Patient and professional perceptions of metabolic syndrome and its management: a qualitative study in the United Arab Emirates

Naseeba, Alozaibi (2011) Patient and professional perceptions of metabolic syndrome and its management: a qualitative study in the United Arab Emirates. PhD thesis, University of Nottingham.

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Abstract

Metabolic syndrome (MetS) is defined as the clustering of medical conditions (that is impaired fasting glucose (IFG) or type 2 diabetes mellitus (T2DM), hypertension (HTN), obesity and dyslipidaemia) that increase an individual's risk of developing diabetes or cardiovascular diseases (CVD). In the United Arab Emirates (UAE), the prevalence of MetS and its features are among the highest in the world. However, research that explores the health needs of patients with MetS within the socio-cultural context of the UAE is lacking. This study aimed to explore patient and professional perceptions of MetS and its management in the UAE.

A qualitative approach that drew on the broad principles of grounded theory was undertaken to meet the aims of the study. Following ethical approval, semi-structured interviews were conducted with 29 patients with MetS and 27 health care professionals (HCP) involved in the management of patients with MetS (10 physicians, 11 pharmacists, 4 dieticians and 2 health educators). This was followed by one focus group discussion with nine pharmacists for further exploration of identified themes. Interviews were audio-recoded and transcribed verbatim. NVivo aided the organisation of data. Thematic analysis based on the principles of grounded theory was conducted.

This study was able to identify a number of factors that influenced patients' perceptions of their health and attitude towards their treatment plan. All patients interviewed were unfamiliar with the MetS concept and claimed to have never been informed by their physicians about their MetS diagnosis. Patients' awareness of the high prevalence of MetS features in the UAE, the asymptomatic nature of the cardiometabolic risk factors (CRFs) and the availability of treatment resulted in downplaying of MetS risk. Not all HCPs were familiar with the MetS concept or definition. Factors such as the complexity of the MetS name and the absence of the MetS diagnosis from the list of reimbursed medical conditions discouraged physicians from informing patients of their MetS diagnosis and limited the clinical utility of the MetS concept respectively. The study found that a number of socio-cultural factors hindered successful implementation of lifestyle interventions. Such factors included family restrictions of outdoor exercising by women, lack of culturally sensitive health clubs, food-centric activities and eating habits. Patients' beliefs about medicine and medicine brands affected their medicine-taking habits and altered their adherence.

HCPs believed that a population-focused health approach would result in behavioural change. They also emphasised the key role of the public health policy to prevent MetS and promote a healthy lifestyle. Patients acknowledged the importance of adhering to lifestyle interventions to control their clustering risk factors. However, they believed that their lack of motivation, willpower, and limited physical mobility, due to coexisting health condition, were detrimental to adherence to lifestyle interventions.

This study provides important new information for understanding the dynamics of patients' health behaviour and attitude towards MetS treatment in the UAE. It also demonstrates how aspects of the health policy and professionals' clinical practice limit the clinical utilisation of the MetS concept. Efforts to promote healthy behaviour and enhance the prevention and management of MetS in the UAE need to be stepped up and be tailored to patients' personal, social and cultural needs.

Item Type:Thesis (PhD)
Supervisors:Anderson, C.
Boyd, M.
Faculties/Schools:UK Campuses > Faculty of Science > School of Pharmacy
ID Code:2884
Deposited By:Ms. K EVANS
Deposited On:30 Oct 2012 14:01
Last Modified:30 Oct 2012 14:01

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