Structure of obstacle factors and challenges ongoing home-care for elderly people with diabetes living in semi-mountainous regions

Abstract

The purpose of this study was to clarify the structure of obstacle factors and challenges for elderly people with diabetes living in semi-mountainous areas to ongoing home-care and to obtain suggestions for support methods. The following are the results of a qualitative synthesis method (KJ method) analysis with a pulse discussion of public health nurses, visiting nurses, and care managers: "Self-care issues due to the patients' age: a lack of awareness of their own condition, the uncharacteristic nature of their diabetes symptoms, and an inability to change established patterns of exercise and eating"; "Self-care issues due to living in semi-mountainous regions: unbalanced eating patterns based on locally-available food, and an unwillingness to let others find out about their condition"; "Difficulty of receiving care due to living in these regions: geographical disadvantages, and a lack of trained caregivers and care-giving family members"; "Support-system issues: lack of goal-uniformity among public health, medical and welfare workers, and an absence of information-sharing systems"; "Limits on the services provided by visiting nurses and public health nurses: the difficulty of focusing on the diabetes, due to the wide range of care services required"; and "Relationship issues between elderly people with diabetes and their families: home visits and cooperation done in order to avoid stress-relationships between the patients and their families." It is important to be aware of the connection between the elderly with diabetes and the people living in the community, including their families.