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      Treatment adherence and associated factors in older people with type 2 diabetes: A qualitative study

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          Abstract

          Patient Contribution

          Older people with T2D participated in this study to achieve the objective of the study.

          Aim

          Treatment adherence is an important indicator for evaluating successful diabetes control and overall disease management. It is necessary to identify the hidden themes of the concept of treatment adherence and related factors based on the experiences of older people with T2D. Therefore, the present study was conducted to identify the concept of treatment adherence and its associated factors in older people with type 2 diabetes (T2D).

          Design

          The study was conducted as a qualitative study using a content analysis approach.

          Methods

          Semi‐structured interviews were conducted with 20 older people with T2D, between May and September 2021. Data were organized using MAXQDA‐10 software and analysed using the Elo and Kyngas qualitative content analysis method. We followed the COREQ Checklist to ensure rigour in our study.

          Results

          Three themes emerged from the analysis of the data, including: ‘Health literacy’, ‘Support umbrella’ and ‘responsibility’.

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          Most cited references43

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          The qualitative content analysis process.

          This paper is a description of inductive and deductive content analysis. Content analysis is a method that may be used with either qualitative or quantitative data and in an inductive or deductive way. Qualitative content analysis is commonly used in nursing studies but little has been published on the analysis process and many research books generally only provide a short description of this method. When using content analysis, the aim was to build a model to describe the phenomenon in a conceptual form. Both inductive and deductive analysis processes are represented as three main phases: preparation, organizing and reporting. The preparation phase is similar in both approaches. The concepts are derived from the data in inductive content analysis. Deductive content analysis is used when the structure of analysis is operationalized on the basis of previous knowledge. Inductive content analysis is used in cases where there are no previous studies dealing with the phenomenon or when it is fragmented. A deductive approach is useful if the general aim was to test a previous theory in a different situation or to compare categories at different time periods.
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            Thematic Analysis

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              Health literacy and public health: A systematic review and integration of definitions and models

              Background Health literacy concerns the knowledge and competences of persons to meet the complex demands of health in modern society. Although its importance is increasingly recognised, there is no consensus about the definition of health literacy or about its conceptual dimensions, which limits the possibilities for measurement and comparison. The aim of the study is to review definitions and models on health literacy to develop an integrated definition and conceptual model capturing the most comprehensive evidence-based dimensions of health literacy. Methods A systematic literature review was performed to identify definitions and conceptual frameworks of health literacy. A content analysis of the definitions and conceptual frameworks was carried out to identify the central dimensions of health literacy and develop an integrated model. Results The review resulted in 17 definitions of health literacy and 12 conceptual models. Based on the content analysis, an integrative conceptual model was developed containing 12 dimensions referring to the knowledge, motivation and competencies of accessing, understanding, appraising and applying health-related information within the healthcare, disease prevention and health promotion setting, respectively. Conclusions Based upon this review, a model is proposed integrating medical and public health views of health literacy. The model can serve as a basis for developing health literacy enhancing interventions and provide a conceptual basis for the development and validation of measurement tools, capturing the different dimensions of health literacy within the healthcare, disease prevention and health promotion settings.
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                Author and article information

                Contributors
                sadeghi@umsha.ac.ir
                oshvandi2005@yahoo.com
                Journal
                Nurs Open
                Nurs Open
                10.1002/(ISSN)2054-1058
                NOP2
                Nursing Open
                John Wiley and Sons Inc. (Hoboken )
                2054-1058
                17 May 2023
                August 2023
                : 10
                : 8 ( doiID: 10.1002/nop2.v10.8 )
                : 5578-5588
                Affiliations
                [ 1 ] Department of Nursing, Student Research Committee, School of Nursing and Midwifery Hamadan University of Medical Sciences Hamadan Iran
                [ 2 ] Department of Nursing, School of Nursing and Midwifery Hamadan University of Medical Sciences Hamadan Iran
                [ 3 ] Mother and Child Care Research Center, Nursing and Midwifery School Hamadan University of Medical Sciences Hamadan Iran
                [ 4 ] Behavioral Sciences Research Center, Life Style Institute, Nursing Faculty Baqiyatallah University of Medical Sciences Tehran Iran
                [ 5 ] Research Center for life & Health Sciences & Biotechnology of the Police Directorate of Health Rescue & Treatment Police Healthquarter Tehran Iran
                [ 6 ] Department of Biostatistics, School of Public Health and Modeling of Noncommunicable Diseases Research Center Hamadan University of Medical Sciences Hamadan Iran
                Author notes
                [*] [* ] Correspondence

                Amir Sadeghi, Department of Nursing, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran.

                Email: sadeghi@ 123456umsha.ac.ir

                khodayar oshvandi, Mother and Child Care Research Center, Nursing and Midwifery School, Hamadan University of Medical Sciences, Hamadan, Iran.

                Email: oshvandi2005@ 123456yahoo.com

                Author information
                https://orcid.org/0000-0002-9300-1066
                Article
                NOP21801 NOP-2022-Apr-0575.R2
                10.1002/nop2.1801
                10333873
                37196154
                88724ded-681e-4584-af9a-3816591634a2
                © 2023 The Authors. Nursing Open published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 21 January 2023
                : 08 June 2022
                : 25 April 2023
                Page count
                Figures: 0, Tables: 2, Pages: 11, Words: 7255
                Funding
                Funded by: Hamadan University of Medical Sciences , doi 10.13039/501100004697;
                Categories
                Research Article
                Research Articles
                Custom metadata
                2.0
                August 2023
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.3.1 mode:remove_FC converted:11.07.2023

                elderly,older people,qualitative research,treatment adherence,type 2 diabetes

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