Table 1

Characteristics of the included studies

StudyCountryStudy typePatients’ diagnosisMethod of analysisStudy populationStudy settingsStudy aimsStudy quality
Al-Qazaz et al27MalaysiaSemistructured interviewsType 2 DMContent analysis12 diabetic patients, with at least 1 year of diabetes and a prescription of oral hypoglycaemicUSM Health ClinicTo explore diabetic patients’ experience and knowledge about diabetes and its medication and to understand the factors contributing to medication adherence in Malaysian population**
Brown et al32UKOne-to-one interviewsType 2 DMThematic analysis17 African–Caribbean diabetes patients aged above 18 years; 13 first generation immigrants and four second-generation immigrantsInner city NottinghamTo gain an understanding of how health beliefs influence the way African–Caribbean people with diabetes manage their illness***
Choudhury et al33UKStructured interviewType 2 DMThematic analysis14 invited Bangladeshi individuals, (4 males and 10 females), aged between 26 to 67 years, with type 2 DM (had it from six months—27 years) and were recruited either in Swansea or Birmingham. Interviews were made in either English or in Sylheti as the researcher was bilingualParticipants from local communities in Swansea and Birmingham were invited for the interviewTo examine the understanding and beliefs of people with diabetes from the Bangladeshi community living in the UK**
Coronado et al38USAFocus groupsType 2 DMMatrix analysis by Morgan and Krueger42 individuals (14 men and 28 women) in six focus groups, who had diabetes, had a family history of diabetes, or knew someone who had diabetesFred Hutchinson Cancer Research Center's project office in Sunnyside, Yakima Village and Skagit Valley Community College and at the Catholic Church in BurlingtonTo investigate the perceptions about the causes of and treatments for type 2 DM*
Cottrell et al21AustraliaStructured interviewHFRepertory grid technique92 patients (older than 18 years) with heart failureHeart Failure Service outpatient clinic, Royal Brisbane and Women's Hospital in Brisbane, AustraliaTo elicit individuals’ beliefs about their heart failure treatment and to investigate whether generated constructs were different between adherent and non-adherent patients*
Gascon et al30SpainFocus groups with open ended questionsHTNThematic analysisSeven focus groups of 44 patients (24 men and 20 women), diagnosed with hypertension, between the ages of 18 and 80 years, being treated with antihypertensives for 3 months, being non-compliant and having sufficiently good physical and mental health to participateTwo primary healthcare centresTo identify factors related to non-compliance with the treatment of patients with hypertension**
Gordon et al7UKFace-to-face interviewsCVDThematic analysis98 patients (41 males and 57 females) aged between 32–89 yearsHome interviews of patients recruited from five general surgeries and pharmacy interviews at four community pharmaciesTo examine medication-related problems from the perspective of patients with a chronic condition and to identify how they may be supported in managing their medication**
Grace et al34UKFocus groupsType 2 DMThematic analysis17 focus groups of adult diabetic patientsTower Hamlets, a socioeconomically deprived
London borough
To understand lay beliefs and attitudes, religious teachings and professional perceptions in relation to diabetes prevention in the Bangladeshi community***
Heymann et al35UKFocus groupsDM and HTNThematic analysis10 focus groups of 86 patients (42 males and 44 females) with hypertension in three age ranges: 41–50, 51–60, 61–70 years (six groups); and patients with hypertension and DM in the age ranges: 51–60, 61–70 years (a total of four groups)UKTo explore beliefs and perceptions regarding hypertension and to gain an understanding of barriers to treatment among patients with and without DM***
Hu et al39USAFocus groupsType 2 DMContent analysisFive focus groups of 73 Hispanic immigrants; 18 years or olderFree health clinic in central North CarolinaTo explore perceived barriers among Hispanic immigrants with diabetes and their family members**
Jolles et al24CanadaSemistructured interviewsHTNThematic analysis26 patients, aged between 26–85 years and 62% females, able to speak, read and write English; diagnosed with hypertension by a healthcare provider, and currently taking an antihypertensive medicationTwo hypertension clinics at the University of Alberta in EdmontonTo understand hypertensive patients’ perspectives regarding blood pressure and hypertension treatment**
Kiawi et al23CameroonIn-depth interviews, semi-structuredType 2 DM, HTN and strokeContent analysis15 interviews of 62 patients (27 women and five men); selection criteria included: having lived at least six months in the community, being nominated by other community members, and aged above 15 yearsFour urban health districts, one from each of the main ecological areas of CameroonTo investigate the lay knowledge, attitudes and behaviours relating to diabetes and its main risk factors of urban Cameroonians***
Lai et al31TaiwanIn-depth interviewsType 2 DMThematic analysis22 diabetic patients (12 males and 10 females), aged between 44–80 years, with a duration of illness more than 1 yearRural Taiwan communityTo investigate Chinese diabetic patients’ perceptions about their illness and treatment strategies to facilitate patient-centred, culture-sensitive clinical skills**
Lawton et al36UKIn-depth interviews with open-ended approachType 2 DMThematic analysis31 patients (23 Pakistani and eight Indian), aged 18 years and over, and diagnosed with type 2 DMGeneral practices in EdinburghPatients’ perception and practical considerations **
Mohd Ali and Jussoff 200928MalaysiaIn-depth open-ended interviewsType 2 DMThematic analysis18 patients (9 males and 9 females) aged between 15–75 years and 13 healthcare professionals (9 doctors, three pharmacists and one diabetic nurse educator)Endocrinology clinic of a teaching hospital in Kuala LumpurTo explore the perspectives and experiences of Malay patients in managing type 2 DM as a chronic illness and to provide recommendations that aim to enhance adherence to treatment and help patients to improve their self-management skills***
Mshunqane et al29South AfricaPatient focus groups (n=10) and healthcare professional focus groups (n=8) and in-depth interviews. The questions were open-endedType 2 DMThematic analysisPatients who had been diagnosed with type 2 diabetes for at least 1 year, and were aged between 30 and 65 yearsDr George Mukhari Hospital outpatients’ diabetes clinicTo determine the knowledge that patients with type 2 DM have about the management of their disease, as well as the perceptions of the healthcare team about the services given to patients***
Peel et al37UKIn-depth interviewsType 2 DMThematic analysis40 newly diagnosed type 2 DM patients aged between 21–77 yearsAcross the Lothian region in ScotlandTo explore the patients’ emotional reactions about their type 2 DM diagnosis, and their views about information provision at the time of diagnosis**
Peres et al22BrazilInterviewsType 2 DMContent analysis24 diabetic females, aged between 25 and 76 years old, literate, with eight years of schooling, from Ribeirão Preto, who perform household activitiesNursing Education Center for Adults and Elderly—CEEAI, University of São PauloIdentify the difficulties patients encounter when controlling diabetes**
Rustveld et al40USAFocus groupsType 2 DMThematic analysis34 patients in six focus groups (three in English and three in Spanish), older than 18 years and with type 2 DMThree HCHD community health centres in Houston, Texas, USATo elicit attitudes, attributions and self-efficacy related to diabetes self-care in English- as well as Spanish-speaking Hispanic men**
Smith et al26IrelandFocus groupsType 2 DMThematic analysis25 patients from three general practices, having DM for at least 1 yearPatients were invited to participate in the focus groupTo explore the views and health beliefs of patients with type 2 DM who had experienced a new structured diabetes shared care service**
Vinter-Repalust et al25CroatiaFocus groupsType 2 DMThematic analysisSeven focus groups of 49 patients (22 males and 27 females), age range 44–83 years, ambulatory patients with the diagnosis of type 2 DM, with differences not only in age and sex, but in the method of treatment of diabetes as wellZagreb Medical SchoolTo explore type 2 diabetic patients’ attitudes, thoughts and fears connected with their illness; their expectations of the healthcare system; and the problems they encountered while adhering to the therapeutic regimen***
  • CVD, cardiovascular diseases; DM, diabetes mellitus; HCHD, Harris County Hospital District; HTN, hypertension; USM, Universiti Sains Malaysia.

  • Studies were grouped into low (one star: 0–3 points), medium (two stars: 4–7 points) and high quality (three stars: 8–10 points).