6.3.1 Doctor-Patient interaction
This study also found that the relationships between people with diabetes and their Health Care Professionals appeared to influence the ways in which people with diabetes made sense of their diabetes and the associated risk. For example, was aspect of this was the ways in which they received the information given to them and how they digested the information:
“We have had a lot of different consultants at the hospital. Obviously you get on with some and you don’t get on with others. I personally think it
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depends on how it is put across to me and whether I actually like the person, not a good thing but you know. I think you need that relationship definitely with either your diabetes nurse or whoever it is.” (Claire, 45, White British, R3)
Older participants appeared to be more concerned regarding their signs and symptoms and appeared to count more on their GPs to explain it for them:
“I would take the advice of the doctors. They know more than I do about it. I have got so many things wrong with me. I have got coronary heart disease, arthritis and diabetes so I don’t know which symptoms apply to which illness.” (Gareth, 86, White British, R0)
It was also the case that those people with diabetes who reported having good relationships with their GPs suggested that this facilitated access to those services involved in their diabetes management:
“I do think that we have been spoiled really because we have got a good relationship with our doctor and the nurse and we have never had any problems and if I was worried that my sugar was very high I would ring them up and just have a chat with them and they will talk to me and yes I think we are very lucky.” (Jane, 82, White British, R0)
6.3.2 Diabetes education
People with diabetes who had attended diabetes education courses appeared to have changed their attitudes towards their diabetes and had become more aware of the risks associated with diabetic complications:
“Well it’s still there but it is not as bad as it was it somehow seems to have retracted naturally because I was going to have laser treatment and it was all about the control of my diabetes. My diabetes was running too high. I
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went on a diabetes course and they helped me to control my sugar levels a lot better.” (Kumar, 57, South Asian, R2)
Diabetes education appeared to have encouraged people with diabetes to think more about their diabetes management and encouraged people with diabetes to control their blood glucose:
“He told me straight really, he told me to alter my diet, life style, he said if you want to drink, you can have a drink, if you want fish and chips or curry, have them but in moderation, if you want chocolate have one but in moderation and it seems it did the trick, yea he is really very good GP.” (Allen, 45, White British, R0)
It was also apparent that such health education sessions and receiving educational materials appeared to influence people’s understanding of diabetes and could lead to improvements in their diabetes self-management:
“Complications can happen over that one year. Yes we were always told that there are complications obviously with the kidneys, with the eyes, we were always told that, yes. I think that comes when you read any leaflet about diabetes, you know that just comes with diabetes and you have to do something about it.” (Claire, 45, White British, R3)
“I do know a little bit about it. I have read a little bit. It causes blindness, I would sort of do anything that I was told to do.” (George, 70, White British, R1)
6.3.3 Existence of visible symptoms or eye complications
There was also evidence that people with diabetes’s experience of diabetes
complications appeared to influence reported behavioural change:
“I mean personally I keep a very stringent eye on my diabetes anyway especially having so many bleeds at the back of my eye where I have
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ended up having laser treatment on it, so I am doing blood tests quite a few times during the day just to make sure everything is stable.” (Keith, 59, White British, R3)
This was in comparison to some of the symptomless people with diabetes who demonstrated less self-motivation regarding making changes to their diabetes self-management:
“If I was diagnosed with it, probably would've changed. We are human beings, you know, once I have not been diagnosed with it, probably none of us may go and read about it until we have been diagnosed with it.” (Abdulla, 47, South Asian, R0)
These data indicate that there were several factors that appeared to influence the perception of risk among people with type 2 diabetes. These included good Health Care Professional-patient relationship, diabetes education, and the presence of existing visible eye symptoms or eye complications or loss in visual acuity. The perceived relationship between people with diabetes and their Health Care Professionals appeared to influence the ways in which people with diabetes received the information given to them and facilitated the ways in which they understand the information. Good relationships with their GPs facilitated access to those services involved in their diabetes management. Older participants appeared to be more worried regarding their signs and symptoms and appeared to depend on their GPs to explain it for them. People with diabetes who had attended diabetes education courses appeared to have changed their attitudes towards their diabetes and had become more aware of the risks associated with diabetic complications. Furthermore, diabetes education appeared to encourage people with diabetes to think more about their diabetes management and encouraged people with diabetes to control their blood glucose. Health education sessions and receiving educational materials
appeared to influence people’s understanding of diabetes and could lead to
improvements in their diabetes self-management. There was also evidence that diabetes complications appeared to influence reported behavioural change.
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This was in comparison to some of the symptomless participants who demonstrated less self-motivation regarding making changes to their diabetes self-management.