A feasible diabetes management guideline for primary health care practitioners in the Free State for workplace learning
Rossouw, Maria Magdalena
MetadataShow full item record
There is overwhelming proof that the management that patients with diabetes mellitus (DM) receive in the primary health care (PHC) settings is not adequate, causing poor control of DM and resultant complications. This poor PHC setting management of DM occurs in spite of the existence of multiple guidelines produced both nationally and internationally, and which is specifically aimed at DM management. The aim of this study was to develop a feasible, primary care DM management guideline for the Free State in order to bridge the knowledge gap of PHC practitioners and consequently improve DM management. The four objectives of this study were thus defined as doing a comparative study of current national and international DM management guidelines and trends; analysing the Adult Primary Care 2016/2017 (APC 2016/2017) its quality; studying the elements of what equates to a feasible PHC setting management guideline; and finally developing a feasible, new DM guideline by synthesizing all of the collected and analysed data. The study was designed as a desktop study with four distinct phases, each linked to a study objective. Phase I encompassed the comparative analysis of the major, referenced national and international DM management guidelines with the APC 2016/2017. Phase II entailed the evaluation of the quality of the APC 2016/2017 two tools as applied by four independent assessors. Phase III consisted of a literature review to contextualise the qualities and characteristics inherent in feasible PHC setting guidelines. In Phase IV of the study, the new management guideline was developed by synthesizing all of the data gathered in the first phases. The newly developed DM management guideline improved on the content of the APC 2016/2017 international and national DM guidelines. A concerted effort was made to enhance the feasibility of the new guideline by incorporating the features inherent in feasible guidelines, especially in terms of ease of use, incorporation of multi-morbid conditions, and clarity of presentation. The end-product of this study is a new DM management guideline, aimed at patients in the PHC setting in the Free State, which contains the features that should enhance its feasibility in this setting. Due to the known application of guidelines as tools for workplace learning, this new guideline was designed to be used as an educational tool during workplace learning and training sessions. Uptake of the new guideline in the PHC setting by means of a pilot study and implementation will improve the knowledge and confidence of PHC practitioners in the Free State. This improvement in DM knowledge will, in turn, have a positive impact on the management and general health of patients with DM in the Free State PHC setting.