The requirement to respect autonomy - The Royal New Zealand ...

ORIGINAL SCIENTIFIC PAPErSquantitative researchommended for people for type 2 diabetes and therole it plays in management of blood glucose.Qualitative responses from patients on the questionnairesuggested more information was wantedabout food and diet. One way of providing thiseducation would be to offer group educationsessions particularly as we have shown only aminority of patients access a dietician. Groupeducation has been shown to be effective inreducing HbA1c, weight and blood pressure andincreasing exercise rates. 20,21,22 In our survey therewas a small group of 36 people who indicatedthat they would prefer group sessions, with anadditional 58 people saying they would be happyto attend. However, the majority of respondents(57%) said they would not want to attend groupsessions. Perhaps by offering group sessions as anoption to newly diagnosed patients we can reachsome of the people who are currently missingWe believe this is important in that it may notonly help the person with diabetes obtain bettercontrol, but also influence other family membersto make some lifestyle changes and reduce theirown risk of developing diabetes.Strengths of this study were that it recordedpatients’ experiences of the health care systemand information was collected from a populationbasedsample of patients who were diagnosedwithin the same year. A weakness is that therewas only a 50% response rate and for ethnicminority groups this was even lower. We tried toensure a more representative sample of Maori byusing the services of the Maori Health Unit totelephone Maori non-responders and, to a certainextent, this strategy was successful, althoughwe only achieved a 39% response rate. The lowresponse rate may be because Maori can be moremobile and so addresses and telephone numbersPerhaps by offering group sessions as an option to newly diagnosedpatients we can reach some of the people who are currently missingout; however group sessions would need to be implemented withseveral factors in mind, such as location, cost and timingout; however group sessions would need to beimplemented with several factors in mind, suchas location, cost and timing. Many of the peoplesurveyed still work and may be unable to attendday sessions. Some people also mentioned cost asa factor, saying they would only attend if it wasfree, with others saying they would be happy topay a small fee. Almost everyone who expressedinterest in group sessions said location was themost important factor, with people not willingto travel long distances. Anyone considering theintroduction of group education sessions shouldtake into account patient preferences.Including spouse/family/whanau was consideredvery important by some people, and even thosewho said they did not want their family includedoften said that they had shared their information.Giving people the option of bringing theirspouse/family/whanau with them to medicalappointments can help educate the entire family.are less reliable when trying to contact patients.The initial response rate from the Asian, Indianand Pacific populations was also disappointing.When following up on the non-responders bytelephone, one of the major obstacles encounteredwas the language barrier. This was mainly anissue with the patients who were Asian, althoughit was also encountered with some of the Indianand Pacific patients. Several of the Asian patientscontacted spoke very little or no English anddid not understand the purpose of the call. Ofthe people who did understand, all but one werereluctant to return the survey. Two of the peoplewho declined cited language barriers as thereason for not wanting to return the survey. Thislanguage barrier could also result in a decreasedunderstanding of the education provided aboutdiabetes and could in turn lead to decreasedcontrol of their diabetes. A study of Asian/Indian health in New Zealand found that theyhave a higher prevalence of diabetes and are lessVOLUME 2 • NUMBER 4 • DECEMBER 2010 J OURNAL OF PRIMARY HEALTH CARE 309