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Duan DF, Wen Y, Yan Y, Li L, Xiao X, Li X, Yan LJ, Ma DY. Chinese Healthcare Workers' Knowledge, Attitudes, and Practices in Diabetic Kidney Management: A Multi-Centered Cross-Sectional Study. Risk Manag Healthc Policy 2024; 17:1211-1225. [PMID: 38742137 PMCID: PMC11090199 DOI: 10.2147/rmhp.s354549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 04/27/2024] [Indexed: 05/16/2024] Open
Abstract
Background Given the importance of diabetic kidney disease (DKD) management, this study aims to explore the knowledge, attitudes, and practices in disease management demonstrated by healthcare workers from the nephrology department. Materials and Methods This study is a multi-centered cross-sectional study, and adopts snowball sampling, with 530 healthcare workers being recruited to complete a questionnaire covering areas such as demographic characteristics, knowledge, attitude, and practices (KAP) of DKD management. This data was analyzed using descriptive statistics and binary logistics analysis. Results In this study, 530 healthcare workers were studied, including 94 doctors and 436 nurses. The participants were mainly from general tertiary hospitals in 14 provinces. For Chinese nurse, the results indicate that both poor knowledge level (Odds Ratio (OR) =0.63, 95% Confidence Interval (CI): 0.42-0.94) and having experience in further medical training in nephrology (OR=1.92, 95% CI: 1.20-3.08) are associated with the practice levels. For Chinese doctors, having not experience in further medical training in nephrology (OR=0.36, 95% CI: 0.15-0.83) are associated with their practice levels. Conclusion In summary, Chinese doctors and nurses in this study showed positive attitudes towards DKD management, but their knowledge and practical skills were lacking. This underscores a notable gap in achieving optimal DKD care. Notably, nurses' knowledge influenced their management practices, and additional nephrology training correlated with better engagement. To improve patient care, enhancing nephrology healthcare professional training and addressing knowledge-practice disparities are recommended.
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Affiliation(s)
- Di-fei Duan
- Department of Nephrology, Kidney Research Institute, West China Hospital of Sichuan University /West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
| | - Yue Wen
- Department of Nephrology, Kidney Research Institute, West China Hospital of Sichuan University /West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
| | - Yu Yan
- Department of Nephrology, Kidney Research Institute, West China Hospital of Sichuan University /West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
| | - Ling Li
- Department of Nephrology, Kidney Research Institute, West China Hospital of Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
| | - Xiang Xiao
- West China School of Medicine, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
| | - Xing Li
- Department of Nephrology, Kidney Research Institute, West China Hospital of Sichuan University /West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
| | - Lin-Jia Yan
- The Nethersole School of Nursing Faculty of Medicine, The Chinese University of Hong Kong, Hongkong, People’s Republic of China
| | - Deng-Yan Ma
- Department of Nephrology, Kidney Research Institute, West China Hospital of Sichuan University /West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
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Speight J, Holmes-Truscott E, Garza M, Scibilia R, Wagner S, Kato A, Pedrero V, Deschênes S, Guzman SJ, Joiner KL, Liu S, Willaing I, Babbott KM, Cleal B, Dickinson JK, Halliday JA, Morrissey EC, Nefs G, O'Donnell S, Serlachius A, Winterdijk P, Alzubaidi H, Arifin B, Cambron-Kopco L, Santa Ana C, Davidsen E, de Groot M, de Wit M, Deroze P, Haack S, Holt RIG, Jensen W, Khunti K, Kragelund Nielsen K, Lathia T, Lee CJ, McNulty B, Naranjo D, Pearl RL, Prinjha S, Puhl RM, Sabidi A, Selvan C, Sethi J, Seyam M, Sturt J, Subramaniam M, Terkildsen Maindal H, Valentine V, Vallis M, Skinner TC. Bringing an end to diabetes stigma and discrimination: an international consensus statement on evidence and recommendations. Lancet Diabetes Endocrinol 2024; 12:61-82. [PMID: 38128969 DOI: 10.1016/s2213-8587(23)00347-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 11/06/2023] [Accepted: 11/10/2023] [Indexed: 12/23/2023]
Abstract
People with diabetes often encounter stigma (ie, negative social judgments, stereotypes, prejudice), which can adversely affect emotional, mental, and physical health; self-care, access to optimal health care; and social and professional opportunities. To accelerate an end to diabetes stigma and discrimination, an international multidisciplinary expert panel (n=51 members, from 18 countries) conducted rapid reviews and participated in a three-round Delphi survey process. We achieved consensus on 25 statements of evidence and 24 statements of recommendations. The consensus is that diabetes stigma is driven primarily by blame, perceptions of burden or sickness, invisibility, and fear or disgust. On average, four in five adults with diabetes experience diabetes stigma and one in five experience discrimination (ie, unfair and prejudicial treatment) due to diabetes, such as in health care, education, and employment. Diabetes stigma and discrimination are harmful, unacceptable, unethical, and counterproductive. Collective leadership is needed to proactively challenge, and bring an end to, diabetes stigma and discrimination. Consequently, we achieved unanimous consensus on a pledge to end diabetes stigma and discrimination.
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Affiliation(s)
- Jane Speight
- School of Psychology and Institute for Health Transformation, Deakin University, Geelong, VIC, Australia; The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia.
| | - Elizabeth Holmes-Truscott
- School of Psychology and Institute for Health Transformation, Deakin University, Geelong, VIC, Australia; The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
| | | | - Renza Scibilia
- Diabetogenic, Melbourne, VIC, Australia; JDRF International, New York, NY, USA
| | - Sabina Wagner
- Department of Prevention, Health Promotions & Community Care, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Asuka Kato
- Department of Health and Social Behavior, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Victor Pedrero
- Faculty of Nursing, Universidad Andrés Bello, Santiago, Chile
| | - Sonya Deschênes
- School of Psychology, University College Dublin, Dublin, Ireland
| | | | - Kevin L Joiner
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | - Shengxin Liu
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
| | - Ingrid Willaing
- Department of Prevention, Health Promotions & Community Care, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Copenhagen, Denmark; Institute of Public Health, Department of Health Services Research, University of Copenhagen, Copenhagen, Denmark
| | - Katie M Babbott
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Bryan Cleal
- Department of Prevention, Health Promotions & Community Care, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Jane K Dickinson
- Department of Health Studies & Applied Educational Psychology, Teachers College Columbia University, New York, NY, USA
| | - Jennifer A Halliday
- School of Psychology and Institute for Health Transformation, Deakin University, Geelong, VIC, Australia; The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
| | - Eimear C Morrissey
- Health Behavior Change Research Group, School of Psychology, University of Galway, Galway, Ireland
| | - Giesje Nefs
- Department of Medical Psychology, Radboudumc, Nijmegen, Netherlands; Center of Research on Psychological Disorders and Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands; Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, Netherlands
| | - Shane O'Donnell
- Birmingham Law School, University of Birmingham, Birmingham, UK
| | - Anna Serlachius
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Per Winterdijk
- Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, Netherlands
| | - Hamzah Alzubaidi
- College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
| | - Bustanul Arifin
- Faculty of Pharmacy, Universitas Hasanuddin, Makassar, Indonesia
| | | | | | - Emma Davidsen
- Department of Prevention, Health Promotions & Community Care, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Mary de Groot
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Maartje de Wit
- Medical Psychology, Amsterdam Public Health, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | | | | | - Richard I G Holt
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK; National Institute for Health Research Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - Kamlesh Khunti
- Leicester Diabetes Centre, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Karoline Kragelund Nielsen
- Department of Prevention, Health Promotions & Community Care, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Tejal Lathia
- Department of Endocrinology, Apollo Hospitals, Navi Mumbai, India
| | | | | | - Diana Naranjo
- Department of Pediatrics, Division of Endocrinology, Stanford School of Medicine, Palo Alto, CA, USA
| | - Rebecca L Pearl
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Suman Prinjha
- Leicester Diabetes Centre, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Rebecca M Puhl
- Department of Human Development & Family Sciences, College of Liberal Arts & Sciences, University of Connecticut, Storrs, CT, USA
| | | | - Chitra Selvan
- Department of Endocrinology, Ramaiah Medical College, Bengaluru, India
| | - Jazz Sethi
- The Diabesties Foundation, Ahmedabad, India
| | - Mohammed Seyam
- Faculty of Medicine, Al-Quds University, Abu Dis, Palestine
| | - Jackie Sturt
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Mythily Subramaniam
- Institute of Mental Health Singapore, Singapore; Saw Swee Hock School of Public Health, National University Singapore, Singapore
| | - Helle Terkildsen Maindal
- Department of Prevention, Health Promotions & Community Care, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Copenhagen, Denmark; Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Michael Vallis
- Department of Family Medicine, Dalhousie University, Halifax, NS, Canada
| | - Timothy C Skinner
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia; La Trobe Rural Health School, La Trobe University, Flora Hill, VIC, Australia; Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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Halpern B, Mancini MC, van de Sande-Lee S, Miranda PAC. "Anti-obesity medications" or "medications to treat obesity" instead of "weight loss drugs" - why language matters - an official statement of the Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO) and the Brazilian Society of Endocrinology and Metabolism (SBEM). ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2023; 67:e230174. [PMID: 37585688 PMCID: PMC10665066 DOI: 10.20945/2359-4292-2023-0174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 07/07/2023] [Indexed: 08/18/2023]
Abstract
Obesity is largely undertreated, in part because of the stigma surrounding the disease and its treatment. The use of the term "weight loss drugs" to refer to medications for the treatment of obesity may contribute to this stigma, leading to the idea that anyone who wants to lose weight could use them and that short-term use, only in the active weight loss phase would be enough. On the contrary, the use of terms such as "medications to treat obesity" or "anti-obesity medications" conveys the idea that the treatment is directed at the disease rather than the symptom. This joint statement by the Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO) and the Brazilian Society of Endocrinology and Metabolism (SBEM) intends to alert the press, healthcare professionals and scientific community about the importance of the appropriate use of language, with the aim of improving obesity care.
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Affiliation(s)
- Bruno Halpern
- Associação Brasileira para o Estudo da Obesidade e Síndrome MetabólicaSão PauloSPBrasilAssociação Brasileira para o Estudo da Obesidade e Síndrome Metabólica, São Paulo, SP, Brasil
- Sociedade Brasileira de Endocrinologia e MetabologiaDepartamento de ObesidadeSão PauloSPBrasilDepartamento de Obesidade, Sociedade Brasileira de Endocrinologia e Metabologia, São Paulo, SP, Brasil
- Hospital 9 de JulhoCentro de ObesidadeSão PauloSPBrasilCentro de Obesidade, Hospital 9 de Julho, São Paulo, SP, Brasil
| | - Marcio C. Mancini
- Sociedade Brasileira de Endocrinologia e MetabologiaDepartamento de ObesidadeSão PauloSPBrasilDepartamento de Obesidade, Sociedade Brasileira de Endocrinologia e Metabologia, São Paulo, SP, Brasil
- Faculdade de Medicina da Universidade de São PauloDepartamento de Endocrinologia e MetabolismoGrupo de Obesidade e Síndrome MetabólicaSão PauloSPBrasilGrupo de Obesidade e Síndrome Metabólica, Departamento de Endocrinologia e Metabolismo, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil
| | - Simone van de Sande-Lee
- Sociedade Brasileira de Endocrinologia e MetabologiaDepartamento de ObesidadeSão PauloSPBrasilDepartamento de Obesidade, Sociedade Brasileira de Endocrinologia e Metabologia, São Paulo, SP, Brasil
- Universidade Federal de Santa CatarinaDepartamento de Clínica MédicaFlorianópolisSCBrasilDepartamento de Clínica Médica, Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil
| | - Paulo Augusto Carvalho Miranda
- Sociedade Brasileira de Endocrinologia e MetabologiaSão PauloSPBrasilSociedade Brasileira de Endocrinologia e Metabologia, São Paulo, SP, Brasil
- Santa Casa de Belo HorizonteBelo HorizonteMGBrasilSanta Casa de Belo Horizonte, Belo Horizonte, MG, Brasil
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