon networks of social support from family and peers to facilitate self-care. Interventions to improve self-care may be more effective if they improve access to prescribed medicines and engage or enhance patients' social support networks.
Competing Interests: The authors have no competing interests to declare.
(Copyright: © 2021 The Author(s).)