“Yes to discuss different models of care between primary care physicians and diabetes-practice nurses, but not to complete implementation yet”: Explorative qualitative study at diabetes clinics in primary health care centres in Muscat, Oman

Abstract

Background: Globally, many models of care through which the way health services are delivered have been adopted within team-based primary health care. Although these models have aimed to solve some of the health care challenges related to physician’s shortages in clinics and further acceptance of non-physician-led clinics, their application is usually determined by a range of factors, such as preparedness of the health care providers, preparedness of patients and support from higher authorities.

Objective: The study was designed to explore health care providers’ perceptions for changes in models of care in diabetes clinics at primary health care in Muscat, Oman.

Methods: A total of 27 semi-structured interviews were conducted with health care providers involved in diabetes clinics at five purposively selected primary health care centres in Muscat. The interviewees included the core members of the diabetes management team and other supportive members available at the centres, and were of mixed genders, nationalities and professions. Qualitative thematic analysis was applied.

Results: The analysis resulted in one main theme, which captured positive responses towards task-sharing model, but revealed worries and requirements for complete implementation. Nurses’ competences and diabetic patients’ acceptance were among the main concerns. Health care providers revealed that for complete implementation of the model, nurses’ involvement in the team could be improved through updating their knowledge and through the provision of support from higher authorities, while diabetic patients’ acceptance could be improved through understanding of their perceived knowledge towards the model which could promote nurse-led clinics.

Conclusion: Task-sharing within the discussed possibilities could provide many positive outcomes and a rewarding future for diabetes clinics at primary health care centres. Omani culture could play a role in its implementation; therefore, if successful implementation is desired, carefully considered steps must be applied by the government and the community.