Health  Vol.6 No.15 , August 2014
The Role of Mutual Support Groups for the Control of Diabetes in a Mexican City: Achievements and Limitations from the Patients’ Perspective
Abstract: Background: Mutual Support Groups (MSG) provides to the patient, the ability to effective self-management behaviors, such as taking prescribed medications, following diet and exercise regimens, self-monitoring, and coping emotionally with the rigors of living with diabetes. Physicians, nurses and health promoters from public primary Health Care Centers (HCC) are responsible for providing follow-up care through MSGs. However, although the MSG program has been carried out, in the last decade Mexico presents the most alarming statistics in the prevalence and complications of Diabetes Mellitus type II (DM-II), suggesting a low impact of MSG in the strategy to support the effective control of the disease. Objetive: The aim of this work was to assess whether knowledge or benefits of effective management to control of DM-II, also to identify strengths and limitations of MSGs, in six different Health Care Centers (HCC), in San Luis Potosi, Mexico. This research provides an overview of patients’ perception, and significant issues that demand to adjust MGSs strategies, with the goal of exceed the expectations of current health statistics. Methods: A qualitative evaluation was carried out, with an ethnographic approach design. The study included 28 diabetic persons, (21 women and 7 men from ruraland urban carecenters). Semi-structured interviews, non-participant observation, and structured content analysis were used. Results: Support groups give patients a way to address emotional issues, and learn about their disease and self-care, although some patients consider participation an inconvenient obligation. Support group users mention barriers such as lack of continuity in support group activities, inconvenient meeting times, and the difficulty of commuting to attend group sessions. They also mention that overworked health care workers find it difficult to provide leadership to keep the group going. These issues have multiple implications for the success of strategies to control the disease. Conclusions: This study shows the need to apply a participatory model to disease support group strategies to reorganize their actions in such a way as to meet the needs and requirements of patients and to ensure their participation and help them control their disease.
Cite this paper: Tejada-Tayabas, L. and Lugo, M. (2014) The Role of Mutual Support Groups for the Control of Diabetes in a Mexican City: Achievements and Limitations from the Patients’ Perspective. Health, 6, 1984-1993. doi: 10.4236/health.2014.615233.

[1]   World Health Organization (2014) Health Topics. 10 Data about Diabetes.

[2]   World Health Organization (2011) Global Status Report on Noncommunicable Diseases 2010. World Health Organization, Geneva.

[3]   Villalpando, S., De la Cruz, V., Rojas, R., Shama-Levt, T., Avila, M.A., Gaona, B., et al. (2010) Prevalence and Distribution of Type 2 Diabetes Mellitus in Mexican Adult Population. A Probabilistic Survey. Salud Pública de México, 52, S19-S26.

[4]   Roglic, G., Unwin, N., Bennett, P.H., Mathers, C., Tuomilehto, J., Nag, S., et al. (2005) The Burden of Mortality Attributable to Diabetes. Diabetes Care, 28, 2130-2135.

[5]   Arrendondo, A. and De Icaza, E. (2009) Financial Requirements for the Treatment of Diabetes in Latin America: Implications for the Health System and for Patients in Mexico. Diabetología, 52, 1693-1695.

[6]   Ministry of Health (2006) Mutual Aid Groups: Technical Guide for Operation 2006. Ministry of Health of Mexico, Mexico City.

[7]   Ministry of Health (2008) Undersecretary of Prevention and Health Protection. Specific Action Program 2007-2012 Diabetes Mellitus. Ministry of Health, Mexico City.

[8]   Naik, A.D., Palmer, N., Petersen, N.J., Street, R.L., Rao, R., Suarez-Almazor, M., et al. (2011) Comparative Effectiveness of Goal Setting in Diabetes Mellitus Group Clinics: Randomized Clinical Trial. Archives of Internal Medicine, 171, 453-459.

[9]   PharmD, D.K., Melkus, G.D., Mickey, P., Stuart, W., McKoy, J.M., Urbanski, P., et al. (2013) Reducing the Risks of Diabetes Complications through Diabetes Self-Management Education and Support. Population Health Management, 16, 74-81.

[10]   Lerma, I., López-Ponce, A., Villa, A.R., Escobedo, M., Caballero, E.A., Velasco, M.A., et al. (2009) Pilot Study Two Different Strategies to Enhance Self-Care Behaviors and Treatment Adherence in Low-Income Patients with Type 2 Diabetes. Gaceta Medica de México, 145, 15-19.

[11]   Schillinger, D., Wang, F., Handley, M. and Hammer, H. (2009) Effects of Self-Management Support on Structure, Process, and Outcomes among Vulnerable Patients with Diabetes. A Three-Arm Practical Clinical Trial. Diabetes Care, 32, 559-566.

[12]   Sapag, J.C., Lange, I., Campos, S. and Piette, J.D. (2010) Innovative Care and Self-Care Strategies for People with Chronic Diseases in Latin America. Revista Panamericana de Salud Pública, 27, 1-9.

[13]   Lawton, J., Peel, E., Parry, O. and Douglas, M. (2008) Patients’ Perceptions and Experiences of Taking Oral Glucose Lowering Agents: A Longitudinal Qualitative Study. Diabetic Medicine, 25, 491-495.

[14]   Beverly, E.A. and Wray, L.A. (2010) The Role of Collective Efficacy in Exercise Adherence: A Qualitative Study of Spousal Support and Type 2 Diabetes Management. Health Education Research, 25, 211-223.

[15]   Patton, M.Q. (2002) Qualitative Research and Evaluation Methods. Sage Publications Ltd, Thousand Oaks.

[16]   Cook, K. (2005) Using Critical Ethnography to Explore Issues in Health Promotion. Qualitative Health Research, 15, 129-138.

[17]   Marshall, M.N. (1996) Sampling for Qualitative Research. Family Practice, 13, 522-525.

[18]   Hsieh, H.F. and Shannon, S. (2005) Three Approaches to Qualitative Content Analysis. Qualitative Health Research, 15, 1277-1288.

[19]   Silverman, D. (2003) Doing Qualitative Research. Sage Publications, Thousand Oaks.

[20]   Chaveepojnkamjorn, W., Pichainarong, N., Schelp, F.P. and Mahaweerawat, U.A. (2009) Randomized Controlled Trial to Improve the Quality of Life of Type 2 Diabetic Patients Using a Self-Help Group Program. The Southeast Asian Journal of Tropical Medicine and Public Health, 40, 169-176.

[21]   Douglas, R. (2011) Design of a Rural Diabetes Self-Directed Care Program. Social Work in Health Care, 50, 775-786.

[22]   Hale, N., Bennett, K. and Probst, J. (2010) Diabetes Care and Outcomes: Disparities across Rural America. Journal of Community Health, 35, 365-374.

[23]   Tejada-Tayabas, L.M. (2010) Between the Availability and Accessibility to Health Care. The Perspective of Patients with Chronic Diseases Living in Poverty. Salud Colectiva, 6, 35-45.

[24]   Costello, J.F. (2013) Roles and Strategies of Diabetes Support Group Facilitators: An Exploratory Study. The Diabetes Educator, 39, 178-186.

[25]   Sukwatjanee, A., Pongthavornkamol, K., Suwaonnaroop, N., Pinyopasakul, W., Low, G. and Chokkhanchitchai, S. (2009) Enhancing Self-Care Ability and Quality of Life among Rural-Dwelling Thai Elders with Type 2 Diabetes through a Self-Help Group: A Participatory Action Research Approach. International Journal of Behavioral Science, 4, 84-91.

[26]   Hillstrom, K., Ruelas, V., Peters, A., Gedebu-Wilson, T. and Iverson, E. (2014) A Retrospective Analysis of the Capacity Built through a Community-Based Participatory Research Project Addressing Diabetes and Obesity in South and East Los Angeles. Health, 6, 1429-1435.