Lay perceptions of type 2 diabetes in Scotland: bringing health services back in

Julia Lawton*, Elizabeth A. Peel, Odette Parry, Gonzalo Araoz, Margaret Douglas

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

The growing prevalence of type 2 diabetes is placing Scottish health services under considerable strain. Consequently, diabetes services are undergoing a major process of reorganisation, including the devolvement of routine diabetes care/diabetic review from secondary to primary healthcare settings. This qualitative study was devised to explore newly diagnosed type 2 diabetes patients' perceptions of their disease and the health services they receive at a time when this restructuring of services is taking place. The sample comprised 40 patients resident in Lothian, Scotland, who had diverse experiences of services, some receiving GP-based care only, others having varying contact with hospital diabetes clinics. In-depth interviews were undertaken with patients, three times at six monthly intervals over 1 year, enabling their experiences to be tracked at critical junctures during the post-diagnostic period. Disease perceptions and health service delivery were found to be mutually informing and effecting. Not only did (different types of) health service delivery influence the ways in which patients thought about and self-managed their disease, over time patients' disease perceptions also informed their expectations of, and preferences for, diabetes services. We thus argue that there is a need for a reconceptualisation within the medical social sciences to take into account the context of healthcare and the economic/policy factors that inform health service delivery when looking at patients' disease perceptions. We also discuss the logistical and ethical challenges of drawing upon patients' perspectives, preferences and views in the design and delivery of future health services. © 2004 Elsevier Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)1423-1435
Number of pages13
JournalSocial science and medicine
Volume60
Issue number7
DOIs
Publication statusPublished - Apr 2005

Fingerprint

diabetes
Scotland
health services
Type 2 Diabetes Mellitus
chronic illness
Health Services
health service
Disease
health care
Economics
Patient Preference
Social Sciences
economic policy
reorganization
Economic Policy
Type 2 Diabetes
Lay
Health services
Type 2 diabetes
Primary Health Care

Keywords

  • diabetes
  • health service delivery
  • lay understandings
  • scotland
  • self-management
  • UK

Cite this

Lawton, Julia ; Peel, Elizabeth A. ; Parry, Odette ; Araoz, Gonzalo ; Douglas, Margaret. / Lay perceptions of type 2 diabetes in Scotland : bringing health services back in. In: Social science and medicine. 2005 ; Vol. 60, No. 7. pp. 1423-1435.
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Lay perceptions of type 2 diabetes in Scotland : bringing health services back in. / Lawton, Julia; Peel, Elizabeth A.; Parry, Odette; Araoz, Gonzalo; Douglas, Margaret.

In: Social science and medicine, Vol. 60, No. 7, 04.2005, p. 1423-1435.

Research output: Contribution to journalArticle

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