Facilitators and Barriers to Insulin Initiation: Results of a Qualitative Study in a Public Hospital, Malaysia

Chai, Jim; Wong, Kok Thong; Hussien, Zanariah; Anderson, Claire

Abstract

This study focused on the lived-experience of type 2 diabetes patients using insulin treatment. Type 2 diabetes is a progressive disease and insulin therapy can significantly reduce morbidity and mortality if introduced to suitable patients at an early stage, or aggressively enough to achieve good glycaemic control. This study aimed to understand the facilitators, which encourage patients to accept insulin treatment and the psychological, social and behavioural barriers to effective diabetes management. This study used Interpretative Phenomenological Analysis and Modified Grounded Theory approach. Purposive sampling method was used to select 37 patients for semi-structured interviews. Interviews were transcribed verbatim and coded. Modified grounded theory and thematic approaches were used to analyse the data and common themes were identified and categorised. From the results, three main barriers to initiate insulin therapy were discovered: worries about inability to handle using insulin, a sense of personal failure and negative perceptions of injections due to past experiences. The facilitators that encourage patients to accept insulin treatment were prior exposure to insulin injections, better side effect profile and wanting a better quality of life. In conclusion, the major fear comes from a lack of knowledge of modern insulin device. Early diabetes education and exposure to modern insulin device are crucial to increase patients' awareness of their health condition and the function of insulin. These will better prepare them mentally for insulin therapy and to ease the transition for patients to initiate insulin therapy.

Citation

Chai, J., Wong, K. T., Hussien, Z., & Anderson, C. (2020). Facilitators and Barriers to Insulin Initiation: Results of a Qualitative Study in a Public Hospital, Malaysia. Malaysian Journal of Qualitative Research, 6(2), 20-32

• Journal Article Type: Article
• Acceptance Date: Nov 30, 2020
• Online Publication Date: Nov 30, 2020
• Publication Date: 2020-11
• Deposit Date: Jun 9, 2021
• Publicly Available Date: Jun 14, 2021
• Journal: Malaysian Journal of Qualitative Research
• Print ISSN: 1823-8521
• Electronic ISSN: 1823-8521
• Publisher: Qualitative Research Association of Malaysia
• Peer Reviewed: Peer Reviewed
• Volume: 6
• Issue: 2
• Pages: 20-32
• Keywords: Type 2 diabetes; psychological barrier; facilitators; insulin injection
• Public URL: https://nottingham-repository.worktribe.com/output/5380479
• Publisher URL: https://www.qramalaysia.org/journal-vol6-no02
• Related Public URLs: https://www.qramalaysia.org/journal
• Additional Information: Jim Chai, Kok Thong Wong, Zanariah Hussien, Claire Anderson, Facilitators and Barriers to Insulin Initiation: Results of a qualitative study in Malaysia, The Malaysian Journal of Qualitative Research, vol. 6 (2), pp. 20-32. https://www.qramalaysia.org/journal-vol6-no02