PubMed · 14760018
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J Moller. 2004. Reconsidering community based interventions.. https://doi.org/10.1136/ip.2003.004606
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Eight studies included in a recent systematic review of the efficacy of diabetes self-management education were qualitatively reexamined to determine the presence of theoretical frameworks, methods used to ensure cultural appropriateness, and the quality of the instrument. Theoretical frameworks that help to explain complex pathways that produce health outcomes were lacking; culture indices were not incorporated into diabetes self-management education; and the instruments used to measure outcomes were inadequate. We provide recommendations to improve research on diabetes self-management education in community settings through use of a contextual framework that encourages targeting multiple levels of influence--individual, family, organizational, community, and policy.
Seeking professional help for the symptoms of incontinence is extremely difficult for many people. Even patients consulting a hospital specialist for bowel problems have difficulties reporting faecal incontinence as one of their symptoms (Johanson and Lafferty, 1996).