AIMS AND OBJECTIVES To explore patient and healthcare provider (HCP) perspectives about patients' barriers to the performance of diabetic self-care behaviours in Ghana. BACKGROUND Sub-Saharan African urban populations are increasingly affected by type 2 diabetes due to nutrition transition, sedentary lifestyles and ageing. Diabetic self-care is critical to improving clinical outcomes. However, little is known about barriers to diabetic self-care (diet, exercise, medication taking, self-monitoring of blood glucose and foot care) in sub-Saharan Africa. DESIGN Qualitative study that followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. METHODS Semi-structured interviews were conducted among 23 people living with type 2 diabetes and 14 HCPs recruited from the diabetes clinics of three hospitals in Tamale, Ghana. Interviews were audiotaped and transcribed verbatim. The constant comparative method of data analysis was used and identified themes classified according to constructs of the theory of planned behaviour (TPB): attitudes/behavioural beliefs, subjective norms and perceived behavioural control. RESULTS Barriers relating to attitudes included misconceptions that diabetes was caused by spiritual forces or curses, use of herbal medicines, intentional nonadherence, difficulty changing old habits, and feeling or lacking motivation to exercise. Barriers relating to subjective norms were inadequate family support, social stigma (usually by spouses and other members of the community) and cultural beliefs. Perceived behavioural control barriers were poor income levels, lack of glucometers, busy work schedules, long distance to the hospital and inadequate access to variety of foods due to erratic supply of foods or seasonality. CONCLUSIONS Both patients and HCPs discussed similar barriers and those relating to attitude and behavioural control were commonly discussed. RELEVANCE TO CLINICAL PRACTICE Interventions to improve adherence to diabetic self-care should focus on helping persons with diabetes develop favourable attitudes and how to overcome behavioural control barriers. Such interventions should have both individualised and community-wide approaches.

中文翻译：

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糖尿病自我护理的障碍：对患者和医疗服务提供者观点的定性研究。

目的和目标探讨患者和医疗服务提供者（HCP）关于加纳患者糖尿病自我护理行为障碍的观点。背景技术由于营养过渡，久坐的生活方式和老龄化，撒哈拉以南非洲城市人口越来越受到2型糖尿病的影响。糖尿病自我护理对改善临床结果至关重要。然而，在撒哈拉以南非洲，关于糖尿病自我护理（饮食，运动，服药，自我监测血糖和足部护理）的障碍知之甚少。遵循《综合报告定性研究标准》（COREQ）准则的“设计”定性研究。方法对塔马利州三家医院的糖尿病诊所招募的23位2型糖尿病患者和14位HCP进行了半结构化访谈。加纳。采访录音和逐字记录。使用了数据分析的持续比较方法，并根据计划行为理论（TPB）的结构确定了主题：态度/行为信念，主观规范和感知的行为控制。结果与态度有关的障碍包括误解，认为糖尿病是由精神力量或诅咒，使用草药，故意不坚持，难以改变旧习惯以及感觉或缺乏运动动机引起的。与主观规范有关的障碍是家庭支持不足，社会污名（通常由配偶和社区其他成员）和文化信仰。可以理解的行为控制障碍包括收入水平低，血糖仪不足，工作日程繁忙，由于食物供应不稳定或季节性不足，因此到医院的距离太远并且无法获得各种食物。结论患者和HCP都讨论了类似的障碍，并且通常讨论了与态度和行为控制有关的障碍。与临床实践的关系改善对糖尿病自我护理依从性的干预措施应侧重于帮助糖尿病患者养成良好的态度以及如何克服行为控制障碍。此类干预措施应采用个体化方法和社区范围的方法。与临床实践的关系改善对糖尿病自我护理依从性的干预措施应侧重于帮助糖尿病患者养成良好的态度以及如何克服行为控制障碍。此类干预措施应采用个体化方法和社区范围的方法。与临床实践的关系改善对糖尿病自我护理依从性的干预措施应侧重于帮助糖尿病患者养成良好的态度以及如何克服行为控制障碍。此类干预措施应采用个体化方法和社区范围的方法。