Zhongguo quanke yixue (Dec 2023)
Conceptual Framework and Responding Approach of Treatment Burden of Type 2 Diabetes: a Video Recording-based Analysis
Abstract
Background Patients with type 2 diabetes commonly experience a high treatment burden. Currently, both domestic and international researches on the treatment burden of the specific diseases is still in its initial stage. Objective To summarize the conceptual framework of treatment burden related to type 2 diabetes in the Chinese population and explore proactive responding approaches for general practitioners based on video recordings of clinical consultation scenarios. Methods A retrospective analysis of video recordings from general practice training clinics in a standardized training base in Guangdong Province from 2018 to 2019 was conducted by using qualitative research methods such as observation record forms, notes from the fields, encoding-retrieval and thematic analysis, combining with existing conceptual framework of treatment burden. Results A total of 49 video recordings of doctor-patient communication about the treatment burden of type 2 diabetes were extracted from 25 video recordings. All 6 themes of the original conceptual framework were mentioned and 2 new themes (burden of medical information and drug-induced hypoglycemia) were identified by analysis that were mentioned repeatedly. A modified conceptual framework of the treatment burden of type 2 diabetes was finally developed containing 7 observable dimensions including economic, drug, medical management, lifestyle change, healthcare system, time/travel, and medical information burdens and the connotation of subtopics in each dimension. According to the analysis of the response approach, general practitioners who have received training can respond consciously to some of the treatment burdens (medications, medical information, time/travel, lifestyle change) by utilizing the skills of health education, enhanced communication, shared decision-making and motivational interviewing. Conclusion This study constructs a modified conceptual framework of treatment burden for patients with type 2 diabetes. General practitioners can consciously respond to treatment burdens of patients by using effective doctor-patient communication skills, in combination with the identification of conceptual dimensions in clinical practice.
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