Table 1 Overview of included studies
From: Challenges of managing diabetes in Iran: meta-synthesis of qualitative studies
First author /year | Setting | Objectives | Study design | Sampling/ participants | Analysis approach | Key emerged themes | CASP score |
|---|---|---|---|---|---|---|---|
Molayaghobi [18], 2019 | A specialized polyclinic-Isfahan | To implement, determine, and solve the challenges of executing the Chronic Care Model in diabetes management | Action research/ semi-structured interviews | 17 patients with type 2 diabetes. | Content analysis | * lack of effective follow-up system * insufficient acre providers * incomplete medical records * limited knowledge of healthcare providers * lack of regular physician visit * lack of commitment to ordered regime | 8 |
Aliasgharpour [24], 2012 | A big university affiliated hospitals in Tehran | to clarify the care process for Iranian patients with diabetes suffering from diabetic foot ulcer condition | Grounded Theory /semi-structured interviews | 11 diabetic patients with food ulcer, 4 physicians, one head nurse and one nurse | Theoretical analysis | * disease management * disease experience * continuity of care | 9 |
Shakibazadeh [21], 2011 | A diabetes clinic in Tehran | to exploreexperience of Iranian diabetic patients regarding barriers to and facilitatingfactors for diabetes self-care | phenomenological study/ focus groups | 43 type 2 diabetic patients | Framework analysis | * physical barriers * psychological barriers * educational barriers * social barriers * care system barriers | 8 |
Ravaghi, 2014 [23] | General (health system) | To evaluate the planning and establishing of the specialized care program for diabetic’s patient from the healthcare providers’ perspectives | documents review and face-to-face semi-structured interviews | Program leaders and relevant executive managers of the local medical universities | Thematic analysis | * program planning * program implementation * Program results | 7 |
Abdoli, 2009 [17] | Hospitals, diabetes clinics, physician offices, and health houses | To identify barriers to and facilitators of empowerment in people with diabetes | grounded theory/ in-depth unstructured interviews | 11 diabetic patients | Thematic analysis | * negative view about diabetes * ineffective healthcare systems * poverty and illiteracy | 8 |
Nouhjah, 2014 [19] | A diabetes clinic/ Ahwaz | to explore diabetic women’s views about the diabetes and its consequences | Semi-structured interview | 40 Diabetic Women’s | Thematic analysis | * unavailability of drugs * high treatment cost * fear and embarrassment of insulin injection * self-treatment | 7 |
Abazari, 2012 [22] | Ministry of health, and officials of the health system in Isfahan | to describe the situation of training of general practitioners who provide diabetes care | unstructured interviews | 8 diabetes management planners and six general practitioners workingin diabetes centers | content analysis | * unstructured education of healthcare provides * inadequate physician’s competence * ineffective education | 8 |
Mousavizadeh, 2018 [26] | Hospitals, diabetes associations, physicians’ offices, patients’ | to explore how adherence to diabetes treatment process occurs among Iranian patients | grounded theory/ Semi-structured in-depth interviews | 21 diabetic patients+ two members of families and healthcare providers | Corbin and Strauss constant comparative analysis | * unperceived threat in diagnosis time * bitter belief * adaptation to treatment | 8 |
Valizadeh, 2017 [27] | Diabetes centers, treatment and health deputies, and health departments | to identify the problems of Type 2 diabetes prevention and control program in Iran | The semi-structured interview | 7 diabetes experts, and 10 diabetic patients | Framework analysis | * Referral system issues * human resources issues * Infrastructure issues * cultural problems issues * access issues * intersectoral coordination issues | 9 |
Dehghani Tafti, 2015 [28] | Health network/ Ardakan | to explore the barriers and incentives for diabetes self-care | focus group discussions and interviews | Diabetic patients and health care providers | content analysis | * product issues * place issues * price issues * promotion issues | 8 |
Molayaghobi, 2019 [25] | A specialized poly-clinic/ Isfahan | To identify diabetes management challenges in Iran | semi-structured interviews | 4 members of clinic diabetesunit and 21 type 2 diabetic patients | content analysis | * weak care delivery system * Defective diabetes self-care | 9 |
Rezaei, 2019 [20] | A diabetes unit / Kurdistan | To identify barriers of medication adherence in Iranian patients with type-2 diabetes | Semi-structured interviews | 12 patients with type-2 diabetes | conventional content analysis | * disbelief in medical explanatory/prescriptive knowledge * lived experiences of the disease * challenges of everyday life * interactive/economic challenges | 9 |