The experiences of patients with diabetes and strategies for their management during the first COVID-19 lockdown: a qualitative study.

BACKGROUND: During the pandemic, primary care systems prioritised attention to COVID-19 patients; chronically ill patients, such as people with Type 2 Diabetes were obliged to take more responsibility for their own care. We aimed to analyse the experiences of patients with Type 2 Diabetes Mellitus during the stay-at-home order that was in place during the first wave of the COVID-19 pandemic and identify the strategies and resources used in managing their care. METHOD: We conducted a qualitative descriptive study. The participants were ten patients with type 2 Diabetes Mellitus who experienced strict lockdown during the first wave of the COVID-19 pandemic in Catalonia, Spain, selected using intentional sampling. We recorded semi-structured interviews with the participants and conducted thematic analysis. RESULTS: We identified 14 subthemes, which we then grouped into three overarching themes: 1) anxiety, fear, and vulnerability (anxiety, fear, vulnerability, rethinking life, loneliness, sadness), 2) insufficient diabetes monitoring by the health system (health care received, glycaemic control, view of treatment by health providers) and proactive self-care (changes in daily routine, diet, physical activity, medication, personal protective equipment & social distancing). CONCLUSION: Despite the exceptional nature of the situation and the stress, worry, and changes in their daily lives, many respondents reported that they had successfully modified their lifestyles. Self-care was effective during confinement and was based on a process of adaptation using the resources available, without face-to-face contact with primary care health staff. RELEVANCE TO CLINICAL PRACTICE: These results can help to guide the design and implementation of self-care-focused strategies and also to explore new ways of empowering patients without access to health care personnel.

Physical Activity Interventions in People with Diabetes: A Systematic Review of The Qualitative Evidence.

OBJECTIVES: The aim of this systematic review is to summarize the results of qualitative research into people with type 2 diabetes mellitus (T2DM) and their propensity to engage in physical activity (PA), and to identify and analyse their experiences and opinions of interventions and programs designed to increase their adherence to PA recommendations. DESIGN: Systematic review of qualitative studies extracted from databases using the SPIDER systematic search method. The review included studies that combined qualitative and mixed methods research and compiled the experiences and opinions of people with T2DM who had participated in interventions to increase their levels of PA. A thematic summary of qualitative data was performed. RESULTS: The review comprised nine studies published between 2017 and 2021, which included 170 people. Four themes and ten subthemes were identified. The four themes include: (1) factors related to PA, (2) factors related to the program, (3) factors related to the support the participants received and (4) factors related to the person. CONCLUSION: The support patients receive, both from family/friends and from health providers, is key to consolidating changes in habits and in promoting individualized health education. Future interventions and health policies should reinforce programs designed to promote PA that prioritize the experiences of people in order to increase their adherence to PA programs.

Affective-Sexual Behaviors in Youth: Analysis of a Public Health Survey in the School Setting.

INTRODUCTION: Adolescence is a critical period for the development of affectivity and sexuality. Adolescents begin to explore their sexual identities, form intimate relationships, and learn to manage their emotions in new and complex contexts. This study aims to analyze the prevalence of habits and behaviors related to the affective-sexual health of adolescents in the fourth year of ESO, identifying risk factors, comparing their behaviors and risks, monitoring these behaviors, analyzing their pornography consumption, and evaluating the use of the internet as a source of sexual information. METHOD: Descriptive cross-sectional study using questionnaires. Participants are fourth-year ESO students from a school in the Baix Llobregat province (Catalonia), aged between 14 and 18 years. Descriptive and bivariate statistical analyses are conducted using the chi-square test and p-value calculations with the R Project software. Frequency and percentage analyses are also used to describe the health behaviors of the participants. RESULTS: The study reveals that girls have better knowledge of the contraceptive pill and male condom than boys. Sexual initiation and condom use management vary between the genders, with girls being more capable of persuading their partners to use them. Pornography consumption also shows significant differences in terms of the age of initiation and frequency between boys and girls. CONCLUSIONS: This study on adolescent affectivity and sexuality reveals knowledge about contraceptives, early sexual initiation, and high pornography consumption, highlighting the need for early and diverse affective-sexual education, youth empowerment, and media misinformation management to promote safer and healthier behaviors within municipal public health.

Successful Practices in Performing and Maintaining Physical Activity in Adults with Type 2 Diabetes Mellitus: A Qualitative Study.

Physical activity has proven to be greatly beneficial in patients with DM2. However, few adhere to physical activity recommendations and are motivated to engage in regular physical activity and the numerous interventions conducted to change their habits tend to be unsuccessful in the long term. The objective in this research is to study patients who adhere to physical activity in order to guide patients who have not succeeded in making this change, assisted by the successful tools in the context of community nursing. A qualitative descriptive study was conducted. The sample included 10 patients with type 2 diabetes mellitus who adhered to physical activity in Catalonia, Spain, having been selected using intentional sampling. We recorded semi-structured interviews with the participants and conducted a thematic analysis. Five categories were identified and grouped into two themes: (1) Integrate physical activity as a lifestyle (meaning of DM2 and physical activity, adaptation to change and strategies on a day-to-day basis, physical activity) and (2) Find support to change physical activity (company and personal motivational strategies). In conclusion, a good adherence to physical activity was achieved thanks to motivation maintained over time related to autonomous motivation and the psychological and physiological benefits that physical activity provides patients, external support and encouragement, and the allocation of time to adhere without making great lifestyle changes.

Barriers and Facilitators for Physical Activity in Adults with Type 2 Diabetes Mellitus: A Scoping Review.

The treatment of Type 2 Diabetes Mellitus (DM2) comprises physical activity (PA), diet, and medication. PA provides important benefits for people with diabetes. However, the majority of patients with DM2 do not attain the recommended levels of PA. Despite the evidence of the benefits to health of engaging in PA, the recommendations have not been fully translated into clinical improvements. Using a scoping review, this study aimed to identify the factors that influence levels of physical activity in adults with DM2. Eighteen studies published from 2009-2020 were identified by a search of relevant systematic databases between March 2019 and December 2020. The scoping review was carried out in accordance with the model defined by Arksey and O'Malley. The synthesis revelated sociodemographic characteristics, and six components-personal, motivation, social, mental, clinical, and self-efficacy-were identified as factors. Those that were most frequently identified were motivation and social support. In conclusion, these results should be considered to implement strategies to encourage people with DM2 to engage in physical exercise and thus improve the management of their condition.