{ "total_codes": 3562, "unique_codes": 890, "codes": [ { "code": "Lack of questions", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "No", "context": "Patient does not have questions about their care", "file_id": "dr_DL0111 (1)", "chunk_id": 0 }, { "code": "Medication adherence", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "just take my-- take my medications", "context": "Patient is taking medications as part of their care", "file_id": "dr_DL0111 (1)", "chunk_id": 0 }, { "code": "Carb counting", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I count carbs--", "context": "Patient is managing their diet as part of their care", "file_id": "dr_DL0111 (1)", "chunk_id": 0 }, { "code": "Effective treatment", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "The Ozempic made it really easy", "context": "Patient has access to effective treatment options", "file_id": "dr_DL0111 (1)", "chunk_id": 0 }, { "code": "A1C monitoring", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "My A1C in January of last year was 15.8", "context": "Patient is receiving regular monitoring and feedback from their provider", "file_id": "dr_DL0111 (1)", "chunk_id": 0 }, { "code": "Provider guidance", "category": "FACILITATOR - Provider Relationship", "subcategory": "Shared decision-making", "quote": "they got me to bring it back up", "context": "Patient is receiving guidance and support from their provider", "file_id": "dr_DL0111 (1)", "chunk_id": 0 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "I wish I had it five years ago", "context": "Patient expresses regret over delayed access to effective treatment", "file_id": "dr_DL0111 (1)", "chunk_id": 1 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "The Ozempic made it really easy", "context": "Patient appreciates provider's prescription of effective medication", "file_id": "dr_DL0111 (1)", "chunk_id": 1 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Just making sure this is working, the-- Dexcom", "context": "Patient prioritizes understanding and managing their condition", "file_id": "dr_DL0111 (1)", "chunk_id": 1 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "The Ozempic made it really easy", "context": "Patient has positive experience with provider's treatment approach", "file_id": "dr_DL0111 (1)", "chunk_id": 1 }, { "code": "Lack of trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "None", "context": "No direct quote, but the conversation implies a need for backup checks, potentially indicating distrust in device readings", "file_id": "dr_DL0111 (1)", "chunk_id": 2 }, { "code": "Device issues", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication/Lack of continuity of care", "quote": "he kept saying I was low reading, low reading, and I was pricking my fingers. And I was in the three hundreds, so.", "context": "Patient experiences faulty readings from device", "file_id": "dr_DL0111 (1)", "chunk_id": 2 }, { "code": "Access to technology", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate access to devices", "quote": "I just don't prick my finger every day. I, -- so, , so-- if I feel off of or feel different than what that number's reading--", "context": "Patient has access to and uses a Dexcom device", "file_id": "dr_DL0111 (1)", "chunk_id": 2 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "and have you, , brought that up with your doctor that-- well, if it was just your last sensor, have you spoke to your doctor since then, your diabetes doctor?", "context": "Patient discusses device issues with their doctor", "file_id": "dr_DL0111 (1)", "chunk_id": 2 }, { "code": "Health literacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I was pricking my fingers. And I was in the three hundreds, so.", "context": "Patient understands how to use and interpret device readings", "file_id": "dr_DL0111 (1)", "chunk_id": 2 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "they didn't have any Libre 3s", "context": "Patient experienced lack of access to preferred device", "file_id": "dr_DL0111 (1)", "chunk_id": 3 }, { "code": "Equipment issues", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of continuity of care", "quote": "the sensors were supposed to last 15 days, and they were only lasting sometimes between 6 and 11", "context": "Patient experienced problems with medical equipment", "file_id": "dr_DL0111 (1)", "chunk_id": 3 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "And they said, 'Do you wanna try it?' And I'm , 'Yeah.'", "context": "Patient received supportive care from provider", "file_id": "dr_DL0111 (1)", "chunk_id": 3 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "And they gave me the Dexcom 7--", "context": "Patient received alternative solution from provider", "file_id": "dr_DL0111 (1)", "chunk_id": 3 }, { "code": "Lack of assistance", "category": "BARRIER - Social Determinants of Health", "subcategory": "Social support", "quote": "I have to have somebody else do it", "context": "Patient needs help with medical device", "file_id": "dr_DL0111 (1)", "chunk_id": 4 }, { "code": "Fear of hypoglycemia", "category": "BARRIER - Emotional/Psychological", "subcategory": "Diabetes distress", "quote": "my main concern, is that it drops too low", "context": "Patient worries about blood sugar levels", "file_id": "dr_DL0111 (1)", "chunk_id": 4 }, { "code": "Self monitoring skills", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I'll finger stick for two or three days, and then I'll put it back on", "context": "Patient takes initiative in tracking blood sugar", "file_id": "dr_DL0111 (1)", "chunk_id": 4 }, { "code": "Social support network", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "I have a friend who wears one", "context": "Patient has friends who understand their condition", "file_id": "dr_DL0111 (1)", "chunk_id": 4 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "my sight was really, really bad", "context": "Patient lacks awareness of diabetes impact on eyes", "file_id": "dr_DL0111 (1)", "chunk_id": 5 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I thought I wet the bed", "context": "Patient experiences anxiety related to diabetes symptoms", "file_id": "dr_DL0111 (1)", "chunk_id": 5 }, { "code": "Emotional distress", "category": "BARRIER - Emotional/Psychological", "subcategory": "Diabetes distress", "quote": "I get very tired", "context": "Patient experiences emotional burden of diabetes management", "file_id": "dr_DL0111 (1)", "chunk_id": 5 }, { "code": "Self-management support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I always keep little candies beside my bed", "context": "Patient uses strategies to manage diabetes", "file_id": "dr_DL0111 (1)", "chunk_id": 5 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I'm very-- I get very tired when it goes too low", "context": "Patient has knowledge of diabetes symptoms", "file_id": "dr_DL0111 (1)", "chunk_id": 5 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "when the numbers are high-- even now, -- I-- there's a little slight difference in my, my-- with my sugar being 300. I don't know why it's 300 right now", "context": "Patient seems unsure about relationship between blood sugar and vision", "file_id": "dr_DL0111 (1)", "chunk_id": 6 }, { "code": "Positive treatment outcome", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Yeah. And that-- The cataract removal and, I think, because of the, the Ozempic and-- numbers coming down.", "context": "Patient attributes improved vision to successful treatment", "file_id": "dr_DL0111 (1)", "chunk_id": 6 }, { "code": "Effective treatment", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "The cataract removal and, I think, because of the, the Ozempic and-- numbers coming down.", "context": "Patient receives effective care from healthcare system", "file_id": "dr_DL0111 (1)", "chunk_id": 6 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't know why it's 300 right now", "context": "Patient unsure about blood sugar levels", "file_id": "dr_DL0111 (1)", "chunk_id": 7 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "when the numbers are high-- even now", "context": "Patient anxious about high blood sugar levels", "file_id": "dr_DL0111 (1)", "chunk_id": 7 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "since the vision's changed?", "context": "Patient aware of vision changes due to diabetes", "file_id": "dr_DL0111 (1)", "chunk_id": 7 }, { "code": "Self management support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "if it's below 140, I-I'm fine", "context": "Patient managing blood sugar levels", "file_id": "dr_DL0111 (1)", "chunk_id": 7 }, { "code": "Lack of provider feedback", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "not really anything", "context": "Patient reports doctor hasn't discussed vision changes", "file_id": "dr_DL0111 (1)", "chunk_id": 8 }, { "code": "Fear of darkness", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "I have no balance. I'm all over the place", "context": "Patient experiences anxiety in dark environments", "file_id": "dr_DL0111 (1)", "chunk_id": 8 }, { "code": "Adaptive strategies", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I always have a-- , a flashlight if I go out", "context": "Patient uses tools to cope with vision loss", "file_id": "dr_DL0111 (1)", "chunk_id": 8 }, { "code": "Environmental modifications", "category": "FACILITATOR - Resources & Access", "subcategory": "Community health programs", "quote": "I've got motion lights all along the path", "context": "Patient makes environmental changes to improve safety", "file_id": "dr_DL0111 (1)", "chunk_id": 8 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "not really anything", "context": "Patient lacks information from doctor about vision changes", "file_id": "dr_DL0111 (1)", "chunk_id": 9 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "you can go blind from it", "context": "Patient aware of potential severe consequences of diabetes", "file_id": "dr_DL0111 (1)", "chunk_id": 9 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "watch your sugar levels", "context": "Patient understands importance of managing blood sugar", "file_id": "dr_DL0111 (1)", "chunk_id": 9 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "they're impressed that", "context": "Patient feels valued by healthcare provider", "file_id": "dr_DL0111 (1)", "chunk_id": 9 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "the chances are that you-- that I- - that I could lose my sight altogether", "context": "Patient expresses fear of losing sight due to DR", "file_id": "dr_DL0111 (1)", "chunk_id": 10 }, { "code": "Provider referral", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "And that's when, , Dr. L sent me to Dr. P,", "context": "Patient was referred to a specialist by their provider", "file_id": "dr_DL0111 (1)", "chunk_id": 10 }, { "code": "Lack of services", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "they don't do the contact exams here", "context": "Patient needs to go elsewhere for contact exams", "file_id": "dr_DL0111 (1)", "chunk_id": 11 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I get them here", "context": "Patient has access to eye care at the clinic", "file_id": "dr_DL0111 (1)", "chunk_id": 11 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "--she shows me the pictures of what's-- she's looking for", "context": "Patient feels informed by provider", "file_id": "dr_DL0111 (1)", "chunk_id": 12 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "--she shows me the pictures of what's-- she's looking for", "context": "Patient receives educational content from provider", "file_id": "dr_DL0111 (1)", "chunk_id": 12 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "--she shows me the pictures of what's-- she's looking for", "context": "Patient has a positive interaction with provider", "file_id": "dr_DL0111 (1)", "chunk_id": 12 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Well, for the last year, I've been going every four weeks", "context": "Patient has regular access to provider", "file_id": "dr_DL0111 (1)", "chunk_id": 12 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "no, she, -- I know that they said there's something with capillaries", "context": "Patient lacks clear understanding of diabetes-related eye conditions", "file_id": "dr_DL0111 (1)", "chunk_id": 13 }, { "code": "Provider explanation", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "they said there's something with capillaries", "context": "Provider explains patient's condition, facilitating understanding", "file_id": "dr_DL0111 (1)", "chunk_id": 13 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "that could progress and cause blindness-- so glaucoma", "context": "Patient fears potential consequences of diabetes-related eye conditions", "file_id": "dr_DL0111 (1)", "chunk_id": 13 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "Dr. L was doing a laser and zapping-- that's what I call it, zapping, --", "context": "Patient feels comfortable with provider's treatment approach", "file_id": "dr_DL0111 (1)", "chunk_id": 13 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "What do you mean they're not bad? I'm looking through a prism sometimes--", "context": "Patient questioning doctor's assessment of cataracts", "file_id": "dr_DL0111 (1)", "chunk_id": 14 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "Oh, you got the cataracts, but they're not bad. They're not bad.", "context": "Doctor downplaying patient's condition", "file_id": "dr_DL0111 (1)", "chunk_id": 14 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "As soon as Dr. L saw them, she sent me to Dr. P.", "context": "Patient receiving timely and effective care from providers", "file_id": "dr_DL0111 (1)", "chunk_id": 14 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "And P-P was, 'Yep, they're coming off.'", "context": "Provider clearly communicating treatment plan to patient", "file_id": "dr_DL0111 (1)", "chunk_id": 14 }, { "code": "Second opinion", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Patient navigation services", "quote": "And as soon as Dr. L saw them, she sent me to Dr. P.", "context": "Patient receiving additional expert opinion", "file_id": "dr_DL0111 (1)", "chunk_id": 14 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "If something's wrong, I tell them", "context": "Patient feels comfortable discussing issues with doctor", "file_id": "dr_DL0111 (1)", "chunk_id": 15 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "If something's wrong, I tell them", "context": "Patient communicates openly with doctor", "file_id": "dr_DL0111 (1)", "chunk_id": 15 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I had a tear in the retina--", "context": "Patient has knowledge of diabetes-related eye problems", "file_id": "dr_DL0111 (1)", "chunk_id": 15 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "If something's wrong, I tell them", "context": "Patient takes initiative in discussing health issues", "file_id": "dr_DL0111 (1)", "chunk_id": 15 }, { "code": "Provider Empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I trust him 100%", "context": "Patient expresses high level of trust in doctor", "file_id": "dr_DL0111 (1)", "chunk_id": 16 }, { "code": "Effective Communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Dr. P, this is what's going on", "context": "Patient uses messaging system to communicate with doctor", "file_id": "dr_DL0111 (1)", "chunk_id": 16 }, { "code": "Healthcare System Support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "MyChart's my best friend", "context": "Patient finds online portal helpful for communication and access to care", "file_id": "dr_DL0111 (1)", "chunk_id": 16 }, { "code": "Patient Engagement", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "if I notice something, I send them a message right away", "context": "Patient takes proactive approach to monitoring health and communicating with doctor", "file_id": "dr_DL0111 (1)", "chunk_id": 16 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I trust him 100%.", "context": "Patient expresses high level of trust in their doctor", "file_id": "dr_DL0111 (1)", "chunk_id": 17 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "speaking with the diabetic educators and, , my family doctor and the pharmacy team has opened my eyes a lot more.", "context": "Patient values open communication with healthcare team", "file_id": "dr_DL0111 (1)", "chunk_id": 17 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "I didn't feel I was getting anywhere with, , endocrinology--", "context": "Patient had negative experience with previous provider", "file_id": "dr_DL0111 (1)", "chunk_id": 17 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "speaking with the diabetic educators... has opened my eyes a lot more.", "context": "Patient benefits from health education", "file_id": "dr_DL0111 (1)", "chunk_id": 17 }, { "code": "Diabetes self-management support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "they got me to counting carbs, , 'Okay, I know that I can have this many carbs, or I can have that many carbs.'", "context": "Patient receives support for managing diabetes", "file_id": "dr_DL0111 (1)", "chunk_id": 17 }, { "code": "Lack of hunger", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I'm not hungry all the time", "context": "Patient experiences reduced hunger due to Ozempic", "file_id": "dr_DL0111 (1)", "chunk_id": 18 }, { "code": "Food aversion", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "a lot of foods turn me off", "context": "Patient experiences food aversion", "file_id": "dr_DL0111 (1)", "chunk_id": 18 }, { "code": "Smell sensitivity", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "the smell of food cooking sometimes makes me sick to my stomach", "context": "Patient experiences smell sensitivity", "file_id": "dr_DL0111 (1)", "chunk_id": 18 }, { "code": "Self management skills", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I know that I can have this many carbs, or I can have that many carbs", "context": "Patient demonstrates understanding of carb counting", "file_id": "dr_DL0111 (1)", "chunk_id": 18 }, { "code": "Positive treatment outcome", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Yes", "context": "Patient is pleased with outcomes from Ozempic", "file_id": "dr_DL0111 (1)", "chunk_id": 18 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "If you were to ask me that a year ago, I would've said, '100%, I think I'll lose it.'", "context": "Patient previously had limited understanding of diabetes impact on vision", "file_id": "dr_DL0111 (1)", "chunk_id": 19 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I wish I would've known about it six years ago, and maybe I would still have my leg.", "context": "Patient expresses regret over not knowing about treatment options sooner, implying fear of diagnosis", "file_id": "dr_DL0111 (1)", "chunk_id": 19 }, { "code": "Positive outlook", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "now I'm, I'm fairly comfortable with it, and I think it's-- if I can keep maintaining what I'm doing--", "context": "Patient feels more in control of their condition after learning about treatment options", "file_id": "dr_DL0111 (1)", "chunk_id": 19 }, { "code": "Health literacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "now I'm, I'm fairly comfortable with it, and I think it's-- if I can keep maintaining what I'm doing--", "context": "Patient demonstrates understanding of their condition and treatment", "file_id": "dr_DL0111 (1)", "chunk_id": 19 }, { "code": "Lack of urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "Okay. I'm coming up on a year next month--", "context": "Patient mentions timing of next appointment, implying they may not see urgent need", "file_id": "dr_DL0111 (1)", "chunk_id": 20 }, { "code": "Family influence", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "my stepmom, she had the cataracts, but she's not diabetic, so", "context": "Patient mentions family member's experience with eye care, potentially influencing their own attitudes", "file_id": "dr_DL0111 (1)", "chunk_id": 20 }, { "code": "Personal experience", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "she just now had to go get an eye exam and get glasses again", "context": "Patient learns from family member's experience, potentially informing their own health decisions", "file_id": "dr_DL0111 (1)", "chunk_id": 20 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "Very scary at first", "context": "Patient describes initial reaction to diagnosis as scary", "file_id": "dr_DL0111 (1)", "chunk_id": 21 }, { "code": "Lack of worry", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "No perceived urgency", "quote": "I haven't-- had any problems", "context": "Patient doesn't perceive follow-ups as urgent", "file_id": "dr_DL0111 (1)", "chunk_id": 22 }, { "code": "Trust in provider", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I don't have to worry about what's gonna happen", "context": "Patient trusts their provider", "file_id": "dr_DL0111 (1)", "chunk_id": 22 }, { "code": "Accessible care", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "everybody's , 'Y-you live an hour and a half away. Why do you keep coming here?'", "context": "Patient finds the healthcare system accessible despite distance", "file_id": "dr_DL0111 (1)", "chunk_id": 22 }, { "code": "Continuity of care", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Lack of continuity of care", "quote": "Everybody knows, so they can see it", "context": "Patient appreciates the continuity of care in the system", "file_id": "dr_DL0111 (1)", "chunk_id": 22 }, { "code": "Transportation issues", "category": "BARRIER - SDOH", "subcategory": "Transportation issues", "quote": "Y-you live an hour and a half away", "context": "Patient faces transportation challenges due to distance", "file_id": "dr_DL0111 (1)", "chunk_id": 22 }, { "code": "Lack of trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "But I don't trust them", "context": "Patient expresses distrust in local healthcare providers", "file_id": "dr_DL0111 (1)", "chunk_id": 23 }, { "code": "Poor care perception", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider issues", "quote": "All you guys did was put lipstick on a pig. You're making those buildings look beautiful, but you need to change the staff", "context": "Patient perceives local healthcare providers as inadequate", "file_id": "dr_DL0111 (1)", "chunk_id": 23 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "The care is better here", "context": "Patient prefers care at current location due to perceived higher quality", "file_id": "dr_DL0111 (1)", "chunk_id": 23 }, { "code": "Rude providers", "category": "BARRIER - Provider/System Issues", "subcategory": "Rude or dismissive providers", "quote": "All you guys did was put lipstick on a pig. You're making those buildings look beautiful, but you need to change the staff.", "context": "Patient expresses dissatisfaction with provider behavior", "file_id": "dr_DL0111 (1)", "chunk_id": 24 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "All you guys did was put lipstick on a pig. You're making those buildings look beautiful, but you need to change the staff.", "context": "Patient implies ineffective communication from providers", "file_id": "dr_DL0111 (1)", "chunk_id": 24 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "I'm talking about the doctors because--", "context": "Patient expresses distrust towards doctors", "file_id": "dr_DL0111 (1)", "chunk_id": 24 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "The care is better here.", "context": "Patient perceives better care at current facility", "file_id": "dr_DL0111 (1)", "chunk_id": 24 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "we were there for 14 hours", "context": "Patient experienced long wait time at the emergency room", "file_id": "dr_DL0111 (1)", "chunk_id": 25 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "they kept saying they were gonna give me fluids. I begged them for water and never got it", "context": "Patient did not receive clear communication about their treatment", "file_id": "dr_DL0111 (1)", "chunk_id": 25 }, { "code": "Lack of access to healthcare", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "the emergency room was coming here. But she said that was too far for what was happening", "context": "Patient had to go to a different hospital due to distance", "file_id": "dr_DL0111 (1)", "chunk_id": 25 }, { "code": "Transportation issues", "category": "BARRIER - SDOH", "subcategory": "Transportation issues", "quote": "I'll drive myself", "context": "Patient had to arrange their own transportation to the hospital", "file_id": "dr_DL0111 (1)", "chunk_id": 25 }, { "code": "Rude providers", "category": "BARRIER - Provider/System Issues", "subcategory": "Rude or dismissive providers", "quote": "I begged them for water and never got it", "context": "Patient felt neglected by healthcare staff", "file_id": "dr_DL0111 (1)", "chunk_id": 26 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "Well, we don't know what to do with you, so we're going-- we're going to get an ambulance and take you to W-- to Ruby", "context": "Patient experienced unclear communication from providers", "file_id": "dr_DL0111 (1)", "chunk_id": 26 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "They didn't give me anything", "context": "Patient distrusts provider's actions and decisions", "file_id": "dr_DL0111 (1)", "chunk_id": 26 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "And they started giving me fluids", "context": "Patient received timely care from responsive providers", "file_id": "dr_DL0111 (1)", "chunk_id": 26 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "they said, Well, we'd to give you another, , bag of fluids, but we can't because Reynolds has already charted that they did do.", "context": "Patient was denied further treatment due to administrative issues", "file_id": "dr_DL0111 (1)", "chunk_id": 27 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "they said, Well, we'd to give you another, , bag of fluids, but we can't because Reynolds has already charted that they did do.", "context": "Patient experienced poor communication from healthcare providers", "file_id": "dr_DL0111 (1)", "chunk_id": 27 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "it's good that you got-- to here and that you're comfortable here.", "context": "Patient felt comfortable with their current healthcare provider", "file_id": "dr_DL0111 (1)", "chunk_id": 27 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "And I-- and I know that one of the things for blood pressure low is to drink water to increase it, so.", "context": "Patient demonstrated knowledge of their condition and how to manage it", "file_id": "dr_DL0111 (1)", "chunk_id": 27 }, { "code": "No Transportation Issues", "category": "FACILITATOR - Resources & Access", "subcategory": "Transportation assistance", "quote": "So it doesn't bother me to drive down here.", "context": "Patient has no issues with driving to appointments", "file_id": "dr_DL0111 (1)", "chunk_id": 28 }, { "code": "Provider Instruction", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "a doctor said, 'This is when you come back,' so that's when I come back.", "context": "Patient follows provider's instructions for follow-up", "file_id": "dr_DL0111 (1)", "chunk_id": 28 }, { "code": "Self Awareness", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I'm just always been one that I know when something's wrong with me.", "context": "Patient is aware of their health and takes initiative", "file_id": "dr_DL0111 (1)", "chunk_id": 28 }, { "code": "Provider Empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "a doctor said, 'This is when you come back,'", "context": "Patient values provider's instruction", "file_id": "dr_DL0111 (1)", "chunk_id": 29 }, { "code": "Patient Empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I know when something's wrong with me", "context": "Patient takes initiative in seeking help", "file_id": "dr_DL0111 (1)", "chunk_id": 29 }, { "code": "Effective Communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "a doctor said, 'This is when you come back,'", "context": "Clear instruction from provider", "file_id": "dr_DL0111 (1)", "chunk_id": 29 }, { "code": "Patient Autonomy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I argued with the doctors", "context": "Patient takes active role in healthcare decisions", "file_id": "dr_DL0111 (1)", "chunk_id": 29 }, { "code": "Lack of trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "Most guys would just let it burst", "context": "Patient questions doctor's decision", "file_id": "dr_DL0111 (1)", "chunk_id": 30 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I know my body", "context": "Patient takes initiative in healthcare", "file_id": "dr_DL0111 (1)", "chunk_id": 30 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "And the doctor asked me, he goes", "context": "Doctor engages with patient's concerns", "file_id": "dr_DL0111 (1)", "chunk_id": 30 }, { "code": "Social support networks", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "I have a nurse, a friend who's a nurse", "context": "Patient has supportive social connections", "file_id": "dr_DL0111 (1)", "chunk_id": 30 }, { "code": "Health literacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "Don't worry about how I know about it", "context": "Patient demonstrates understanding of medical procedures", "file_id": "dr_DL0111 (1)", "chunk_id": 30 }, { "code": "Social Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "I have a nur-- a friend who's a nurse, so who's an ex-girlfriend, and-- we're still good friends.", "context": "Patient has a supportive friend who is a nurse", "file_id": "dr_DL0111 (1)", "chunk_id": 31 }, { "code": "Healthcare Advice", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "And she told me, she said, 'Ask them for HIDA scan.'", "context": "Patient receives healthcare advice from a supportive friend", "file_id": "dr_DL0111 (1)", "chunk_id": 31 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "sometimes I, I will plan it, and I'll say, 'Okay. I, I need somebody to drive me home.'", "context": "Patient needs someone to drive them home after appointment", "file_id": "dr_DL0111 (1)", "chunk_id": 32 }, { "code": "Provider empathy", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "2. Provider Relationship", "quote": "We were so in tune to each other that, , we could actually have a conversation and not say a word.", "context": "Patient feels comfortable with provider", "file_id": "dr_DL0111 (1)", "chunk_id": 32 }, { "code": "Trust in provider", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "2. Provider Relationship", "quote": "if your doctor's suggesting it, follow through with it-- , because it-- they're the professionals, and they know best.", "context": "Patient trusts provider's expertise", "file_id": "dr_DL0111 (1)", "chunk_id": 32 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "because I wasn't paying attention and I wasn't doing anything", "context": "Patient initially lacked awareness of disease progression", "file_id": "dr_DL0111 (1)", "chunk_id": 33 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "when Dr. L started doing the, the lasers on my eyes", "context": "Patient feared treatment and diagnosis", "file_id": "dr_DL0111 (1)", "chunk_id": 33 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "Dr. L started doing the, the lasers on my eyes and, and I was coming back and she goes, 'They're coming back. They're, they're growing faster, and I can zap them away'", "context": "Provider showed empathy and explained treatment", "file_id": "dr_DL0111 (1)", "chunk_id": 33 }, { "code": "Social support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "my mom lives next door. And the first thing she says when she see me, 'Did you take your meds?'", "context": "Patient has social support from family member", "file_id": "dr_DL0111 (1)", "chunk_id": 33 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I need to follow through with getting my sugars down and getting--everything down", "context": "Patient learned about importance of managing diabetes", "file_id": "dr_DL0111 (1)", "chunk_id": 33 }, { "code": "Self management", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I don't eat carbs. Well, I don't eat potatoes. I don't eat bread. I don't eat all this stuff, the carbs. I eat a lot of protein", "context": "Patient is managing diet to control diabetes", "file_id": "dr_DL0111 (1)", "chunk_id": 33 }, { "code": "Social Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "my mom lives next door. And the first thing she says when she see me, 'Did you take your meds?'", "context": "Patient has a supportive family member", "file_id": "dr_DL0111 (1)", "chunk_id": 34 }, { "code": "Family Involvement", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "And she actually comes over and checks to make sure that I've filled up my weekly pill bottle.", "context": "Patient's family member helps with medication management", "file_id": "dr_DL0111 (1)", "chunk_id": 34 }, { "code": "Healthcare Team Support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "'Cause I got the ha-- the, the pharmacy team-- and Dr", "context": "Patient has a supportive healthcare team", "file_id": "dr_DL0111 (1)", "chunk_id": 34 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "they message me and say, 'Hey, how's this going? How's--'", "context": "Patient feels supported by provider's regular check-ins", "file_id": "dr_DL0111 (1)", "chunk_id": 35 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "they message me and say, 'Hey, how's this going? How's--'", "context": "Patient receives regular updates and feedback from provider", "file_id": "dr_DL0111 (1)", "chunk_id": 35 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "the pharmacy team-- and Dr. P--", "context": "Patient has access to multiple healthcare professionals", "file_id": "dr_DL0111 (1)", "chunk_id": 35 }, { "code": "Reminder systems", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "They sent me a message yesterday", "context": "Patient receives reminders and follow-ups from healthcare team", "file_id": "dr_DL0111 (1)", "chunk_id": 35 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "That feels more personal", "context": "Patient appreciates personalized care from provider", "file_id": "dr_DL0111 (1)", "chunk_id": 36 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "it is more personalized", "context": "Patient values clear and personal communication with provider", "file_id": "dr_DL0111 (1)", "chunk_id": 36 }, { "code": "Patient comfort with provider", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "I feel comfortable with them", "context": "Patient feels at ease with their healthcare provider", "file_id": "dr_DL0111 (1)", "chunk_id": 36 }, { "code": "Positive attitude", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "If you can't laugh about it--", "context": "Patient uses humor to cope with health issues", "file_id": "dr_DL0111 (1)", "chunk_id": 37 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I will call here", "context": "Patient has access to healthcare providers for advice", "file_id": "dr_DL0111 (1)", "chunk_id": 37 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Dr. M came in, the surgeon, saw me in recovery", "context": "Patient receives clear communication from healthcare provider", "file_id": "dr_DL0111 (1)", "chunk_id": 37 }, { "code": "Coping mechanism", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "It is what it is. I'm-- I gotta live with it, so", "context": "Patient uses coping mechanisms to deal with health issues", "file_id": "dr_DL0111 (1)", "chunk_id": 37 }, { "code": "Healthcare access", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate insurance coverage", "quote": "I will call here", "context": "Patient has access to healthcare services", "file_id": "dr_DL0111 (1)", "chunk_id": 37 }, { "code": "Appointment scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "And i-it's hard to get an appointment-- that quick anyways", "context": "Patient finds it challenging to schedule appointments quickly", "file_id": "dr_DL0111 (1)", "chunk_id": 38 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I will call here", "context": "Patient has easy access to healthcare providers via MyChart messaging", "file_id": "dr_DL0111 (1)", "chunk_id": 38 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "'Hey, this is going on. What should I do, or any suggestions?'", "context": "Patient communicates effectively with providers via messaging", "file_id": "dr_DL0111 (1)", "chunk_id": 38 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "You mentioned earlier that you did, , diabetes education classes, right--", "context": "Patient has participated in diabetes education classes", "file_id": "dr_DL0111 (1)", "chunk_id": 38 }, { "code": "Appointment scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "it's hard to get an appointment-- that quick anyways", "context": "Patient finds it challenging to schedule appointments quickly", "file_id": "dr_DL0111 (1)", "chunk_id": 39 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "diabetes education classes", "context": "Patient participated in diabetes education classes", "file_id": "dr_DL0111 (1)", "chunk_id": 39 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "the diabetic educators. A lot of it was when I was hospitalized. They'd come in and talk to me", "context": "Patient had access to diabetic educators during hospitalization", "file_id": "dr_DL0111 (1)", "chunk_id": 39 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "someone from family medicine would come in and talk to me", "context": "Patient received communication from family medicine providers", "file_id": "dr_DL0111 (1)", "chunk_id": 39 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "when I started counting carbs and I learned how to count carbs", "context": "Patient received education on carb counting", "file_id": "dr_DL0111 (1)", "chunk_id": 40 }, { "code": "Effective self management", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I saw a big difference", "context": "Patient experienced positive outcomes from self-management", "file_id": "dr_DL0111 (1)", "chunk_id": 40 }, { "code": "Lack of side effects", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I am not having any side effects on them", "context": "Patient feels empowered by lack of side effects from medication", "file_id": "dr_DL0111 (1)", "chunk_id": 43 }, { "code": "Social support networks", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "I tell people all the time", "context": "Patient has social support from friends", "file_id": "dr_DL0111 (1)", "chunk_id": 43 }, { "code": "Health literacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I'm not having any side effects on them", "context": "Patient understands medication side effects", "file_id": "dr_DL0111 (1)", "chunk_id": 43 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "I live, an hour a half away up", "context": "Patient mentions living far from the clinic", "file_id": "dr_DL0111 (1)", "chunk_id": 45 }, { "code": "Telehealth options", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "1. Healthcare System Support", "quote": "I've done that a couple of times, not with the eye doctor, but", "context": "Patient has experience with telemedicine", "file_id": "dr_DL0111 (1)", "chunk_id": 45 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "couldn't get down here to it", "context": "Patient had difficulty traveling to appointments", "file_id": "dr_DL0111 (1)", "chunk_id": 46 }, { "code": "Telehealth options", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "1. Healthcare System Support", "quote": "I've done that a couple of times, not with the eye doctor, but", "context": "Patient has experience with telemedicine", "file_id": "dr_DL0111 (1)", "chunk_id": 46 }, { "code": "Provider technical limitations", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "3. Provider/System Issues", "quote": "if it was for eyes-- them being able to visually see my eyes", "context": "Patient concerns about telemedicine limitations for eye exams", "file_id": "dr_DL0111 (1)", "chunk_id": 46 }, { "code": "Accessible providers", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "1. Healthcare System Support", "quote": "Oh, no, we do that", "context": "Patient has access to primary care provider via telemedicine", "file_id": "dr_DL0111 (1)", "chunk_id": 46 }, { "code": "Poor provider change experience", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "3. Provider/System Issues", "quote": "I actually tried changing my PCP to a local, and that was a disaster", "context": "Patient had negative experience changing primary care providers", "file_id": "dr_DL0111 (1)", "chunk_id": 46 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "--couldn't get down here to it", "context": "Patient had difficulty traveling to the clinic", "file_id": "dr_DL0111 (1)", "chunk_id": 47 }, { "code": "Lack of access to healthcare", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "--couldn't get down here to it", "context": "Patient had difficulty accessing healthcare due to location", "file_id": "dr_DL0111 (1)", "chunk_id": 47 }, { "code": "Rude or dismissive providers", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "3. Provider/System Issues", "quote": "--We told you there's nothing wrong with you. Why do you keep coming here?", "context": "Patient experienced rude treatment from healthcare providers", "file_id": "dr_DL0111 (1)", "chunk_id": 47 }, { "code": "Poor communication", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "3. Provider/System Issues", "quote": "--We told you there's nothing wrong with you. Why do you keep coming here?", "context": "Patient experienced poor communication from healthcare providers", "file_id": "dr_DL0111 (1)", "chunk_id": 47 }, { "code": "Lack of patient-provider trust", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "3. Provider/System Issues", "quote": "I actually tried changing my PCP to a local, and that was a disaster", "context": "Patient lacked trust in their healthcare provider", "file_id": "dr_DL0111 (1)", "chunk_id": 47 }, { "code": "Accessible providers", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "1. Healthcare System Support", "quote": "I actually tried changing my PCP to a local", "context": "Patient attempted to find a more accessible provider", "file_id": "dr_DL0111 (1)", "chunk_id": 47 }, { "code": "Rude providers", "category": "BARRIER - Provider/System Issues", "subcategory": "Rude or dismissive providers", "quote": "'We told you there's nothing wrong with you. Why do you keep coming here?'", "context": "Patient feels dismissed by provider", "file_id": "dr_DL0111 (1)", "chunk_id": 48 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "'We told you you had Lyme disease.' But they admitted me every time for one night.", "context": "Patient experiences inconsistent messaging from providers", "file_id": "dr_DL0111 (1)", "chunk_id": 48 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "And the person who was supposed-- doctor who's supposed to be my PCP, walk past the room every time I was in the hospital but never stepped in to see me.", "context": "Patient feels neglected by their PCP", "file_id": "dr_DL0111 (1)", "chunk_id": 48 }, { "code": "Appointment scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "I'd make a P-- appointment with PCP, and then they tell me I didn't have an appointment, or they cancel it or change it.", "context": "Patient experiences issues with scheduling appointments", "file_id": "dr_DL0111 (1)", "chunk_id": 48 }, { "code": "Lack of continuity of care", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of continuity of care", "quote": "And the person who was supposed-- doctor who's supposed to be my PCP, walk past the room every time I was in the hospital but never stepped in to see me.", "context": "Patient lacks consistent care from their PCP", "file_id": "dr_DL0111 (1)", "chunk_id": 48 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "She goes, 'Oh, somebody screwed up,' and that's all she said and slid the window u-- down.", "context": "Patient experiences poor communication with healthcare staff", "file_id": "dr_DL0111 (1)", "chunk_id": 49 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "And he just look-looked at me, and I just got up and walked away.", "context": "Patient loses trust in healthcare provider", "file_id": "dr_DL0111 (1)", "chunk_id": 49 }, { "code": "Appointment scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "They're -- she's, 'No, you don't. We, we don't have appointments on Friday.'", "context": "Patient experiences difficulty with appointment scheduling", "file_id": "dr_DL0111 (1)", "chunk_id": 49 }, { "code": "Rude or dismissive providers", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "And he just look-looked at me, and I just got up and walked away.", "context": "Patient experiences rude behavior from healthcare provider", "file_id": "dr_DL0111 (1)", "chunk_id": 49 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Healthcare System Support", "quote": "I called Dr", "context": "Patient has access to a preferred healthcare provider", "file_id": "dr_DL0111 (1)", "chunk_id": 49 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "I don't have an appointment for-- , I don't have anything available until August something.", "context": "Patient faces difficulty in getting an appointment", "file_id": "dr_DL0111 (1)", "chunk_id": 50 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "Nobody will listen to me at all.", "context": "Patient feels not heard by healthcare providers", "file_id": "dr_DL0111 (1)", "chunk_id": 50 }, { "code": "Accessible provider", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "She has this lovely Thursday night office hours.", "context": "Patient appreciates flexible office hours of provider", "file_id": "dr_DL0111 (1)", "chunk_id": 50 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "And she said, 'I'll find it.' And she kept looking and looking", "context": "Patient feels heard and helped by provider", "file_id": "dr_DL0111 (1)", "chunk_id": 50 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "And she said, 'I'll find it.' And she kept looking and looking", "context": "Patient experiences effective communication with provider", "file_id": "dr_DL0111 (1)", "chunk_id": 50 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "nobody will listen to me in, in Glendale. Nobody--will listen to me at all.", "context": "Patient felt unheard by previous providers", "file_id": "dr_DL0111 (1)", "chunk_id": 51 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I trust her", "context": "Patient has a trusting relationship with current provider", "file_id": "dr_DL0111 (1)", "chunk_id": 51 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "she likes very thorough, da, da, da.", "context": "Provider is described as thorough and communicative", "file_id": "dr_DL0111 (1)", "chunk_id": 51 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "I trust her", "context": "Patient feels comfortable with provider", "file_id": "dr_DL0111 (1)", "chunk_id": 52 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I trust her. I trust--", "context": "Patient has established trust with provider", "file_id": "dr_DL0111 (1)", "chunk_id": 52 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "they'll ask me, 'Do you mind if--'", "context": "Provider involves patient in decision-making process", "file_id": "dr_DL0111 (1)", "chunk_id": 52 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "So, but, -- so I trust her", "context": "Patient feels comfortable with provider", "file_id": "dr_DL0111 (1)", "chunk_id": 53 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "And it's good that you felt comfortable enough to express that to her", "context": "Patient and provider have open communication", "file_id": "dr_DL0111 (1)", "chunk_id": 53 }, { "code": "Patient-provider trust", "category": "FACILITATOR - Provider Relationship", "subcategory": "Lack of patient-provider trust", "quote": "So, but, -- so I trust her", "context": "Patient has established trust with provider", "file_id": "dr_DL0111 (1)", "chunk_id": 53 }, { "code": "Fear of diagnosis/treatment", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "the first two, , I was in pain, and it felt he was pushing the needle", "context": "Patient experienced pain during injections", "file_id": "dr_DL0111 (1)", "chunk_id": 53 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I pretty much just go with whatever she suggests", "context": "Patient trusts doctor's suggestions", "file_id": "dr_DL0111 (1)", "chunk_id": 54 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "If it's something that I'm not familiar with or something's changing", "context": "Patient feels comfortable asking questions", "file_id": "dr_DL0111 (1)", "chunk_id": 54 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "And it's good that you felt comfortable enough to express that to her", "context": "Interviewer acknowledges patient's comfort with doctor", "file_id": "dr_DL0111 (1)", "chunk_id": 54 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "You're crazy", "context": "Patient expresses distrust in doctor's diagnosis", "file_id": "dr_DL0111 (1)", "chunk_id": 54 }, { "code": "Lack of trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "I'm not going back", "context": "Patient lost trust in providers after a negative experience", "file_id": "dr_DL0111 (1)", "chunk_id": 55 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "nobody came in", "context": "Patient felt neglected and not communicated with by healthcare staff", "file_id": "dr_DL0111 (1)", "chunk_id": 55 }, { "code": "Rude providers", "category": "BARRIER - Provider/System Issues", "subcategory": "Rude or dismissive providers", "quote": "You're crazy", "context": "Patient felt disrespected by a provider", "file_id": "dr_DL0111 (1)", "chunk_id": 55 }, { "code": "Lack of continuity of care", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of continuity of care", "quote": "the doctors changed at midnight", "context": "Patient experienced a change in providers during their care", "file_id": "dr_DL0111 (1)", "chunk_id": 55 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "the second doctor, he at least attempted", "context": "Patient appreciated a provider's effort to understand and help", "file_id": "dr_DL0111 (1)", "chunk_id": 55 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "they talk to me, not down to me or at me", "context": "Patient feels respected by providers", "file_id": "dr_DL0111 (1)", "chunk_id": 56 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "they will explain it so that I understand it", "context": "Patient feels heard and understood by providers", "file_id": "dr_DL0111 (1)", "chunk_id": 56 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I've been with Dr", "context": "Patient has established a relationship with their doctor", "file_id": "dr_DL0111 (1)", "chunk_id": 56 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I've been with Dr. P since she was a resident", "context": "Patient has long-term relationship with provider", "file_id": "dr_DL0111 (1)", "chunk_id": 57 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "I do. Yeah", "context": "Patient feels respected by provider", "file_id": "dr_DL0111 (1)", "chunk_id": 57 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Could you explain that so I can understand it?", "context": "Patient asks for clarification from provider", "file_id": "dr_DL0111 (1)", "chunk_id": 57 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "everybody needs to learn to count carbs", "context": "Patient emphasizes importance of health education", "file_id": "dr_DL0111 (1)", "chunk_id": 57 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "everybody needs to learn to count carbs", "context": "Patient emphasizes importance of health education", "file_id": "dr_DL0111 (1)", "chunk_id": 58 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "Dr. P and I made the decision", "context": "Patient feels supported by provider in decision-making", "file_id": "dr_DL0111 (1)", "chunk_id": 58 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "She said, 'Yeah?' And I was, 'It is-- the--' what do I want to say? 'The side effects-- the, the benefits far outweigh the side effects.'", "context": "Patient engages in open conversation with provider", "file_id": "dr_DL0111 (1)", "chunk_id": 58 }, { "code": "Shared decision-making", "category": "FACILITATOR - Provider Relationship", "subcategory": "Shared decision-making", "quote": "Dr. P and I made the decision", "context": "Patient collaborates with provider in making decisions", "file_id": "dr_DL0111 (1)", "chunk_id": 58 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "She said, 'Are you sure?' And I'm , 'Yep.' She said, 'Okay.'", "context": "Patient feels heard and understood by provider", "file_id": "dr_DL0111 (1)", "chunk_id": 59 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "I told her, I said, 'Yeah.' I was , 'I think the, the side effects-- the benefits are-- far outweigh the side effects.'", "context": "Patient and provider discuss treatment options", "file_id": "dr_DL0111 (1)", "chunk_id": 59 }, { "code": "Insurance coverage", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate insurance coverage", "quote": "the insurance. I have to pay for it.", "context": "Patient mentions insurance as a factor in using healthcare services", "file_id": "dr_MD0610(part3)", "chunk_id": 1 }, { "code": "Insurance coverage", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate insurance coverage", "quote": "the insurance. I have to pay for it.", "context": "Patient mentions insurance as a factor in using healthcare services", "file_id": "dr_MD0610(part3)", "chunk_id": 2 }, { "code": "Healthcare system knowledge", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I'm a paramedic, so.", "context": "Patient's profession gives them understanding of healthcare", "file_id": "dr_MD0610(part3)", "chunk_id": 2 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "Because I can see people that do take care of themselves lots of the time", "context": "Patient's experience as a paramedic influences their view of healthcare providers", "file_id": "dr_MD0610(part3)", "chunk_id": 2 }, { "code": "Rude providers", "category": "BARRIER - Provider/System Issues", "subcategory": "Rude or dismissive providers", "quote": "when the people are nice and they're not a-holes to everybody", "context": "Patient mentions importance of provider personality", "file_id": "dr_MD0610(part3)", "chunk_id": 3 }, { "code": "Cost concerns", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Expensive treatments/surgery", "quote": "the cost of the-- stuff", "context": "Patient mentions cost as a factor affecting people", "file_id": "dr_MD0610(part3)", "chunk_id": 3 }, { "code": "Cost concerns", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Expensive treatments/surgery", "quote": "the cost of the-- stuff", "context": "Patient mentions cost as a concern", "file_id": "dr_MD0610(part3)", "chunk_id": 4 }, { "code": "Insurance issues", "category": "BARRIER - SDOH", "subcategory": "Insurance coverage issues", "quote": "especially if they don't have insurance", "context": "Patient highlights lack of insurance as a barrier", "file_id": "dr_MD0610(part3)", "chunk_id": 4 }, { "code": "Lack of social support", "category": "BARRIER - Social Determinants of Health", "subcategory": "Education/health literacy barriers", "quote": "No", "context": "Patient indicates no help with daily diabetes care", "file_id": "dr_MD0610(part3)", "chunk_id": 4 }, { "code": "Social support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "Oh, yeah", "context": "Patient has someone to help with daily chores if needed", "file_id": "dr_MD0610(part3)", "chunk_id": 4 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Hmm", "context": "Patient is asked about participating in diabetes education classes", "file_id": "dr_MD0610(part3)", "chunk_id": 4 }, { "code": "Lack of health education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "I didn't pay too much attention", "context": "Patient did not fully engage with diabetes education", "file_id": "dr_MD0610(part3)", "chunk_id": 5 }, { "code": "Limited social support", "category": "BARRIER - Social Determinants of Health (SDOH)", "subcategory": "Social support networks", "quote": "No", "context": "Patient lacks people to share worries or fears with", "file_id": "dr_MD0610(part3)", "chunk_id": 5 }, { "code": "Doctor as resource", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I talk to my doctor", "context": "Patient relies on doctor for health advice", "file_id": "dr_MD0610(part3)", "chunk_id": 5 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "it don't really limit me now", "context": "Patient seems unaware of potential future vision problems", "file_id": "dr_MD0610(part3)", "chunk_id": 6 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I was hoping he would tell me it's okay, but it's detaching a little bit again", "context": "Patient expresses concern about diagnosis", "file_id": "dr_MD0610(part3)", "chunk_id": 6 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "he tells me it's--", "context": "Patient trusts provider to explain condition", "file_id": "dr_MD0610(part3)", "chunk_id": 6 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "if I got a health problem, I talk to my doctor", "context": "Patient has easy access to healthcare provider", "file_id": "dr_MD0610(part3)", "chunk_id": 6 }, { "code": "Lack of worry", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "I wasn't really worried about it then either", "context": "Patient doesn't perceive urgency for follow-up", "file_id": "dr_MD0610(part3)", "chunk_id": 7 }, { "code": "Lack of context", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "we're exploring the views perspectives on eyecare, , and eye exams for those individuals who have diabetes", "context": "Patient seems unclear about purpose of interview", "file_id": "dr_KS1121", "chunk_id": 1 }, { "code": "Time constraints", "category": "BARRIER - Social Determinants of Health (SDOH)", "subcategory": "Financial constraints", "quote": "I know you have, , something to do", "context": "Patient has other commitments limiting their time", "file_id": "dr_KS1121", "chunk_id": 1 }, { "code": "Incentivization", "category": "FACILITATOR - Resources & Access", "subcategory": "Financial assistance programs", "quote": "you'll get that $20 Visa gift card", "context": "Patient is motivated by financial reward", "file_id": "dr_KS1121", "chunk_id": 1 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "what are some things you do each day related to your diabetes?", "context": "Patient is engaged in health discussions", "file_id": "dr_KS1121", "chunk_id": 1 }, { "code": "Self management", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I check my blood sugars, take my medications", "context": "Patient is proactive about managing their diabetes", "file_id": "dr_KS1121", "chunk_id": 1 }, { "code": "Health awareness", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I really am trying to watch my carb intake", "context": "Patient demonstrates understanding of healthy habits", "file_id": "dr_KS1121", "chunk_id": 1 }, { "code": "Lack of awareness", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "not yet", "context": "Patient seems unaware of potential eye damage from diabetes", "file_id": "dr_KS1121", "chunk_id": 2 }, { "code": "Provider communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Yes", "context": "Patient indicates doctor has informed them about diabetes effects on eyes", "file_id": "dr_KS1121", "chunk_id": 2 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Here", "context": "Patient goes to the same location for eye exams, implying accessibility", "file_id": "dr_KS1121", "chunk_id": 2 }, { "code": "Lack of perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "since I don't have any problems", "context": "Patient believes they don't need frequent check-ups", "file_id": "dr_KS1121", "chunk_id": 3 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "It's good", "context": "Patient finds doctor's availability satisfactory", "file_id": "dr_KS1121", "chunk_id": 3 }, { "code": "Easy appointment scheduling", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Appointment scheduling difficulties", "quote": "I just get an appointment, and come, and go", "context": "Patient finds scheduling process straightforward", "file_id": "dr_KS1121", "chunk_id": 3 }, { "code": "Provider Availability", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "It's good", "context": "Patient finds doctor's availability satisfactory", "file_id": "dr_KS1121", "chunk_id": 4 }, { "code": "Positive Experience", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I think it all goes very well", "context": "Patient is satisfied with eye care experience", "file_id": "dr_KS1121", "chunk_id": 4 }, { "code": "Lack Of Challenges", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "No", "context": "Patient does not face challenges in receiving eye care", "file_id": "dr_KS1121", "chunk_id": 4 }, { "code": "Self Care Practices", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I wear my eyeglasses", "context": "Patient takes care of their eyes by wearing glasses", "file_id": "dr_KS1121", "chunk_id": 4 }, { "code": "Awareness Of Risk", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "they can sneak up on you at any time", "context": "Patient is aware of the risk of vision loss due to diabetes", "file_id": "dr_KS1121", "chunk_id": 4 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "they can sneak up on you at any time", "context": "Patient lacks knowledge about diabetes-related eye problems", "file_id": "dr_KS1121", "chunk_id": 5 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "And then you could go blind", "context": "Patient is aware of potential vision loss due to diabetes", "file_id": "dr_KS1121", "chunk_id": 5 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I'm fine", "context": "Patient feels comfortable discussing concerns with doctor", "file_id": "dr_KS1121", "chunk_id": 5 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "today, I ask him", "context": "Patient is able to express concerns to doctor", "file_id": "dr_KS1121", "chunk_id": 5 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I hope I'm not likely at all", "context": "Patient shows lack of understanding about diabetes vision loss", "file_id": "dr_KS1121", "chunk_id": 6 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "My current vision is good", "context": "Patient feels no urgency due to current good vision", "file_id": "dr_KS1121", "chunk_id": 6 }, { "code": "Calendar reminder", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "My calendar.", "context": "Patient uses calendar to keep track of appointments", "file_id": "dr_KS1121", "chunk_id": 7 }, { "code": "Transportation assistance", "category": "FACILITATOR - Resources & Access", "subcategory": "Transportation assistance", "quote": "You go elevator", "context": "Patient is being helped with transportation within the clinic", "file_id": "dr_KS1121", "chunk_id": 8 }, { "code": "Healthcare System Support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "She'll take you", "context": "Patient is being escorted by a staff member", "file_id": "dr_KS1121", "chunk_id": 8 }, { "code": "Social Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "My mom", "context": "Patient has someone to share worries with", "file_id": "dr_KS1121", "chunk_id": 9 }, { "code": "Self Management", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I do it myself, basically", "context": "Patient feels comfortable managing diabetes alone", "file_id": "dr_KS1121", "chunk_id": 9 }, { "code": "Home health support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Patient navigation services", "quote": "right now I have home health", "context": "Patient receives help from home health services", "file_id": "dr_KS1121", "chunk_id": 10 }, { "code": "Positive expectations", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "To tell me everything was okay", "context": "Patient has positive expectations for their visit", "file_id": "dr_KS1121", "chunk_id": 10 }, { "code": "Lack of awareness", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't know what else there is to ...", "context": "Patient unsure about comprehensive diabetic care", "file_id": "dr_TK0914", "chunk_id": 0 }, { "code": "Health literacy", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "I don't know what else there is to ...", "context": "Patient lacks knowledge about diabetes management", "file_id": "dr_TK0914", "chunk_id": 0 }, { "code": "Self-monitoring", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I scan my blood sugar at least five, 10 times a day", "context": "Patient actively monitors blood sugar levels", "file_id": "dr_TK0914", "chunk_id": 0 }, { "code": "Adherence to medication", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I'll take my medications", "context": "Patient prioritizes taking prescribed medications", "file_id": "dr_TK0914", "chunk_id": 0 }, { "code": "Proactive care", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "check my blood sugar level multiple times", "context": "Patient engages in proactive diabetic care activities", "file_id": "dr_TK0914", "chunk_id": 0 }, { "code": "Lack of symptoms", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "No perceived urgency", "quote": "None. Speaker 1: None? Okay. , has your doctor said anything, , regarding your eyes and no diabetes? Speaker 3: No.", "context": "Patient hasn't noticed any changes in their eyes", "file_id": "dr_TK0914", "chunk_id": 1 }, { "code": "Provider advice", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I mean, they, they of course say, , you gotta keep it under control.", "context": "Patient receives guidance from their doctor", "file_id": "dr_TK0914", "chunk_id": 1 }, { "code": "Self monitoring", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I scan my blood sugar at least five, 10 times a day so I don't have to look for symptoms 'cause this tells me.", "context": "Patient actively manages their diabetes", "file_id": "dr_TK0914", "chunk_id": 1 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "my eye problems are not related to diabetes", "context": "Patient believes their eye issues are unrelated to diabetes", "file_id": "dr_TK0914", "chunk_id": 2 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "they let me know how important that is", "context": "Patient feels informed by their provider", "file_id": "dr_TK0914", "chunk_id": 2 }, { "code": "Access to healthcare", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate access to care", "quote": "I see two different doctors here", "context": "Patient has access to multiple specialists", "file_id": "dr_TK0914", "chunk_id": 2 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "the neuro ophthalmologist is Dr. Chaudhary and she tea- treats me for non-arteritic anterior ischemic optic neuropathy", "context": "Patient seems unsure about their condition", "file_id": "dr_TK0914", "chunk_id": 3 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I see two different doctors here", "context": "Patient has access to multiple specialists", "file_id": "dr_TK0914", "chunk_id": 3 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "the neuro ophthalmologist is Dr. Chaudhary and she tea- treats me for non-arteritic anterior ischemic optic neuropathy", "context": "Patient understands their treatment", "file_id": "dr_TK0914", "chunk_id": 3 }, { "code": "Thorough eye exam", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "they do a vision field, they do pictures, and they do an eye exam, a thorough eye exam", "context": "Patient receives comprehensive care", "file_id": "dr_TK0914", "chunk_id": 3 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Well, I don't understand what you wanna know", "context": "Patient expresses lack of understanding about their eye exams", "file_id": "dr_TK0914", "chunk_id": 4 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "(laughs) ... how has the experience for you?", "context": "Patient and provider share a laugh, indicating a positive relationship", "file_id": "dr_TK0914", "chunk_id": 4 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Each doctor sees me twice a year", "context": "Patient has regular access to their healthcare providers", "file_id": "dr_TK0914", "chunk_id": 4 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "Since I can't drive", "context": "Patient cannot drive due to eye dilation", "file_id": "dr_TK0914", "chunk_id": 5 }, { "code": "Lack of access", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "on the way home, it's a trip", "context": "Patient experiences difficulty traveling after eye dilation", "file_id": "dr_TK0914", "chunk_id": 5 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "central scheduling kept calling me because they said I was scheduled with the wrong doctor.", "context": "Patient experiences issues with scheduling process due to poor communication", "file_id": "dr_TK0914", "chunk_id": 6 }, { "code": "Appointment scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "I did try to change doctors recently and I was successful at doing it, but central scheduling kept calling me", "context": "Patient faces challenges with scheduling appointments", "file_id": "dr_TK0914", "chunk_id": 6 }, { "code": "Patient liaison support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Healthcare System Support", "quote": "a liaison, a patient liaison called me- ... and then that was the end of it", "context": "Patient receives helpful support from patient liaison", "file_id": "dr_TK0914", "chunk_id": 6 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "problems with communication", "context": "Patient experienced issues with communication", "file_id": "dr_TK0914", "chunk_id": 7 }, { "code": "Appointment scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "that's where you had a big problem", "context": "Patient had issues with central scheduling", "file_id": "dr_TK0914", "chunk_id": 7 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Long wait times", "quote": "once or twice I've had to wait", "context": "Patient experienced wait times on some occasions", "file_id": "dr_TK0914", "chunk_id": 7 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I think it's fine", "context": "Patient generally finds it easy to access care", "file_id": "dr_TK0914", "chunk_id": 7 }, { "code": "Reminder systems", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "a liaison, a patient liaison called me", "context": "Patient received support from a patient liaison", "file_id": "dr_TK0914", "chunk_id": 7 }, { "code": "Easy scheduling", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "for the most part it's been pretty easy- ... and you can get right in?", "context": "Patient finds scheduling appointments to be easy", "file_id": "dr_TK0914", "chunk_id": 8 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I'm very satisfied with Dr. Chaudhary. She's very thorough", "context": "Patient has a positive relationship with their provider", "file_id": "dr_TK0914", "chunk_id": 8 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "they tell me there's nothing they can do and they're sorry", "context": "Patient feels that providers communicate effectively", "file_id": "dr_TK0914", "chunk_id": 8 }, { "code": "Thorough care", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "She's very thorough", "context": "Patient receives thorough care from their provider", "file_id": "dr_TK0914", "chunk_id": 8 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "Getting here.", "context": "Patient mentions difficulty getting to appointments", "file_id": "dr_TK0914", "chunk_id": 9 }, { "code": "Transportation barriers", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "we're a ... more than an hour away", "context": "Patient lives far from the clinic, making transportation difficult", "file_id": "dr_TK0914", "chunk_id": 9 }, { "code": "Lack of access", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "I can't drive", "context": "Patient's lack of driving ability limits access to clinic", "file_id": "dr_TK0914", "chunk_id": 9 }, { "code": "Family support", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "3. Patient Empowerment", "quote": "my husband brings me", "context": "Patient has family support for transportation to appointments", "file_id": "dr_TK0914", "chunk_id": 9 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "I can't drive", "context": "Patient has difficulty with transportation due to inability to drive", "file_id": "dr_TK0914", "chunk_id": 10 }, { "code": "Scheduling difficulties", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "3. Provider/System Issues", "quote": "I try and schedule on days that he has off", "context": "Patient has to work around schedules to make appointments", "file_id": "dr_TK0914", "chunk_id": 10 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I can see fine now", "context": "Patient doesn't perceive urgency for follow-up", "file_id": "dr_TK0914", "chunk_id": 11 }, { "code": "Feeling overwhelmed", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "I just get tired", "context": "Patient feels overwhelmed with daily activities", "file_id": "dr_TK0914", "chunk_id": 11 }, { "code": "Health literacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I have a magnifier that's really good", "context": "Patient uses tools to manage condition, indicating some health literacy", "file_id": "dr_TK0914", "chunk_id": 11 }, { "code": "Accessible resources", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate resources", "quote": "I have a magnifier that's really good", "context": "Patient has access to tools that help with daily activities", "file_id": "dr_TK0914", "chunk_id": 11 }, { "code": "Feeling overwhelmed", "category": "BARRIER - Emotional/Psychological", "subcategory": "Emotional/Psychological", "quote": "but I just get tired", "context": "Patient expresses emotional exhaustion", "file_id": "dr_TK0914", "chunk_id": 12 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't", "context": "Patient doesn't have additional information to share about vision loss risk", "file_id": "dr_TK0914", "chunk_id": 12 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "Very comfortable", "context": "Patient feels at ease discussing diabetes-related eye problems with doctor", "file_id": "dr_TK0914", "chunk_id": 12 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I'm one of those people that thinks of doctors as, they put their pants on the same way as you and I every morning.", "context": "Patient feels comfortable with doctor", "file_id": "dr_TK0914", "chunk_id": 13 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "I don't hesitate to talk to 'em about any problem I might have.", "context": "Patient feels open with doctor", "file_id": "dr_TK0914", "chunk_id": 13 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "They're there to help me.", "context": "Patient perceives doctor as helpful", "file_id": "dr_TK0914", "chunk_id": 13 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "Dr. Chaudhary is so thorough", "context": "Patient appreciates their eye doctor's thoroughness", "file_id": "dr_TK0914", "chunk_id": 14 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "I don't hesitate to talk to 'em about any problem I might have", "context": "Patient feels comfortable discussing problems with their doctor", "file_id": "dr_TK0914", "chunk_id": 14 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "Dr. Chaudhary is so thorough", "context": "Patient implies their eye doctor is caring and attentive", "file_id": "dr_TK0914", "chunk_id": 14 }, { "code": "Rude or dismissive providers", "category": "BARRIER - Provider/System Issues", "subcategory": "Rude or dismissive providers", "quote": "Dr. Halenda doesn't, ... His personage does not allow for chitchat", "context": "Patient describes a doctor as not allowing for conversation", "file_id": "dr_TK0914", "chunk_id": 14 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "And they're doing a good job", "context": "Patient feels providers are competent and caring", "file_id": "dr_TK0914", "chunk_id": 15 }, { "code": "Trust in provider", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "I am not going to question them", "context": "Patient has trust in their healthcare providers", "file_id": "dr_TK0914", "chunk_id": 15 }, { "code": "Perceived severity", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I think it's extremely serious", "context": "Patient understands the seriousness of diabetes-related vision loss", "file_id": "dr_TK0914", "chunk_id": 15 }, { "code": "Acceptance of condition", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I've already lost my eyesight", "context": "Patient has experienced vision loss due to diabetes", "file_id": "dr_TK0914", "chunk_id": 15 }, { "code": "Satisfaction with care", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Fully satisfactory", "context": "Patient is satisfied with their current eye care", "file_id": "dr_TK0914", "chunk_id": 15 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I think there's a 50/50 chance- ... that I'll get retinopathy", "context": "Patient unsure about disease progression", "file_id": "dr_TK0914", "chunk_id": 16 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "the worst that could happen is that I would have total vision loss", "context": "Patient fears potential outcome", "file_id": "dr_TK0914", "chunk_id": 16 }, { "code": "Positive outlook", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I think it's extremely serious", "context": "Patient acknowledges disease severity", "file_id": "dr_TK0914", "chunk_id": 16 }, { "code": "Social support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "I have a good friend with retinopathy", "context": "Patient has supportive social network", "file_id": "dr_TK0914", "chunk_id": 16 }, { "code": "Lack of urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "You don't see it making any worse, but there's always the possibility", "context": "Patient does not perceive immediate need for follow-up", "file_id": "dr_TK0914", "chunk_id": 17 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "the worst that could happen is that I would have total vision loss", "context": "Patient fears potential consequences of diagnosis", "file_id": "dr_TK0914", "chunk_id": 17 }, { "code": "Positive attitude", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "People say, You have a good attitude. Well, what are you gonna do?", "context": "Patient maintains positive outlook despite challenges", "file_id": "dr_TK0914", "chunk_id": 17 }, { "code": "Social support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "I've got 22 grandkids. Come on", "context": "Patient has strong social support system", "file_id": "dr_TK0914", "chunk_id": 17 }, { "code": "Lack of awareness", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "It's just poor", "context": "Patient seems unaware of potential vision changes due to DR", "file_id": "dr_TK0914", "chunk_id": 18 }, { "code": "Pre-existing conditions", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I have non-arteritic, anterior ischemic optic neuropathy- ... probable glaucoma", "context": "Patient has multiple eye conditions that may impact perception of DR", "file_id": "dr_TK0914", "chunk_id": 18 }, { "code": "Family history", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "glaucoma", "context": "Patient's family history may motivate them to prioritize eye health", "file_id": "dr_TK0914", "chunk_id": 18 }, { "code": "Thorough care", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "very thorough", "context": "Patient describes positive experience with eye doctors", "file_id": "dr_TK0914", "chunk_id": 19 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "they did everything", "context": "Patient feels informed about treatment plan", "file_id": "dr_TK0914", "chunk_id": 19 }, { "code": "Health literacy", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "I'm smart enough to know the outcome-", "context": "Patient implies understanding of health information", "file_id": "dr_TK0914", "chunk_id": 20 }, { "code": "Family influence", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "I was raised you go to the eye doctor, you go to the dentist", "context": "Patient mentions family upbringing as a factor", "file_id": "dr_TK0914", "chunk_id": 20 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Intelligence. I mean, that's the truth. I'm smart enough to know the outcome-", "context": "Patient values knowledge and understanding of health", "file_id": "dr_TK0914", "chunk_id": 20 }, { "code": "Provider Issues", "category": "BARRIER - Provider/System Issues", "subcategory": "Rude or dismissive providers", "quote": "I did not find that person to be helpful, nor did I find them to give a darn", "context": "Patient had negative experience with new doctor after original doctor retired", "file_id": "dr_TK0914", "chunk_id": 21 }, { "code": "Positive Upbringing", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I was raised you go to the eye doctor, you go to the dentist", "context": "Patient's upbringing encouraged regular health checkups", "file_id": "dr_TK0914", "chunk_id": 21 }, { "code": "Lack of Provider Continuity", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of continuity of care", "quote": "when my original doctor retired", "context": "Patient experienced disruption in care due to doctor's retirement", "file_id": "dr_TK0914", "chunk_id": 21 }, { "code": "Rude provider", "category": "BARRIER - Provider/System Issues", "subcategory": "Rude or dismissive providers", "quote": "I did not find that person to be helpful, nor did I find them to give a darn", "context": "Patient had negative experience with new doctor", "file_id": "dr_TK0914", "chunk_id": 22 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "he didn't dilate my eyes, he didn't do a vision field, he did nothing", "context": "Patient felt doctor did not communicate or perform proper examination", "file_id": "dr_TK0914", "chunk_id": 22 }, { "code": "Appointment scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "They canceled it, , because he was gonna be out of the office and they moved it four months", "context": "Patient's appointment was rescheduled without their input", "file_id": "dr_TK0914", "chunk_id": 22 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "I did not find that person to be helpful, nor did I find them to give a darn", "context": "Patient lacks trust in new doctor", "file_id": "dr_TK0914", "chunk_id": 22 }, { "code": "Appointment scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "They canceled it, , because he was gonna be out of the office and they moved it four months", "context": "Patient's appointment was rescheduled without their input", "file_id": "dr_TK0914", "chunk_id": 23 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "Just they just didn't seem to understand (laughs) that I wanted to change", "context": "Patient had trouble communicating with staff about changing providers", "file_id": "dr_TK0914", "chunk_id": 23 }, { "code": "Rude or dismissive providers", "category": "BARRIER - Provider/System Issues", "subcategory": "Rude or dismissive providers", "quote": "he's just very curt", "context": "Patient perceived their previous provider as being unfriendly", "file_id": "dr_TK0914", "chunk_id": 23 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I'm very happy with her", "context": "Patient is satisfied with their new provider, Dr. Chaudhary", "file_id": "dr_TK0914", "chunk_id": 23 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I'm very happy with her", "context": "Patient has found a provider they like and can work with", "file_id": "dr_TK0914", "chunk_id": 23 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "find the right provider that works for you", "context": "Patient emphasizes importance of finding a suitable provider", "file_id": "dr_TK0914", "chunk_id": 24 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "does the care that you expect", "context": "Patient values a positive and expectation-meeting provider relationship", "file_id": "dr_TK0914", "chunk_id": 24 }, { "code": "Scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "It was just a problem with the- ... with the scheduling and stuff", "context": "Patient experienced issues with scheduling appointments", "file_id": "dr_TK0914", "chunk_id": 25 }, { "code": "Provider preference", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of continuity of care", "quote": "I want to see Dr. Chaudhary", "context": "Patient has a preferred provider, indicating potential issue with assigned doctor", "file_id": "dr_TK0914", "chunk_id": 25 }, { "code": "Reminder systems", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "They just kept either texting me or calling me and saying ... You're supposed to see Dr. (name)", "context": "Patient receives reminders from the healthcare system, facilitating follow-up", "file_id": "dr_TK0914", "chunk_id": 25 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "they're not translating?", "context": "Patient experiences poor communication between providers", "file_id": "dr_TK0914", "chunk_id": 26 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "I don't want to see him", "context": "Patient lacks trust in provider", "file_id": "dr_TK0914", "chunk_id": 26 }, { "code": "Social support networks", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Patient Empowerment", "quote": "My husband. He, he, he fixes my food", "context": "Patient has social support from husband", "file_id": "dr_TK0914", "chunk_id": 26 }, { "code": "Lack of adherence", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Doesn't mean that I do it all the time", "context": "Patient knows what to do but doesn't always follow through", "file_id": "dr_TK0914", "chunk_id": 27 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I know it all. I mean, I do ... I researched a lot", "context": "Patient has received health education and researched diabetes management", "file_id": "dr_TK0914", "chunk_id": 27 }, { "code": "Social support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "He fixes my food", "context": "Patient receives help from husband with daily tasks", "file_id": "dr_TK0914", "chunk_id": 27 }, { "code": "Lack of time", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "a mother of 10 kids didn't have time to cook two plus", "context": "Patient had limited time due to family responsibilities", "file_id": "dr_TK0914", "chunk_id": 28 }, { "code": "Family responsibilities", "category": "BARRIER - SDOH", "subcategory": "Social Determinants of Health", "quote": "I was the mother of 10 children", "context": "Patient's family responsibilities impacted her ability to manage diabetes", "file_id": "dr_TK0914", "chunk_id": 28 }, { "code": "Health education needs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Maybe ... Well, a, a, a wild dream would be for there to be one plan that works for everybody", "context": "Patient suggests improvement in diabetic education classes", "file_id": "dr_TK0914", "chunk_id": 28 }, { "code": "Personalized care", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "one plan that works for everybody", "context": "Patient desires tailored approach to diabetes management", "file_id": "dr_TK0914", "chunk_id": 28 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "it makes it very difficult", "context": "Patient finds dietary management challenging due to family members' different needs", "file_id": "dr_TK0914", "chunk_id": 29 }, { "code": "Education barriers", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "a wild dream would be for there to be one plan that works for everybody", "context": "Patient desires a simplified diabetes management plan", "file_id": "dr_TK0914", "chunk_id": 29 }, { "code": "Healthcare system support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Maybe ... Well, a, a, a wild dream would be for there to be one plan that works for everybody", "context": "Patient seeks standardized diabetes education", "file_id": "dr_TK0914", "chunk_id": 29 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Is there anything different you would to see with, , diabetic education classes?", "context": "Patient inquires about diabetes education", "file_id": "dr_TK0914", "chunk_id": 29 }, { "code": "Lack of practical support", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR management", "quote": "I'd to see something practical- that fits everybody", "context": "Patient seeking practical solutions for diabetes management", "file_id": "dr_TK0914", "chunk_id": 30 }, { "code": "Unhelpful advice", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "Don't eat this, don't eat that. Oh, no. You should eat that and you should eat that", "context": "Patient frustrated with unhelpful dietary advice from providers", "file_id": "dr_TK0914", "chunk_id": 30 }, { "code": "Need for inclusive support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Just something that caters to everybody- and everybody's needs", "context": "Patient desires personalized and inclusive health education", "file_id": "dr_TK0914", "chunk_id": 30 }, { "code": "Misinformation barriers", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "So there's so much misinformation- ... that it's amazing that anybody can ever, ever figure things out.", "context": "Patient discusses the challenge of navigating conflicting health information", "file_id": "dr_TK0914", "chunk_id": 31 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "Is that a feasible thing? Are they affordable or, , the stuff they're saying in the education classes, if that's one of their barriers to implementation?", "context": "Patient discusses the cost of food plans and potential financial burden", "file_id": "dr_TK0914", "chunk_id": 31 }, { "code": "Education barriers", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "So there's so much misinformation- ... that it's amazing that anybody can ever, ever figure things out.", "context": "Patient highlights the issue of inadequate health education", "file_id": "dr_TK0914", "chunk_id": 31 }, { "code": "Health education support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "the stuff they're saying in the education classes", "context": "Patient mentions education classes as a potential resource for health information", "file_id": "dr_TK0914", "chunk_id": 31 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "raw vegetables are expensive", "context": "Patient mentions expense of healthy food", "file_id": "dr_TK0914", "chunk_id": 32 }, { "code": "Food cost barriers", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "I eat good meat. It's expensive", "context": "Patient discusses high cost of healthy food options", "file_id": "dr_TK0914", "chunk_id": 32 }, { "code": "Lack of access to healthcare", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "a lot of people in ... particularly in West Virginia are on food stamps", "context": "Patient implies limited access to healthy food due to socioeconomic factors", "file_id": "dr_TK0914", "chunk_id": 32 }, { "code": "Health education barriers", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "if that's one of their barriers to implementation", "context": "Patient discusses potential lack of understanding about healthy food choices", "file_id": "dr_TK0914", "chunk_id": 32 }, { "code": "Health literacy barriers", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "the stuff they're saying in the education classes", "context": "Patient implies potential lack of understanding about healthy food choices due to education", "file_id": "dr_TK0914", "chunk_id": 32 }, { "code": "Accessible healthcare resources", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate insurance coverage", "quote": "my two autistic sons both receive benefits", "context": "Patient mentions access to benefits for family members", "file_id": "dr_TK0914", "chunk_id": 32 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "it's all very expensive", "context": "Patient mentions that eating healthy is expensive", "file_id": "dr_TK0914", "chunk_id": 33 }, { "code": "Lack of access to healthcare", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "they can't afford to eat that way", "context": "Patient's sons cannot afford healthy food due to financial constraints", "file_id": "dr_TK0914", "chunk_id": 33 }, { "code": "Healthcare System Support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "My doctors", "context": "Patient mentions having doctors to call for advice", "file_id": "dr_TK0914", "chunk_id": 33 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "I have to get this- ... to see", "context": "Patient implies difficulty accessing necessary care", "file_id": "dr_TK0914", "chunk_id": 34 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "None explicitly mentioned", "context": "No direct quote, but patient's situation implies potential financial struggles", "file_id": "dr_TK0914", "chunk_id": 34 }, { "code": "Education barriers", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "None explicitly mentioned", "context": "Patient's understanding of their condition is not directly discussed", "file_id": "dr_TK0914", "chunk_id": 34 }, { "code": "Provider support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "My doctors", "context": "Patient mentions relying on doctors for advice", "file_id": "dr_TK0914", "chunk_id": 34 }, { "code": "Health literacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "None explicitly mentioned", "context": "No direct discussion of patient's understanding of their condition", "file_id": "dr_TK0914", "chunk_id": 34 }, { "code": "Vision Loss", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "This vision loss I have is a kaleidoscope almost", "context": "Patient describes their experience with vision loss", "file_id": "dr_TK0914", "chunk_id": 35 }, { "code": "Daily Activity Barriers", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I mean, you want me to list all the other can’ts", "context": "Patient lists limitations due to vision loss", "file_id": "dr_TK0914", "chunk_id": 35 }, { "code": "Expectation Of Quick Visit", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "In and out", "context": "Patient expects a quick and efficient visit", "file_id": "dr_TK0914", "chunk_id": 35 }, { "code": "Lack of comparison", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I have no basis for comparison", "context": "Patient lacks prior experience with glaucoma doctor", "file_id": "dr_TK0914", "chunk_id": 36 }, { "code": "Brief appointment", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "In and out", "context": "Patient expects a quick visit", "file_id": "dr_TK0914", "chunk_id": 36 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "He asks if I'm still using the drops", "context": "Provider inquires about patient's treatment adherence", "file_id": "dr_TK0914", "chunk_id": 36 }, { "code": "Brief appointment", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "it's just very brief", "context": "Patient perceives appointment as too short", "file_id": "dr_TK0914", "chunk_id": 37 }, { "code": "Lack of comparison", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I have no basis for comparison", "context": "Patient lacks understanding of their condition", "file_id": "dr_TK0914", "chunk_id": 37 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "they said since I had so many eye surgeries", "context": "Patient has had multiple eye surgeries, implying potential lack of access to preventive care", "file_id": "dr_DA1010_Part1", "chunk_id": 0 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "they pre-treating it with drops", "context": "Patient is receiving pre-treatment, potentially implying cost concerns", "file_id": "dr_DA1010_Part1", "chunk_id": 0 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "what are some things that you do each day, regarding your diabetes", "context": "Patient is being asked about daily diabetes management, implying some level of health education", "file_id": "dr_DA1010_Part1", "chunk_id": 0 }, { "code": "Self-management support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "Take my blood sugar", "context": "Patient is actively managing their diabetes, implying some level of self-management support", "file_id": "dr_DA1010_Part1", "chunk_id": 0 }, { "code": "Lack of discussion", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "So they pre-treating it with drops.", "context": "Patient seems unclear about treatment", "file_id": "dr_DA1010_Part1", "chunk_id": 1 }, { "code": "Medication management", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Take my blood sugar.", "context": "Patient is managing diabetes through medication and monitoring", "file_id": "dr_DA1010_Part1", "chunk_id": 1 }, { "code": "Priority on health", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "Keep my A1C down as low as possible.", "context": "Patient prioritizes controlling diabetes through A1C management", "file_id": "dr_DA1010_Part1", "chunk_id": 1 }, { "code": "Self monitoring", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "Well, if I have a week of high blood sugars-", "context": "Patient is aware of the impact of high blood sugar on their health", "file_id": "dr_DA1010_Part1", "chunk_id": 1 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "No, I don't think diabetes has affected my eyes", "context": "Patient shows lack of awareness about diabetes impact on eyes", "file_id": "dr_DA1010_Part1", "chunk_id": 2 }, { "code": "Provider education", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Health education programs", "quote": "Yes, my doctor explained how diabetes could affect my eyesight", "context": "Patient received education from provider about diabetes and eye health", "file_id": "dr_DA1010_Part1", "chunk_id": 2 }, { "code": "Access to care", "category": "FACILITATOR - Resources & Access", "subcategory": "Accessible providers", "quote": "I get my eye exams here, 50/50", "context": "Patient has access to eye care services", "file_id": "dr_DA1010_Part1", "chunk_id": 2 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't know what you mean by procedure, because the, , the doctor determines that.", "context": "Patient unsure about procedures during eye exams", "file_id": "dr_DA1010_Part1", "chunk_id": 3 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "I don't know what you mean by procedure, because the, , the doctor determines that.", "context": "Patient unclear about procedures, possibly due to poor communication", "file_id": "dr_DA1010_Part1", "chunk_id": 3 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "For a normal eye exam? ... the doctor determines that.", "context": "Patient has access to a provider for regular exams", "file_id": "dr_DA1010_Part1", "chunk_id": 3 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't know what you mean by procedure", "context": "Patient unsure about medical procedures", "file_id": "dr_DA1010_Part1", "chunk_id": 4 }, { "code": "Familiarity with process", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I'm familiar with the process", "context": "Patient has knowledge of medical procedures", "file_id": "dr_DA1010_Part1", "chunk_id": 4 }, { "code": "Appointment scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "they cancel just as many times as I do", "context": "Patient experiences challenges with scheduling follow-up appointments due to cancellations", "file_id": "dr_DA1010_Part1", "chunk_id": 5 }, { "code": "Flexible scheduling", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "they're far enough apart from each other that pretty well pick your own time", "context": "Patient appreciates the flexibility in scheduling eye care visits", "file_id": "dr_DA1010_Part1", "chunk_id": 5 }, { "code": "Provider availability issues", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of continuity of care", "quote": "No, because- they cancel just as many times as I do", "context": "Patient experiences difficulties with provider availability", "file_id": "dr_DA1010_Part1", "chunk_id": 5 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "And there's nobody, there's nobody t- to push me around", "context": "Patient has mobility issues and lacks assistance with transportation", "file_id": "dr_DA1010_Part1", "chunk_id": 6 }, { "code": "Lack of accessibility", "category": "BARRIER - SDOH", "subcategory": "Transportation issues", "quote": "nobody to push me around", "context": "Patient has mobility issues and lacks assistance", "file_id": "dr_DA1010_Part1", "chunk_id": 7 }, { "code": "Inaccessible facilities", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "no place to sit", "context": "Clinic lacks seating for patients with mobility issues", "file_id": "dr_DA1010_Part1", "chunk_id": 7 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of continuity of care", "quote": "stand out there so long", "context": "Patient experiences prolonged waiting periods", "file_id": "dr_DA1010_Part1", "chunk_id": 7 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "When you're by yourself, yes", "context": "Patient implies difficulty accessing care alone", "file_id": "dr_DA1010_Part1", "chunk_id": 8 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I feel comfortable with him", "context": "Patient feels at ease with their doctor", "file_id": "dr_DA1010_Part1", "chunk_id": 8 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "I'm still working on him for a secret on fishing", "context": "Patient has casual conversation with doctor, indicating good rapport", "file_id": "dr_DA1010_Part1", "chunk_id": 8 }, { "code": "Understanding of DR progression", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I'd say it's about 100%", "context": "Patient shows awareness of diabetes-related vision loss risk", "file_id": "dr_DA1010_Part1", "chunk_id": 8 }, { "code": "Lack of trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "A doctor here that botched up a detached retina", "context": "Patient expresses distrust due to past negative experience", "file_id": "dr_DA1010_Part1", "chunk_id": 9 }, { "code": "Poor provider care", "category": "BARRIER - Provider/System Issues", "subcategory": "Rude or dismissive providers", "quote": "A doctor here that botched up a detached retina", "context": "Patient had a negative experience with a provider", "file_id": "dr_DA1010_Part1", "chunk_id": 9 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I'm greatly disappointed in my vision", "context": "Patient expresses fear and disappointment about their vision loss", "file_id": "dr_DA1010_Part1", "chunk_id": 9 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "All my life I've had problems with my eyes", "context": "Patient lacks understanding of their condition and its progression", "file_id": "dr_DA1010_Part1", "chunk_id": 9 }, { "code": "Lack of family health history", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "No, but keep in mind I grew up at a time where, , adults looked at kids should be seen and not heard", "context": "Patient lacks knowledge about family health history due to cultural upbringing", "file_id": "dr_DA1010_Part1", "chunk_id": 10 }, { "code": "Cultural beliefs about healthcare", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Cultural beliefs about healthcare", "quote": "And anytime the adults were talking, the kids left the room", "context": "Patient's cultural background may influence their perception of healthcare and communication with providers", "file_id": "dr_DA1010_Part1", "chunk_id": 10 }, { "code": "Lack of health education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "No way for you to know", "context": "Patient lacks knowledge about family medical history", "file_id": "dr_DA1010_Part1", "chunk_id": 11 }, { "code": "Cultural beliefs", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Cultural beliefs about healthcare", "quote": "adults looked at kids should be seen and not heard", "context": "Patient's cultural upbringing may impact health communication", "file_id": "dr_DA1010_Part1", "chunk_id": 11 }, { "code": "Social support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "I live with a woman", "context": "Patient has someone to help with daily care", "file_id": "dr_DA1010_Part1", "chunk_id": 11 }, { "code": "Acceptance of diagnosis", "category": "BARRIER - Emotional/Psychological", "subcategory": "Diabetes distress", "quote": "you just gotta accept that and go on", "context": "Patient's emotional response to diagnosis may impact adherence", "file_id": "dr_DA1010_Part1", "chunk_id": 11 }, { "code": "Social Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "I live with a woman", "context": "Patient has a partner for potential support", "file_id": "dr_DA1010_Part1", "chunk_id": 12 }, { "code": "Lack of Clarity", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "that's a really gray area there", "context": "Patient expresses uncertainty about their care", "file_id": "dr_DA1010_Part1", "chunk_id": 12 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don’t know. It’s been a while.", "context": "Patient unsure about normal eye exam process", "file_id": "dr_MD0610(part2)", "chunk_id": 0 }, { "code": "Limited health knowledge", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "I don’t know. It’s been a while.", "context": "Patient lacks knowledge about eye exam procedures", "file_id": "dr_MD0610(part2)", "chunk_id": 0 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "the only diabetic one I do is here at the retina specialist", "context": "Patient has access to a retina specialist", "file_id": "dr_MD0610(part2)", "chunk_id": 0 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "It's usually pretty easy", "context": "Patient finds scheduling appointments easy", "file_id": "dr_MD0610(part2)", "chunk_id": 1 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "they tell me about that", "context": "Patient receives clear explanations from provider", "file_id": "dr_MD0610(part2)", "chunk_id": 1 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "the doctor says he wants to see me in four weeks", "context": "Patient feels provider is invested in their care", "file_id": "dr_MD0610(part2)", "chunk_id": 1 }, { "code": "Easy scheduling", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Appointment scheduling difficulties", "quote": "they schedule me one", "context": "Patient finds scheduling appointments straightforward", "file_id": "dr_MD0610(part2)", "chunk_id": 1 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "It's usually pretty easy", "context": "Patient finds it easy to access healthcare provider", "file_id": "dr_MD0610(part2)", "chunk_id": 2 }, { "code": "Appointment scheduling ease", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "you can get into them quickly too", "context": "Patient can easily schedule appointments", "file_id": "dr_MD0610(part2)", "chunk_id": 2 }, { "code": "Insurance coverage issues", "category": "BARRIER - SDOH", "subcategory": "Insurance coverage issues", "quote": "Well, we're not in your plan. It'd be 180 bucks for today.", "context": "Patient faces out-of-network costs", "file_id": "dr_MD0610(part2)", "chunk_id": 3 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "I was, I don't think so.", "context": "Patient is deterred by high costs", "file_id": "dr_MD0610(part2)", "chunk_id": 3 }, { "code": "Appointment scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "So I called up here, and he's -- made the appointment a month later.", "context": "Patient experiences delay in scheduling", "file_id": "dr_MD0610(part2)", "chunk_id": 3 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "So I called up here, and he's -- made the appointment", "context": "Patient finds alternative provider", "file_id": "dr_MD0610(part2)", "chunk_id": 3 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "I figured it'll be another month waiting to get in", "context": "Patient expects a long wait for the next appointment", "file_id": "dr_MD0610(part2)", "chunk_id": 4 }, { "code": "Lack of continuity of care", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "He goes, 'I won't be seeing you anymore. Dr. G is going to be taking over your care'", "context": "Patient experiences a change in healthcare provider", "file_id": "dr_MD0610(part2)", "chunk_id": 4 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "He walks out, the nurse comes in, and she's , ', let's go'", "context": "Patient experiences abrupt communication from healthcare staff", "file_id": "dr_MD0610(part2)", "chunk_id": 4 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Healthcare System Support", "quote": "They come in, and he looked, and he said, 'Well, you do have catar-- cataracts, but that's not your problem'", "context": "Patient has access to a specialist who can assess their condition", "file_id": "dr_MD0610(part2)", "chunk_id": 4 }, { "code": "Insurance coverage issues", "category": "BARRIER - SDOH", "subcategory": "Insurance coverage issues", "quote": "the insurance change was a bit of a challenge", "context": "Patient experienced challenges due to insurance changes", "file_id": "dr_MD0610(part2)", "chunk_id": 5 }, { "code": "Poor vision insurance", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "the vision insurances - it don't matter where you work - is not usually very good for just regular stuff a lot", "context": "Patient expresses dissatisfaction with vision insurance coverage", "file_id": "dr_MD0610(part2)", "chunk_id": 5 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "So, yeah, he-- they're pretty up on it", "context": "Patient expresses satisfaction with provider responsiveness", "file_id": "dr_MD0610(part2)", "chunk_id": 5 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "somebody going to poke you in the eye with something", "context": "Patient expresses fear of eye exam procedure", "file_id": "dr_MD0610(part2)", "chunk_id": 6 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "they have that eye care thing. It's awesome", "context": "Patient appreciates gentle eye care approach", "file_id": "dr_MD0610(part2)", "chunk_id": 6 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "they have that eye care thing. It's awesome", "context": "Patient values provider's use of gentle technology", "file_id": "dr_MD0610(part2)", "chunk_id": 6 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "it's just somebody going to poke you in the eye with something", "context": "Patient expresses fear of eye examination", "file_id": "dr_MD0610(part2)", "chunk_id": 7 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "He explains everything to you and tells you what he recommends to do for right now", "context": "Patient praises provider's communication skills", "file_id": "dr_MD0610(part2)", "chunk_id": 7 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "He's really good", "context": "Patient expresses positive sentiment towards provider", "file_id": "dr_MD0610(part2)", "chunk_id": 7 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "He explains everything to you and tells you what he recommends to do for right now.", "context": "Patient appreciates provider's clear explanations", "file_id": "dr_MD0610(part2)", "chunk_id": 8 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "He's really good.", "context": "Patient has positive perception of provider", "file_id": "dr_MD0610(part2)", "chunk_id": 8 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Patient Empowerment", "quote": "He explains everything to you and tells you what he recommends to do for right now.", "context": "Provider educates patient on eye care", "file_id": "dr_MD0610(part2)", "chunk_id": 8 }, { "code": "Adherence to recommendations", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Patient Empowerment", "quote": "I just take what my doctor tells me.", "context": "Patient follows provider's advice", "file_id": "dr_MD0610(part2)", "chunk_id": 8 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Not really. They said it could cause you problems, but never really explained what.", "context": "Patient lacked clear understanding of diabetes impact on vision", "file_id": "dr_MD0610(part2)", "chunk_id": 9 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "Not really. They said it could cause you problems, but never really explained what.", "context": "Patient received inadequate information from provider", "file_id": "dr_MD0610(part2)", "chunk_id": 9 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "Oh, very. Oh, yeah, .", "context": "Patient feels comfortable discussing health issues with doctor", "file_id": "dr_MD0610(part2)", "chunk_id": 9 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Oh, very. Oh, yeah, .", "context": "Patient has open and honest communication with provider", "file_id": "dr_MD0610(part2)", "chunk_id": 9 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "He's easy to talk to", "context": "Patient feels comfortable with doctor due to personal connection", "file_id": "dr_MD0610(part2)", "chunk_id": 10 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "Comes down to my level", "context": "Doctor shows understanding and relates to patient", "file_id": "dr_MD0610(part2)", "chunk_id": 10 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "He's easy to talk to", "context": "Patient feels doctor listens and understands them", "file_id": "dr_MD0610(part2)", "chunk_id": 10 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "He used to be a paramedic, so he's easy to talk to", "context": "Patient feels comfortable with provider due to shared background", "file_id": "dr_MD0610(part2)", "chunk_id": 11 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Comes down to my level", "context": "Provider communicates in a way that is understandable to patient", "file_id": "dr_MD0610(part2)", "chunk_id": 11 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "He's easy to talk to", "context": "Patient feels provider is approachable and caring", "file_id": "dr_MD0610(part2)", "chunk_id": 11 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "All my doctors are really good about explaining everything", "context": "Patient has access to providers who explain things clearly", "file_id": "dr_MD0610(part2)", "chunk_id": 11 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "they're very descriptive, and they explain things well", "context": "Patient appreciates provider's clear explanations", "file_id": "dr_MD0610(part2)", "chunk_id": 12 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "he explains it well, and then if I have a question, he answers it", "context": "Patient feels heard and supported by provider", "file_id": "dr_MD0610(part2)", "chunk_id": 12 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Patient Empowerment", "quote": "he explains it well, and then if I have a question, he answers it", "context": "Patient learns about their condition through provider explanations", "file_id": "dr_MD0610(part2)", "chunk_id": 12 }, { "code": "Lack of understanding about DR progression", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Patient Beliefs & Perceptions", "quote": "I mean, it's 20/80 right now, but I can still see", "context": "Patient may not fully understand the risks of DR", "file_id": "dr_MD0610(part2)", "chunk_id": 12 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "he explains it well, and then if I have a question, he answers it", "context": "Patient has a positive relationship with their provider", "file_id": "dr_MD0610(part2)", "chunk_id": 12 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't know. It seems --", "context": "Patient unsure about potential vision loss due to diabetes", "file_id": "dr_MD0610(part2)", "chunk_id": 13 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "if you watch it and--", "context": "Patient implies concern about monitoring and potential diagnosis", "file_id": "dr_MD0610(part2)", "chunk_id": 13 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "And it seems he's fixed it.", "context": "Patient feels provider has helped resolve issue, implying positive relationship", "file_id": "dr_MD0610(part2)", "chunk_id": 13 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "And I told her, my A1C was it's-- my A1C was very bad.", "context": "Patient discusses A1C levels, indicating some understanding of health metrics", "file_id": "dr_MD0610(part2)", "chunk_id": 13 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "And honestly, my doctor, he put me on another, , medicine to go with what I was taking--", "context": "Patient reports open discussion with provider about treatment adjustments", "file_id": "dr_MD0610(part2)", "chunk_id": 13 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't know what you mean", "context": "Patient unsure about diabetes care priorities", "file_id": "dr_CL0110", "chunk_id": 0 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Watch what you eat", "context": "Doctor suggests diet monitoring for diabetes management", "file_id": "dr_CL0110", "chunk_id": 0 }, { "code": "Patient-provider communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Keep my A1C down", "context": "Doctor and patient discuss importance of A1C levels", "file_id": "dr_CL0110", "chunk_id": 0 }, { "code": "Lack of awareness", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Can't really tell", "context": "Patient unsure about signs of worsening diabetes", "file_id": "dr_CL0110", "chunk_id": 0 }, { "code": "Lack of awareness", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Can't really tell", "context": "Patient is unaware of symptoms indicating worsening diabetes", "file_id": "dr_CL0110", "chunk_id": 1 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I didn't talk to him about it", "context": "Patient avoids discussing eye changes with doctor due to fear", "file_id": "dr_CL0110", "chunk_id": 1 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "I didn't talk to him about it", "context": "Patient does not communicate effectively with healthcare provider", "file_id": "dr_CL0110", "chunk_id": 1 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Watch what you eat", "context": "Doctor provides patient with dietary advice for managing diabetes", "file_id": "dr_CL0110", "chunk_id": 1 }, { "code": "Provider guidance", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Keep my A1C down", "context": "Doctor advises patient on importance of monitoring blood sugar levels", "file_id": "dr_CL0110", "chunk_id": 1 }, { "code": "Lack of education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "None really", "context": "Patient lacks understanding about diabetes and its effect on eyes", "file_id": "dr_CL0110", "chunk_id": 2 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "Nobody has told you anything?", "context": "Patient feels uninformed by healthcare providers", "file_id": "dr_CL0110", "chunk_id": 2 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "I didn't talk to him about it", "context": "Patient does not discuss concerns with doctor", "file_id": "dr_CL0110", "chunk_id": 2 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "They just come and get me, take me to the room", "context": "Patient receives convenient care at clinic", "file_id": "dr_CL0110", "chunk_id": 2 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "None really", "context": "Patient lacks health education, implying a need for it", "file_id": "dr_CL0110", "chunk_id": 2 }, { "code": "Blurry vision", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "Oh, yeah, blurry", "context": "Patient experiences discomfort after eye dilation", "file_id": "dr_CL0110", "chunk_id": 3 }, { "code": "Difficulty with daily activities", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "Oh, yeah", "context": "Patient has trouble with daily tasks due to blurry vision", "file_id": "dr_CL0110", "chunk_id": 3 }, { "code": "Work schedule conflict", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "Working, getting back to work, getting back to driving", "context": "Patient faces challenges in scheduling appointments due to work commitments", "file_id": "dr_CL0110", "chunk_id": 4 }, { "code": "Accessible provider", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Yeah. Your doctor's availability is good?", "context": "Patient finds the doctor's schedule accommodating", "file_id": "dr_CL0110", "chunk_id": 4 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "closer to home", "context": "Patient prefers care closer to home due to transportation concerns", "file_id": "dr_CL0110", "chunk_id": 5 }, { "code": "Returning to work", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "5. Emotional/Psychological", "quote": "Working, getting back to work, getting back to driving", "context": "Patient is concerned about resuming daily activities after treatment", "file_id": "dr_CL0110", "chunk_id": 5 }, { "code": "Provider trust issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "3. Provider/System Issues", "quote": "If I can get somebody else to do a better job, I'd take it", "context": "Patient expresses dissatisfaction with current provider and seeks alternative care", "file_id": "dr_CL0110", "chunk_id": 5 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "Distance is a problem. How far are you-- If I got to get somebody to drive.", "context": "Patient mentions distance as an issue and needing someone to drive them", "file_id": "dr_CL0110", "chunk_id": 6 }, { "code": "Lack of access to healthcare", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "We live about 45 minutes, almost an hour or so away.", "context": "Patient lives far from the clinic, implying limited access", "file_id": "dr_CL0110", "chunk_id": 6 }, { "code": "Poor communication", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "3. Provider/System Issues", "quote": "They said that, , they don't understand what's going on.", "context": "Patient feels providers do not communicate effectively about their condition", "file_id": "dr_CL0110", "chunk_id": 6 }, { "code": "Lack of answers", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "They never knew the-- They don't have answers?", "context": "Patient expresses frustration with lack of information from provider", "file_id": "dr_CL0110", "chunk_id": 7 }, { "code": "Discomfort", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "And you're still in discomfort", "context": "Patient experiences physical and emotional distress", "file_id": "dr_CL0110", "chunk_id": 7 }, { "code": "Motivation to recover", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I got to get my eyesight back", "context": "Patient expresses desire to regain vision and participate in activities", "file_id": "dr_CL0110", "chunk_id": 7 }, { "code": "Self care practices", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "Outside, yep", "context": "Patient takes steps to protect eyes by wearing sunglasses", "file_id": "dr_CL0110", "chunk_id": 7 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I got to get my eyesight back", "context": "Patient's motivation for treatment, but unclear understanding of DR", "file_id": "dr_CL0110", "chunk_id": 8 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "what kinds of ways do you take care of your eyes?", "context": "Interviewer inquiring about patient's knowledge of eye care", "file_id": "dr_CL0110", "chunk_id": 8 }, { "code": "Access to healthcare", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate insurance coverage", "quote": "Just the eye drops", "context": "Patient has access to medication for their condition", "file_id": "dr_CL0110", "chunk_id": 8 }, { "code": "Lack of education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "I don't know the name of it", "context": "Patient lacks knowledge about eye drops", "file_id": "dr_CL0110", "chunk_id": 9 }, { "code": "No cost issues mentioned", "category": "NO BARRIER - Cost-Related Barriers", "subcategory": "None", "quote": "None", "context": "No cost-related concerns discussed", "file_id": "dr_CL0110", "chunk_id": 9 }, { "code": "No system issues mentioned", "category": "NO BARRIER - Provider/System Issues", "subcategory": "None", "quote": "None", "context": "No provider or system issues discussed", "file_id": "dr_CL0110", "chunk_id": 9 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Do you ever give your eyes a rest when working on the computer or watching TV for a long time?", "context": "Interviewer provides health education", "file_id": "dr_CL0110", "chunk_id": 9 }, { "code": "No emotional issues mentioned", "category": "NO BARRIER - Emotional/Psychological", "subcategory": "None", "quote": "None", "context": "No emotional or psychological concerns discussed", "file_id": "dr_CL0110", "chunk_id": 9 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "They said you could go blind. That's pretty much it.", "context": "Patient lacks detailed information about diabetes-related vision loss", "file_id": "dr_CL0110", "chunk_id": 10 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "They said you could go blind. That's pretty much it.", "context": "Patient receives limited information from healthcare provider", "file_id": "dr_CL0110", "chunk_id": 10 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "I've asked him a few questions.", "context": "Patient feels comfortable asking questions to their eye doctor", "file_id": "dr_CL0110", "chunk_id": 10 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I'm all right with it. Because I've asked him a few questions.", "context": "Patient feels comfortable discussing diabetes with their eye doctor", "file_id": "dr_CL0110", "chunk_id": 10 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "He said, 'I don't-- I don't understand it.'", "context": "Patient's eye doctor did not understand or address patient's concern", "file_id": "dr_CL0110", "chunk_id": 11 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "He said, 'I don't-- I don't understand it.'", "context": "Patient's eye doctor did not understand or address patient's concern, potentially indicating lack of trust", "file_id": "dr_CL0110", "chunk_id": 11 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "I've asked him a few questions.", "context": "Patient feels comfortable asking eye doctor questions, indicating effective communication", "file_id": "dr_CL0110", "chunk_id": 11 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "I'm all right with it. Because I--", "context": "Patient feels comfortable discussing diabetes with eye doctor, indicating positive relationship", "file_id": "dr_CL0110", "chunk_id": 11 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't know anything about it", "context": "Patient lacks knowledge about their condition", "file_id": "dr_CL0110", "chunk_id": 12 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "Get my eyes fixed", "context": "Patient implies concern about their eye health", "file_id": "dr_CL0110", "chunk_id": 12 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "My primary doctor-- and my sugar doc-- or eye doctor", "context": "Patient mentions multiple providers, implying a supportive relationship", "file_id": "dr_CL0110", "chunk_id": 12 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "They've told you it's a serious problem", "context": "Patient reports being informed about their condition by providers", "file_id": "dr_CL0110", "chunk_id": 12 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "My primary doctor-- and my sugar doc-- or eye doctor", "context": "Patient has received information about their condition from providers", "file_id": "dr_CL0110", "chunk_id": 12 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I really don't know", "context": "Patient unsure about potential vision loss due to diabetes", "file_id": "dr_CL0110", "chunk_id": 13 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "My eyeball hurts a little bit", "context": "Patient experiences eye pain after laser surgery", "file_id": "dr_CL0110", "chunk_id": 13 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "My primary doctor-- and my sugar doc-- or eye doctor", "context": "Patient mentions multiple healthcare providers involved in care", "file_id": "dr_CL0110", "chunk_id": 13 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "it was getting a little blurry, but I could still see to drive", "context": "Patient doesn't understand the severity of their condition", "file_id": "dr_CL0110", "chunk_id": 14 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now' (no perceived urgency)", "quote": "it was getting a little blurry, but I could still see to drive", "context": "Patient doesn't feel urgent need for follow-up", "file_id": "dr_CL0110", "chunk_id": 14 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "What's that?", "context": "Patient shows lack of knowledge about age-related eyesight decline and macular degeneration", "file_id": "dr_CL0110", "chunk_id": 15 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "not too happy", "context": "Patient expresses negative emotions after being diagnosed with eye conditions", "file_id": "dr_CL0110", "chunk_id": 15 }, { "code": "Emotional distress", "category": "BARRIER - Emotional/Psychological", "subcategory": "Depression/anxiety", "quote": "not too happy", "context": "Patient experiences emotional discomfort after diagnosis", "file_id": "dr_CL0110", "chunk_id": 15 }, { "code": "Healthcare system support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "You don't know? Okay.", "context": "Provider shows patience and understanding in explaining conditions to patient", "file_id": "dr_CL0110", "chunk_id": 15 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "it's a particular condition with that-- where it, , affects a part of your retina called your macula.", "context": "Provider takes time to explain complex medical conditions to patient", "file_id": "dr_CL0110", "chunk_id": 15 }, { "code": "Lack of satisfaction", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "Fair", "context": "Patient expresses dissatisfaction with follow-up experience", "file_id": "dr_CL0110", "chunk_id": 16 }, { "code": "Procedures discomfort", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "two weeks ago they'd done the--", "context": "Patient experiences discomfort due to procedures", "file_id": "dr_CL0110", "chunk_id": 16 }, { "code": "Personal motivation", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Just trying to save my eyes", "context": "Patient's personal motivation for attending follow-ups", "file_id": "dr_CL0110", "chunk_id": 16 }, { "code": "Social support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "I got a friend that drives me when I need to--", "context": "Patient receives social support from friends for transportation", "file_id": "dr_CL0110", "chunk_id": 16 }, { "code": "No discouragement", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Not yet", "context": "Patient experiences no discouragement from using healthcare services", "file_id": "dr_CL0110", "chunk_id": 16 }, { "code": "Transportation assistance", "category": "FACILITATOR - Resources & Access", "subcategory": "Transportation assistance", "quote": "I got a friend that drives me when I need to", "context": "Patient has a friend who provides transportation", "file_id": "dr_CL0110", "chunk_id": 17 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "He just said, 'Well, me too. Hopefully, it clears up now.'", "context": "Patient had a positive interaction with their provider", "file_id": "dr_CL0110", "chunk_id": 17 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "He just said, 'Well, me too. Hopefully, it clears up now.'", "context": "Provider communicated effectively with the patient", "file_id": "dr_CL0110", "chunk_id": 17 }, { "code": "Lack of information", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Probably", "context": "Patient feels they don't have enough information about their condition", "file_id": "dr_CL0110", "chunk_id": 18 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "He said, 'I don't know. I don't understand it.'", "context": "Patient experiences poor communication with provider", "file_id": "dr_CL0110", "chunk_id": 18 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "what kinds of information would you prefer, you had that would help you maybe manage things better?", "context": "Patient suggests needing more health education to manage their condition", "file_id": "dr_CL0110", "chunk_id": 18 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "He just said, 'Well, me too. Hopefully, it clears up now.'", "context": "Patient experiences provider empathy", "file_id": "dr_CL0110", "chunk_id": 18 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't know", "context": "Patient lacks understanding about their condition and treatment", "file_id": "dr_CL0110", "chunk_id": 18 }, { "code": "Lack of education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "No, I'd try it", "context": "Patient expresses interest in diabetes education but lacks access", "file_id": "dr_CL0110", "chunk_id": 19 }, { "code": "Lack of provider support", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "No one's ever mentioned it or--", "context": "Patient reports lack of discussion about diabetes education from healthcare providers", "file_id": "dr_CL0110", "chunk_id": 19 }, { "code": "Social support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "My wife. She checks my sugars", "context": "Patient has a supportive spouse who helps with daily diabetes care", "file_id": "dr_CL0110", "chunk_id": 19 }, { "code": "Limited health literacy", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "We just eat what we want", "context": "Patient lacks understanding of healthy diet for diabetes management", "file_id": "dr_CL0110", "chunk_id": 19 }, { "code": "Primary care only", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of continuity of care", "quote": "Just primary doc", "context": "Patient sees only a primary care physician, potentially lacking specialized diabetes care", "file_id": "dr_CL0110", "chunk_id": 19 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "No one's ever mentioned it or-- offered it", "context": "Patient not offered additional resources for diabetes management", "file_id": "dr_CL0110", "chunk_id": 20 }, { "code": "Poor provider relationship", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "Just primary doc", "context": "Patient only sees primary doctor, may indicate lack of specialized care", "file_id": "dr_CL0110", "chunk_id": 20 }, { "code": "Social support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "My wife", "context": "Patient has spouse for emotional support", "file_id": "dr_CL0110", "chunk_id": 20 }, { "code": "Practical support", "category": "FACILITATOR - Resources & Access", "subcategory": "Transportation assistance", "quote": "My wife", "context": "Patient's wife may provide practical help, including transportation", "file_id": "dr_CL0110", "chunk_id": 20 }, { "code": "Lack of health education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Well, if it'd help, yeah, I'd try it", "context": "Patient unsure about benefits of additional resources for diabetes management", "file_id": "dr_CL0110", "chunk_id": 20 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I wanted them to say, your sight's going to come back tomorrow or something", "context": "Patient has unrealistic expectations about treatment outcomes", "file_id": "dr_CL0110", "chunk_id": 21 }, { "code": "Transportation issues", "category": "BARRIER - SDOH", "subcategory": "Transportation issues", "quote": "He can't drive to the campsite", "context": "Patient's vision loss affects daily activities, including driving", "file_id": "dr_CL0110", "chunk_id": 21 }, { "code": "Emotional frustration", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "Oh, it's frustrating for him", "context": "Patient experiences emotional distress due to vision loss", "file_id": "dr_CL0110", "chunk_id": 21 }, { "code": "Positive expectations", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I wanted them to say, your sight's going to come back tomorrow or something", "context": "Patient has positive expectations from healthcare providers", "file_id": "dr_CL0110", "chunk_id": 21 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "He said, We're working on it", "context": "Provider shows empathy and reassurance", "file_id": "dr_CL0110", "chunk_id": 21 }, { "code": "Lack of education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "Well, just young and dumb. Didn't do it.", "context": "Patient lacked understanding of importance of regular eye checks", "file_id": "dr_CL0110", "chunk_id": 22 }, { "code": "Lack of provider recommendation", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "No. I-- He never went to the doctor", "context": "Patient was not advised by doctor to get regular eye checks", "file_id": "dr_CL0110", "chunk_id": 22 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Tell people they better-- take care of their eyes.", "context": "Patient emphasizes importance of self-care for eye health", "file_id": "dr_CL0110", "chunk_id": 22 }, { "code": "Regular check-ups", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate access to care", "quote": "They better go once a year and get them checked.", "context": "Patient recognizes importance of regular eye checks for maintaining health", "file_id": "dr_CL0110", "chunk_id": 22 }, { "code": "Lack of insurance", "category": "BARRIER - SDOH", "subcategory": "Insurance coverage issues", "quote": "Because he didn't have, , good insurance and stuff", "context": "Patient lacked good insurance", "file_id": "dr_CL0110", "chunk_id": 23 }, { "code": "No provider visits", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "He never went to the doctor", "context": "Patient did not visit doctors prior to 2021", "file_id": "dr_CL0110", "chunk_id": 23 }, { "code": "Insurance barrier", "category": "BARRIER - SDOH", "subcategory": "Insurance coverage issues", "quote": "Insurance was a barrier", "context": "Patient confirms insurance as a barrier", "file_id": "dr_CL0110", "chunk_id": 23 }, { "code": "Lack of health education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Well, just young and dumb. Didn't do it", "context": "Patient lacked knowledge about importance of check-ups", "file_id": "dr_CL0110", "chunk_id": 23 }, { "code": "Primary care doctor", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Yeah. I've got my primary care doctor", "context": "Patient has a primary care doctor", "file_id": "dr_CL0110", "chunk_id": 23 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "you guys mentioned you come from far to get here", "context": "Patient has to travel far for healthcare", "file_id": "dr_CL0110", "chunk_id": 24 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "He's right there at Bridgeport", "context": "Patient has a nearby primary care doctor", "file_id": "dr_CL0110", "chunk_id": 24 }, { "code": "Importance of follow-up", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "You better keep up with it", "context": "Patient understands the importance of regular healthcare", "file_id": "dr_CL0110", "chunk_id": 24 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I'm not planning on going blind", "context": "Patient is motivated by fear of blindness", "file_id": "dr_CL0110", "chunk_id": 24 }, { "code": "Appreciation for support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I really appreciate it", "context": "Patient expresses gratitude for healthcare service", "file_id": "dr_CL0110", "chunk_id": 25 }, { "code": "Lack of adherence to meds", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I just take my meds when I can", "context": "Patient does not prioritize medication schedule", "file_id": "dr_RW1026", "chunk_id": 0 }, { "code": "Poor health literacy", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "What now?", "context": "Patient seems unclear about diabetes management questions", "file_id": "dr_RW1026", "chunk_id": 0 }, { "code": "Health education importance", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "check my sugar, pretty much make meal plans", "context": "Patient values learning about diabetes management", "file_id": "dr_RW1026", "chunk_id": 0 }, { "code": "Provider guidance", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "my doctor has discussed with you that it's important for people with diabetes to do", "context": "Patient receives guidance from healthcare provider", "file_id": "dr_RW1026", "chunk_id": 0 }, { "code": "Self-management support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "check blood sugar, get exercise, plenty of sleep, diet, take my medication", "context": "Patient is aware of self-management strategies", "file_id": "dr_RW1026", "chunk_id": 0 }, { "code": "Lack of symptoms", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now' (no perceived urgency)", "quote": "far as symptoms go, there really wasn't no symptoms", "context": "Patient does not experience noticeable symptoms", "file_id": "dr_RW1026", "chunk_id": 1 }, { "code": "No education on DR progression", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "That's pretty much it", "context": "Patient lacks knowledge on diabetes management and complications", "file_id": "dr_RW1026", "chunk_id": 1 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "check blood sugar, get exercise, plenty of sleep, diet, take my medication", "context": "Patient has received guidance on diabetes management", "file_id": "dr_RW1026", "chunk_id": 1 }, { "code": "Provider discussion on self-care", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "And what are some things your doctor has discussed with you that it's important for people with diabetes to do?", "context": "Patient receives guidance from provider on self-care", "file_id": "dr_RW1026", "chunk_id": 1 }, { "code": "Lack of awareness", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I noticed my eyes are getting worse", "context": "Patient is unaware of the severity of their condition", "file_id": "dr_RW1026", "chunk_id": 2 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I went from seeing to not", "context": "Patient is experiencing vision loss, potentially fearing diagnosis", "file_id": "dr_RW1026", "chunk_id": 2 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "It's going swimming in a pool and coming up and having water, water in your eyes", "context": "Patient is describing their condition without clear understanding", "file_id": "dr_RW1026", "chunk_id": 2 }, { "code": "Healthcare system support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I've had blood-- high blood sugar. I've had low blood sugar", "context": "Patient has received medical attention, indicating some level of healthcare support", "file_id": "dr_RW1026", "chunk_id": 2 }, { "code": "Patient awareness", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I noticed my eyes are getting worse", "context": "Patient is aware of their condition, potentially due to health education", "file_id": "dr_RW1026", "chunk_id": 2 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "he didn't really say diabetic retinopathy", "context": "Patient unclear about diagnosis", "file_id": "dr_RW1026", "chunk_id": 3 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "No, he didn't say nothing about them", "context": "Provider did not communicate effectively", "file_id": "dr_RW1026", "chunk_id": 3 }, { "code": "Lack of education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "Not really, no. No.", "context": "Patient reports lack of information about diabetes effects on eyes", "file_id": "dr_RW1026", "chunk_id": 4 }, { "code": "Poor provider communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "Nobody's told you anything about how ?", "context": "Patient indicates providers did not inform them about diabetes effects on eyes", "file_id": "dr_RW1026", "chunk_id": 4 }, { "code": "Lack of continuity of care", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of continuity of care", "quote": "And I had to find another one.", "context": "Patient experienced change in primary care provider", "file_id": "dr_RW1026", "chunk_id": 4 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I had an eye doctor--", "context": "Patient reports having access to a specialist", "file_id": "dr_RW1026", "chunk_id": 4 }, { "code": "Lack of explanation", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "didn't really get into too much of, , the explanation part of it", "context": "Patient felt doctor didn't explain diabetes effects on eyes thoroughly", "file_id": "dr_RW1026", "chunk_id": 5 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "And she got my diabetes down and really informed me a lot about diabetes", "context": "Patient had a positive experience with a specialist doctor", "file_id": "dr_RW1026", "chunk_id": 5 }, { "code": "Access to healthcare", "category": "FACILITATOR - Resources & Access", "subcategory": "Accessible providers", "quote": "I got it here", "context": "Patient has access to eye exams at their current location", "file_id": "dr_RW1026", "chunk_id": 5 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "And she got my diabetes down and really informed me a lot about diabetes", "context": "Patient received health education from their doctor", "file_id": "dr_RW1026", "chunk_id": 5 }, { "code": "Workplace health programs", "category": "FACILITATOR - Resources & Access", "subcategory": "Community health programs", "quote": "we had our eyes tested every three years", "context": "Patient's workplace offers regular eye exams", "file_id": "dr_RW1026", "chunk_id": 5 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "I didn't really-- --", "context": "Patient implies lack of prior eye exams", "file_id": "dr_RW1026", "chunk_id": 6 }, { "code": "Healthcare system support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "we get-- , we had our eyes tested every three years", "context": "Patient's workplace provides regular eye exams", "file_id": "dr_RW1026", "chunk_id": 6 }, { "code": "Resources and access", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate insurance coverage", "quote": "at work, we get-- , we had our eyes tested every three years", "context": "Patient's workplace provides eye exams, implying access to resources", "file_id": "dr_RW1026", "chunk_id": 6 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't know where to begin", "context": "Patient unsure about the examination process", "file_id": "dr_RW1026", "chunk_id": 7 }, { "code": "Poor health literacy", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "I don't know 'cause I really haven't-- really haven't been through it before", "context": "Patient lacks knowledge about the examination procedure", "file_id": "dr_RW1026", "chunk_id": 7 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "They pretty much did everything", "context": "Patient received thorough care from providers", "file_id": "dr_RW1026", "chunk_id": 7 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I think you should have your eyes checked once a year, or if you started having problems", "context": "Patient lacks knowledge about necessary follow-up frequency", "file_id": "dr_RW1026", "chunk_id": 8 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "Oh, man. Horrible.", "context": "Patient expresses negative emotions about eye exam experience", "file_id": "dr_RW1026", "chunk_id": 8 }, { "code": "Vision problems", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "I couldn't hardly see at all.", "context": "Patient experiences vision difficulties, contradicting 'no perceived urgency' belief", "file_id": "dr_RW1026", "chunk_id": 8 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I think you should have your eyes checked once a year, or if you started having problems", "context": "Patient demonstrates some knowledge about eye exam frequency", "file_id": "dr_RW1026", "chunk_id": 8 }, { "code": "Lack of clarity on schedule", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "And, , after that, I don't-- really don't know--", "context": "Patient unsure about future appointments", "file_id": "dr_RW1026", "chunk_id": 9 }, { "code": "Easy scheduling process", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "No, it wasn't. -- Yeah. Pretty much.", "context": "Patient found scheduling easy and convenient", "file_id": "dr_RW1026", "chunk_id": 9 }, { "code": "Flexible doctor availability", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I can match it too.", "context": "Patient's schedule matches doctor's availability", "file_id": "dr_RW1026", "chunk_id": 9 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "it's an hour 45-minute drive, right?", "context": "Patient mentions long distance to clinic", "file_id": "dr_RW1026", "chunk_id": 10 }, { "code": "Transportation barriers", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "Well, that's a little bit difficult, 'cause I gotta get a ride to get up here", "context": "Patient lacks transportation to clinic", "file_id": "dr_RW1026", "chunk_id": 10 }, { "code": "Lack of education", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "2. Patient Beliefs & Perceptions", "quote": "they really didn't say anything", "context": "Patient received no educational information", "file_id": "dr_RW1026", "chunk_id": 10 }, { "code": "Poor communication", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "3. Provider/System Issues", "quote": "they really didn't say anything", "context": "Patient received no information from provider", "file_id": "dr_RW1026", "chunk_id": 10 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "I gotta get a ride to get up here", "context": "Patient faces difficulty due to lack of transportation", "file_id": "dr_RW1026", "chunk_id": 11 }, { "code": "Long distance", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "hour and 45 minutes drive makes it inconvenient", "context": "Patient finds long travel time to clinic inconvenient", "file_id": "dr_RW1026", "chunk_id": 11 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "they explained what diabetes would do with the, , the blood vessels in your eye--", "context": "Patient lacked knowledge about diabetes effects on eyes", "file_id": "dr_RW1026", "chunk_id": 12 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "they explained what diabetes would do with the, , the blood vessels in your eye--", "context": "Patient received clear information from doctor", "file_id": "dr_RW1026", "chunk_id": 12 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "Oh, I'm very comfortable", "context": "Patient feels at ease with their eye doctor", "file_id": "dr_RW1026", "chunk_id": 12 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "I'm just another number, just another--", "context": "Patient feels like just a number to their provider", "file_id": "dr_RW1026", "chunk_id": 13 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "we didn't understand what really was going on", "context": "Patient had difficulty understanding their condition due to poor communication", "file_id": "dr_RW1026", "chunk_id": 13 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I'm very comfortable", "context": "Patient feels comfortable discussing their concerns with their provider", "file_id": "dr_RW1026", "chunk_id": 13 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "they tell me what, what could happen, what I could do", "context": "Patient receives clear information from their provider", "file_id": "dr_RW1026", "chunk_id": 13 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "I'm just another number, just another--", "context": "Patient feels like just a number to providers", "file_id": "dr_RW1026", "chunk_id": 14 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "they-they've got so many people coming through a day", "context": "Patient perceives providers as too busy to communicate effectively", "file_id": "dr_RW1026", "chunk_id": 14 }, { "code": "Lack of understanding about DR progression", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "they tell me what, , what could happen, what, what I could do", "context": "Patient lacks clear understanding of diabetes and its effects", "file_id": "dr_RW1026", "chunk_id": 14 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Just tell them", "context": "Patient reports being able to communicate needs to providers", "file_id": "dr_RW1026", "chunk_id": 14 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I've told them, , , what I do as far as my medication and stuff goes", "context": "Patient takes active role in managing health", "file_id": "dr_RW1026", "chunk_id": 14 }, { "code": "Perceived severity of diabetes", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "Very serious", "context": "Patient understands the seriousness of diabetes-related vision loss", "file_id": "dr_RW1026", "chunk_id": 14 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "So I can't really say, one way or the other, whether diabetes really had anything to do with that or not", "context": "Patient unsure about diabetes impact on vision", "file_id": "dr_RW1026", "chunk_id": 15 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "Well, the last two years I've seen what-- know what it's", "context": "Patient hesitant to discuss vision loss", "file_id": "dr_RW1026", "chunk_id": 15 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Well, well, right now I got partial", "context": "Patient has some knowledge about diabetes and vision", "file_id": "dr_RW1026", "chunk_id": 15 }, { "code": "Diabetes awareness", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "Very serious", "context": "Patient recognizes diabetes severity", "file_id": "dr_RW1026", "chunk_id": 15 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "but with the diabetes, I don't know, it's, it's up in the air", "context": "Patient unsure about diabetes impact on vision", "file_id": "dr_RW1026", "chunk_id": 16 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I don't know, it's, it's up in the air", "context": "Patient anxious about potential vision loss", "file_id": "dr_RW1026", "chunk_id": 16 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "doctor said I wouldn't have-- I wouldn't have the eyesight of a 20-year-old, but 30 is all right", "context": "Patient feels reassured by doctor's words", "file_id": "dr_RW1026", "chunk_id": 16 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "doctor said I wouldn't have-- I wouldn't have the eyesight of a 20-year-old, but 30 is all right", "context": "Patient receives information about vision expectations", "file_id": "dr_RW1026", "chunk_id": 16 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I can see colors, and-- I can see copiers and papers, the pencils--", "context": "Patient describes visual limitations without mentioning disease progression", "file_id": "dr_RW1026", "chunk_id": 17 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I've got all kinds of-- I've go eye problems", "context": "Patient expresses concern about multiple eye issues", "file_id": "dr_RW1026", "chunk_id": 17 }, { "code": "Healthcare System Support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "we've got injections, , dilate", "context": "Patient mentions receiving treatments, implying access to care", "file_id": "dr_RW1026", "chunk_id": 17 }, { "code": "Patient Empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I can see colors, and-- I can see copiers and papers, the pencils--", "context": "Patient demonstrates some understanding of visual limitations", "file_id": "dr_RW1026", "chunk_id": 17 }, { "code": "Rude provider", "category": "BARRIER - Provider/System Issues", "subcategory": "Rude or dismissive providers", "quote": "He's a quack", "context": "Patient had negative experience with provider", "file_id": "dr_RW1026", "chunk_id": 18 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "And then he just left the room", "context": "Patient felt provider did not communicate effectively", "file_id": "dr_RW1026", "chunk_id": 18 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "I called him a quack when I left", "context": "Patient does not trust provider", "file_id": "dr_RW1026", "chunk_id": 18 }, { "code": "Rude provider", "category": "BARRIER - Provider/System Issues", "subcategory": "Rude or dismissive providers", "quote": "I called him a quack when I left", "context": "Patient had negative experience with provider", "file_id": "dr_RW1026", "chunk_id": 19 }, { "code": "Lack of trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "I called him a quack when I left", "context": "Patient does not trust provider", "file_id": "dr_RW1026", "chunk_id": 19 }, { "code": "Negative experience", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "It sucks", "context": "Patient had negative experience with diagnosis", "file_id": "dr_RW1026", "chunk_id": 19 }, { "code": "Fear of vision loss", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "it-it's going from being able to see to not being able to see", "context": "Patient fears losing vision", "file_id": "dr_RW1026", "chunk_id": 19 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "it come on fairly quick", "context": "Patient expresses surprise at rapid vision loss", "file_id": "dr_RW1026", "chunk_id": 20 }, { "code": "Feeling overwhelmed", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "It sucks", "context": "Patient expresses negative emotions about diagnosis", "file_id": "dr_RW1026", "chunk_id": 20 }, { "code": "Positive experience", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Oh, that's been pretty good", "context": "Patient describes overall positive experience with eye doctors", "file_id": "dr_RW1026", "chunk_id": 21 }, { "code": "Lack of prior issues", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I haven't had any dealings with-- , I seen the eye doctor or having a normal eye doctor, or nor-normal examination", "context": "Patient has not had negative experiences with providers", "file_id": "dr_RW1026", "chunk_id": 21 }, { "code": "New process", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "So right now, it's still new process", "context": "Patient is in the initial stages of treatment and follow-up", "file_id": "dr_RW1026", "chunk_id": 21 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "I haven't had any dealings with-- , I seen the eye doctor or having a normal eye doctor, or nor-normal examination", "context": "Patient is new to the process and lacks experience with eye care", "file_id": "dr_RW1026", "chunk_id": 22 }, { "code": "Lack of trust", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of patient-provider trust", "quote": "So I'm not gonna give, , anyone excellent until I know them", "context": "Patient is hesitant to trust new healthcare providers", "file_id": "dr_RW1026", "chunk_id": 22 }, { "code": "Visual impairment", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "I can't see my phone", "context": "Patient's visual impairment limits their ability to use technology", "file_id": "dr_RW1026", "chunk_id": 22 }, { "code": "Accessible communication", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "being available, , calling them--", "context": "Patient values being able to call and communicate with healthcare providers", "file_id": "dr_RW1026", "chunk_id": 22 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "being available, calling them-- and, schedule appointments and stuff", "context": "Patient finds it helpful to be able to call and schedule appointments", "file_id": "dr_RW1026", "chunk_id": 23 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "being available, calling them-- and, schedule appointments and stuff", "context": "Patient values being able to communicate with providers", "file_id": "dr_RW1026", "chunk_id": 23 }, { "code": "Reminder systems", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "being available, calling them-- and, schedule appointments and stuff", "context": "Patient implies that being able to schedule appointments is helpful, possibly due to reminder systems", "file_id": "dr_RW1026", "chunk_id": 23 }, { "code": "Lack of support system", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Emotional/Psychological", "quote": "No, you do it by yourself?", "context": "Patient lacks daily diabetes care support", "file_id": "dr_RW1026", "chunk_id": 24 }, { "code": "Social support networks", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "I got some. my sisters.", "context": "Patient has supportive family members", "file_id": "dr_RW1026", "chunk_id": 24 }, { "code": "Emotional support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "They support me", "context": "Patient receives emotional support from sisters", "file_id": "dr_RW1026", "chunk_id": 24 }, { "code": "Social Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "Yeah. They support me.", "context": "Patient has sisters who provide emotional support", "file_id": "dr_RW1026", "chunk_id": 25 }, { "code": "Transportation Assistance", "category": "FACILITATOR - Resources & Access", "subcategory": "Transportation assistance", "quote": "My sister do. My transportation.", "context": "Patient has sisters who help with transportation", "file_id": "dr_RW1026", "chunk_id": 25 }, { "code": "Health Education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Yep. I wanna say, , seven years ago.", "context": "Patient participated in a diabetes education class", "file_id": "dr_RW1026", "chunk_id": 25 }, { "code": "Limited Health Advice", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "No. Mostly just you doc-- call your doctor for advice.", "context": "Patient relies solely on doctor for health advice", "file_id": "dr_RW1026", "chunk_id": 25 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "They tell-- , diet, -- medications", "context": "Patient attended a week-long education class", "file_id": "dr_RW1026", "chunk_id": 26 }, { "code": "Prior knowledge", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "So I knew a little bit-- prior going into it", "context": "Patient had existing knowledge about diabetes", "file_id": "dr_RW1026", "chunk_id": 26 }, { "code": "Family support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "my father was diabetic", "context": "Patient has a family history of diabetes", "file_id": "dr_RW1026", "chunk_id": 26 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "can't really go outdoors much", "context": "Patient has difficulty going out due to eyesight and mobility issues", "file_id": "dr_RW1026", "chunk_id": 27 }, { "code": "Mobility issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "can't move", "context": "Patient has difficulty with mobility, using a cane", "file_id": "dr_RW1026", "chunk_id": 27 }, { "code": "Lack of access to activities", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "can't really go outdoors much", "context": "Patient has limited ability to participate in outdoor activities", "file_id": "dr_RW1026", "chunk_id": 27 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "that's been so tough", "context": "Patient mentions difficulty related to their condition", "file_id": "dr_RW1026", "chunk_id": 28 }, { "code": "Internet Access", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "having access to the information", "context": "Patient mentions internet access as a potential issue for telemedicine", "file_id": "dr_RW1026", "chunk_id": 28 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "I get pretty good, yeah", "context": "Patient describes their interaction with the eye doctor as positive", "file_id": "dr_RW1026", "chunk_id": 28 }, { "code": "Patient Comfort", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "Oh, I'm comfortable", "context": "Patient feels comfortable asking questions to their eye doctor", "file_id": "dr_RW1026", "chunk_id": 28 }, { "code": "Telehealth options", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Telehealth options", "quote": "I'd be all right", "context": "Patient is open to using telemedicine for follow-up appointments", "file_id": "dr_RW1026", "chunk_id": 28 }, { "code": "Lack of control", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Not much at all", "context": "Patient feels they have no control over their eye care decisions", "file_id": "dr_RW1026", "chunk_id": 29 }, { "code": "Rushing communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "it's just monotonous", "context": "Patient feels their doctor rushes through explanations", "file_id": "dr_RW1026", "chunk_id": 29 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "I'm comfortable", "context": "Patient feels at ease asking questions to their eye doctor", "file_id": "dr_RW1026", "chunk_id": 29 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "he just rattled off", "context": "Patient feels eye doctor rushes through communication", "file_id": "dr_RW1026", "chunk_id": 30 }, { "code": "Rushed communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "I feel that they are rushing their communication", "context": "Patient perceives eye doctor as rushed", "file_id": "dr_RW1026", "chunk_id": 30 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "he explains results recommendations for your eyes pretty good", "context": "Patient feels eye doctor communicates effectively", "file_id": "dr_RW1026", "chunk_id": 30 }, { "code": "Clear explanations", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "the explanations are clear in a way that everybody can understand", "context": "Patient appreciates clear communication from eye doctor", "file_id": "dr_RW1026", "chunk_id": 30 }, { "code": "Respected provider", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "I feel pretty good about my eye doctor", "context": "Patient has positive relationship with eye doctor", "file_id": "dr_RW1026", "chunk_id": 30 }, { "code": "Lack of choice", "category": "BARRIER - SDOH", "subcategory": "Social Determinants of Health", "quote": "some people ain't got choice", "context": "Patient mentions lack of choice as a factor", "file_id": "dr_RW1026", "chunk_id": 31 }, { "code": "Lifestyle factors", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Patient beliefs about diabetes", "quote": "some it's lifestyle", "context": "Patient attributes diabetes to lifestyle choices", "file_id": "dr_RW1026", "chunk_id": 31 }, { "code": "Genetic factors", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Some are born with it", "context": "Patient mentions genetic predisposition to diabetes", "file_id": "dr_RW1026", "chunk_id": 31 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "monitoring and checking it", "context": "Patient discusses importance of monitoring blood sugar", "file_id": "dr_JC0228", "chunk_id": 1 }, { "code": "Medication adherence", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I do take my medications of course", "context": "Patient prioritizes taking medications", "file_id": "dr_JC0228", "chunk_id": 1 }, { "code": "Lifestyle modifications", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I have been doing a keto diet", "context": "Patient makes dietary changes to manage diabetes", "file_id": "dr_JC0228", "chunk_id": 1 }, { "code": "Physical activity", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "when I can, I try to go to the gym", "context": "Patient engages in physical activity for diabetes management", "file_id": "dr_JC0228", "chunk_id": 1 }, { "code": "Blood sugar monitoring", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "so I use that and check my sugars with that", "context": "Patient uses device to monitor blood sugar levels", "file_id": "dr_JC0228", "chunk_id": 1 }, { "code": "Provider guidance", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "what has she, or she or he told you to do?", "context": "Patient discusses provider's recommendations", "file_id": "dr_JC0228", "chunk_id": 1 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "getting my A1C down is my, my one I'm working on the most right now", "context": "Patient focuses on blood sugar control but doesn't mention DR or eye care", "file_id": "dr_JC0228", "chunk_id": 2 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "monitoring and checking it", "context": "Patient mentions importance of monitoring blood sugar levels", "file_id": "dr_JC0228", "chunk_id": 2 }, { "code": "Medication adherence", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "making sure you take your medications at the right times", "context": "Patient emphasizes importance of taking medications correctly", "file_id": "dr_JC0228", "chunk_id": 2 }, { "code": "Exercise awareness", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "that exercise is very good for it", "context": "Patient recognizes benefits of exercise for diabetes management", "file_id": "dr_JC0228", "chunk_id": 2 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't really feel, I guess when I get high", "context": "Patient lacks clear understanding of diabetes effects", "file_id": "dr_JC0228", "chunk_id": 3 }, { "code": "Feeling overwhelmed", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "it makes me feel tired", "context": "Patient experiences emotional distress due to diabetes", "file_id": "dr_JC0228", "chunk_id": 3 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "even though I have been doing things, making better choices, this has been going on longer than I knew", "context": "Patient was unaware of the progression of their diabetic retinopathy", "file_id": "dr_JC0228", "chunk_id": 4 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "the last two doctors just said it should get better", "context": "Patient received inadequate information from healthcare providers", "file_id": "dr_JC0228", "chunk_id": 4 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "another doctor where they didn't tell me it'd come to something this until I found out a couple days ago", "context": "Patient feels that healthcare providers have not been transparent about their condition", "file_id": "dr_JC0228", "chunk_id": 4 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "my primary care doctor is in Weirton currently, and I'm trying to transfer", "context": "Patient having difficulty accessing primary care due to location", "file_id": "dr_JC0228", "chunk_id": 5 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "I had another doctor where they didn't tell me it'd come to something this until I found out a couple days ago", "context": "Patient experienced poor communication from healthcare provider", "file_id": "dr_JC0228", "chunk_id": 5 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "the last two doctors just said it should get better", "context": "Patient lacks trust in providers due to inconsistent information", "file_id": "dr_JC0228", "chunk_id": 5 }, { "code": "Difficulty with communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "I've had some difficulty with communicating with them about the fl- these few things", "context": "Patient having trouble communicating with primary care doctor", "file_id": "dr_JC0228", "chunk_id": 5 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "So I've had some difficulty with communicating with them about the fl- these few things.", "context": "Patient experiences difficulty communicating with healthcare providers", "file_id": "dr_JC0228", "chunk_id": 6 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "she did say she wanted to make sure that I got it checked again.", "context": "Patient's endocrinologist shows concern for their care", "file_id": "dr_JC0228", "chunk_id": 6 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "she did say she wanted to make sure that I got it checked again.", "context": "Patient's endocrinologist communicates effectively with them", "file_id": "dr_JC0228", "chunk_id": 6 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "So when I got it checked again, just that's whenever I noticed all this extra stuff, so.", "context": "Patient feels supported by provider", "file_id": "dr_JC0228", "chunk_id": 7 }, { "code": "Aggressive treatment", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "he wants to be aggressive with my treatments", "context": "Provider is proactive in treatment approach", "file_id": "dr_JC0228", "chunk_id": 7 }, { "code": "Positive attitude", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I'd rather be aggressive than not, so.", "context": "Patient is motivated to manage condition", "file_id": "dr_JC0228", "chunk_id": 7 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "it's circulation... it can restrict blood flow and that causes the, , tension and the squeezing in your eyes", "context": "Patient has limited knowledge about diabetes effects on eyes", "file_id": "dr_JC0228", "chunk_id": 8 }, { "code": "Provider education", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Health education programs", "quote": "just that basically the sugars, , it's circulation", "context": "Doctor provided patient with information about diabetes and eye health", "file_id": "dr_JC0228", "chunk_id": 8 }, { "code": "Patient awareness", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "diabetes is, is, , directly linked to that and it can restrict blood flow", "context": "Patient demonstrates understanding of diabetes effects on eyes", "file_id": "dr_JC0228", "chunk_id": 8 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "I haven't had a typical doctor for quite a while", "context": "Patient lacks consistent healthcare provider", "file_id": "dr_JC0228", "chunk_id": 9 }, { "code": "Insurance coverage issues", "category": "BARRIER - SDOH", "subcategory": "Insurance coverage issues", "quote": "we had changed insurance a couple times", "context": "Patient experiences changes in insurance coverage", "file_id": "dr_JC0228", "chunk_id": 9 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I'm hoping this will be more consistent", "context": "Patient seeks consistent healthcare provider", "file_id": "dr_JC0228", "chunk_id": 9 }, { "code": "Healthcare access", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate insurance coverage", "quote": "we are settled and moved into Morgantown, so I'm hoping this will be more consistent", "context": "Patient has access to healthcare in new location", "file_id": "dr_JC0228", "chunk_id": 9 }, { "code": "Insurance coverage issues", "category": "BARRIER - SDOH", "subcategory": "Insurance coverage issues", "quote": "we had changed insurance a couple times", "context": "Patient experienced changes in insurance coverage", "file_id": "dr_JC0228", "chunk_id": 10 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I'm hoping this will be more consistent", "context": "Patient expects consistent care from new provider", "file_id": "dr_JC0228", "chunk_id": 10 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "she did everything from the ch- the glaucoma, , scanned, , the eye exam", "context": "Patient describes thorough and clear explanation of eye exam process", "file_id": "dr_JC0228", "chunk_id": 10 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "she had some very good technology too for that", "context": "Patient appreciates provider's use of advanced technology", "file_id": "dr_JC0228", "chunk_id": 10 }, { "code": "Uncomfortable procedure", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor patient experience", "quote": "It's uncomfortable", "context": "Patient finds eye dilation uncomfortable", "file_id": "dr_JC0228", "chunk_id": 11 }, { "code": "Positive provider interaction", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "they did a good job", "context": "Patient appreciates provider's care during procedure", "file_id": "dr_JC0228", "chunk_id": 11 }, { "code": "Frequent follow-up needed", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "minimum would be probably three months", "context": "Patient understands importance of regular eye checks", "file_id": "dr_JC0228", "chunk_id": 11 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "they did a good job", "context": "Patient had positive experience with provider", "file_id": "dr_JC0228", "chunk_id": 12 }, { "code": "Appointment scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "try to call in and get my dates set up", "context": "Patient describes process of scheduling appointments", "file_id": "dr_JC0228", "chunk_id": 12 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "they'll call me to confirm my appointment or whatever", "context": "Patient receives clear communication from provider", "file_id": "dr_JC0228", "chunk_id": 12 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "A little bit longer, more waits", "context": "Patient experienced long wait times in the past", "file_id": "dr_JC0228", "chunk_id": 13 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Healthcare System Support", "quote": "Today was amazing. It was fast", "context": "Patient had a positive experience with provider availability", "file_id": "dr_JC0228", "chunk_id": 13 }, { "code": "Appointment scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "try to call in and then they'll call me to confirm my appointment", "context": "Patient describes a potentially cumbersome appointment scheduling process", "file_id": "dr_JC0228", "chunk_id": 13 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "So I mean, I would say here was excellent", "context": "Patient expresses satisfaction with their provider interaction", "file_id": "dr_JC0228", "chunk_id": 13 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "A little bit longer, more waits", "context": "Patient experienced long wait times previously", "file_id": "dr_JC0228", "chunk_id": 14 }, { "code": "Rushed appointments", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "I feel rushed, occasionally the, , , the doctor I had in Weirton and I felt it wasn't very thorough", "context": "Patient felt rushed during appointments with previous doctor", "file_id": "dr_JC0228", "chunk_id": 14 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "it was more, , , just in and out. Didn't really take the time to really do the, the work", "context": "Patient felt doctor did not communicate effectively", "file_id": "dr_JC0228", "chunk_id": 14 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Healthcare System Support", "quote": "And I got in in three days, so I was very happy with that today", "context": "Patient had easy access to provider", "file_id": "dr_JC0228", "chunk_id": 14 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "But here it's been very good. So", "context": "Patient has positive relationship with current provider", "file_id": "dr_JC0228", "chunk_id": 14 }, { "code": "Personal issues", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "I have my own personal, self issues", "context": "Patient mentions personal issues as a challenge", "file_id": "dr_JC0228", "chunk_id": 15 }, { "code": "Stress levels", "category": "BARRIER - Emotional/Psychological", "subcategory": "Depression/anxiety", "quote": "working on my stress levels", "context": "Patient identifies stress as an area for improvement", "file_id": "dr_JC0228", "chunk_id": 15 }, { "code": "Self management", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "trying to keep my sugar levels, down in the 70 range-ish", "context": "Patient is actively managing their diabetes", "file_id": "dr_JC0228", "chunk_id": 15 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I've been told is stress", "context": "Patient has received health advice on stress management", "file_id": "dr_JC0228", "chunk_id": 15 }, { "code": "Personal issues", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "as more I have my own personal, , self issues-", "context": "Patient mentions personal challenges affecting follow-up", "file_id": "dr_JC0228", "chunk_id": 16 }, { "code": "Crowded facilities", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of continuity of care", "quote": "just crowded-", "context": "Patient finds clinic environment overwhelming", "file_id": "dr_JC0228", "chunk_id": 16 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Long wait times", "quote": "you'll get there and you'll have to wait-", "context": "Patient experiences delays at the clinic", "file_id": "dr_JC0228", "chunk_id": 16 }, { "code": "Anxiety issues", "category": "BARRIER - Emotional/Psychological", "subcategory": "Depression/anxiety", "quote": "I have anxiety issues", "context": "Patient's mental health affects follow-up adherence", "file_id": "dr_JC0228", "chunk_id": 16 }, { "code": "ADHD", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "I have ADHD-", "context": "Patient's neurodevelopmental disorder may impact follow-up", "file_id": "dr_JC0228", "chunk_id": 16 }, { "code": "Anxiety issues", "category": "BARRIER - Emotional/Psychological", "subcategory": "Depression/anxiety", "quote": "well I have anxiety issues", "context": "Patient experiences anxiety", "file_id": "dr_JC0228", "chunk_id": 17 }, { "code": "Frustration issues", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "the frustration issues with the problems I have", "context": "Patient feels frustrated with health issues", "file_id": "dr_JC0228", "chunk_id": 17 }, { "code": "Lack of education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "so that, , you could almost connect someone to something, especially if you're diabetic", "context": "Patient suggests needing more information on diabetes management", "file_id": "dr_JC0228", "chunk_id": 17 }, { "code": "Health education support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "one of the things that I would suggest personally is somehow a better linkage to a dietary certain thing", "context": "Patient suggests needing health education on diet and diabetes", "file_id": "dr_JC0228", "chunk_id": 17 }, { "code": "Accessible resources", "category": "FACILITATOR - Resources & Access", "subcategory": "Community health programs", "quote": "so that, , you could almost connect someone to something, especially if you're diabetic", "context": "Patient suggests needing accessible resources for diabetes management", "file_id": "dr_JC0228", "chunk_id": 17 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "plan for food management or, or things of that nature", "context": "Patient suggests needing guidance on managing diabetes", "file_id": "dr_JC0228", "chunk_id": 18 }, { "code": "Diabetes self-management support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "self-management", "context": "Patient emphasizes importance of self-care", "file_id": "dr_JC0228", "chunk_id": 18 }, { "code": "Holistic approaches", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "minor holistic things that you could do", "context": "Patient open to alternative methods for managing health", "file_id": "dr_JC0228", "chunk_id": 18 }, { "code": "Accessible healthcare", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "having something for people that would be able to go to, for a, a beginner", "context": "Patient suggests needing accessible resources for diabetes management", "file_id": "dr_JC0228", "chunk_id": 18 }, { "code": "Stress relief methods", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "ways to relieve stress", "context": "Patient recognizes importance of stress management in diabetes care", "file_id": "dr_JC0228", "chunk_id": 18 }, { "code": "Family History", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "my grandmother had glaucoma, my aunt had, , eye issues, and my grand- my aunt had diabetes", "context": "Patient aware of family history of eye issues and diabetes", "file_id": "dr_JC0228", "chunk_id": 19 }, { "code": "Preventative Measures", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I'm trying to be more preventative of the things that, , for that", "context": "Patient taking proactive steps for health", "file_id": "dr_JC0228", "chunk_id": 19 }, { "code": "Healthy Diet", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I'm trying to eat better and do things, anything I can do to, , as I basically turned 50", "context": "Patient making lifestyle changes for health", "file_id": "dr_JC0228", "chunk_id": 19 }, { "code": "Stress Management", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I am trying, I said, I'm working on meditation and breathing", "context": "Patient using stress management techniques for health", "file_id": "dr_JC0228", "chunk_id": 19 }, { "code": "Family History Awareness", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "my grandmother had glaucoma, my aunt had, , eye issues, and my grand- my aunt had diabetes", "context": "Patient is aware of family history and trying to be preventative", "file_id": "dr_JC0228", "chunk_id": 20 }, { "code": "Preventative Motivation", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I'm trying to be more preventative of the things that, , for that", "context": "Patient is motivated to take care of their health", "file_id": "dr_JC0228", "chunk_id": 20 }, { "code": "Lack Of Self Care", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "But I don't, there are times where I will probably overstress my eyes with certain things that", "context": "Patient is not prioritizing self-care for their eyes", "file_id": "dr_JC0228", "chunk_id": 20 }, { "code": "Intention To Change", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "But that's something I definitely would to work on", "context": "Patient intends to make positive changes for their health", "file_id": "dr_JC0228", "chunk_id": 20 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "if you don't treat, if untreated, it can lead to blindness", "context": "Patient's understanding of diabetes and vision loss", "file_id": "dr_JC0228", "chunk_id": 21 }, { "code": "Education/health literacy", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "I am, I'm a little self-educated enough to know it as well", "context": "Patient's self-education on diabetes and its consequences", "file_id": "dr_JC0228", "chunk_id": 21 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "he did say I was doing a better path", "context": "Patient's interaction with their doctor", "file_id": "dr_JC0228", "chunk_id": 21 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I have some nursing background and some medical background and, and dietary actually", "context": "Patient's background knowledge on health and diabetes", "file_id": "dr_JC0228", "chunk_id": 21 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I do know that there are consequences to your actions when it comes to those things", "context": "Patient's understanding of their health and its consequences", "file_id": "dr_JC0228", "chunk_id": 21 }, { "code": "Open communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "I'm open", "context": "Patient feels comfortable discussing diabetes with eye doctor", "file_id": "dr_JC0228", "chunk_id": 22 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I feel I need to ask questions", "context": "Patient takes initiative to learn about their condition", "file_id": "dr_JC0228", "chunk_id": 22 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "I'm fine with it", "context": "Patient feels at ease discussing concerns with provider", "file_id": "dr_JC0228", "chunk_id": 22 }, { "code": "Lack of provider empathy", "category": "BARRIER - Provider/System Issues", "subcategory": "Rude or dismissive providers", "quote": "they weren't really going to gimme any answers", "context": "Patient felt dismissed by previous healthcare providers", "file_id": "dr_JC0228", "chunk_id": 23 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "they weren't really going to gimme any answers", "context": "Patient experienced poor communication with previous healthcare providers", "file_id": "dr_JC0228", "chunk_id": 23 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I feel I need to ask questions", "context": "Patient takes initiative to ask questions and understand their condition", "file_id": "dr_JC0228", "chunk_id": 23 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "I have felt that way before, so-", "context": "Patient experiences effective communication with current healthcare provider", "file_id": "dr_JC0228", "chunk_id": 23 }, { "code": "Patient advocacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "Do you ever tell them what you feel is good for you, advocating for yourself? Speaker 2: Absolutely. Yeah", "context": "Patient advocates for themselves and expresses their needs to healthcare providers", "file_id": "dr_JC0228", "chunk_id": 23 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I try to tell them the things that, , as far as , what, what things that I'm trying to do", "context": "Patient takes initiative to inform themselves", "file_id": "dr_JC0228", "chunk_id": 24 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "I try to ask, , as far as , , or if I, I feel I need something, if I need to ask a doctor", "context": "Patient feels comfortable asking questions", "file_id": "dr_JC0228", "chunk_id": 24 }, { "code": "Self-advocacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I would definitely advocate for myself to be , 'Can we move this along or could we do that?'", "context": "Patient speaks up for their needs", "file_id": "dr_JC0228", "chunk_id": 24 }, { "code": "Understanding of DR severity", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "Very, , yeah. Very s- very, very serious", "context": "Patient recognizes the seriousness of diabetes-related vision loss", "file_id": "dr_JC0228", "chunk_id": 24 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I would definitely advocate for myself", "context": "Patient takes initiative to manage care", "file_id": "dr_JC0228", "chunk_id": 25 }, { "code": "Provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "be honest. be forward.", "context": "Patient values open communication with provider", "file_id": "dr_JC0228", "chunk_id": 25 }, { "code": "Understanding of DR progression", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Very, , yeah. Very s- very, very serious.", "context": "Patient acknowledges seriousness of diabetes-related vision loss", "file_id": "dr_JC0228", "chunk_id": 25 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "be kind", "context": "Patient values a kind and honest provider", "file_id": "dr_JC0228", "chunk_id": 26 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "shoot me straight", "context": "Patient wants clear and direct communication from provider", "file_id": "dr_JC0228", "chunk_id": 26 }, { "code": "Bedside manner", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "just have a bedside manner", "context": "Patient values a good bedside manner in their provider", "file_id": "dr_JC0228", "chunk_id": 26 }, { "code": "Lack of understanding about DR progression", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I think not very likely", "context": "Patient underestimates risk of losing eyesight due to diabetes", "file_id": "dr_JC0228", "chunk_id": 26 }, { "code": "Honest provider communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "be honest", "context": "Patient values honesty in provider communication", "file_id": "dr_JC0228", "chunk_id": 26 }, { "code": "Lack of perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "I think not very likely", "context": "Patient does not believe they are at risk for vision loss", "file_id": "dr_JC0228", "chunk_id": 27 }, { "code": "Positive outlook", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I'm taking steps to not make that happen", "context": "Patient is proactive about their health", "file_id": "dr_JC0228", "chunk_id": 27 }, { "code": "Good health literacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I'm taking steps to not make that happen", "context": "Patient understands importance of self-care", "file_id": "dr_JC0228", "chunk_id": 27 }, { "code": "Lack of provider referral", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "I wish the other doctors would've told me to go to the eye doctor", "context": "Patient feels providers failed to recommend necessary care", "file_id": "dr_JC0228", "chunk_id": 28 }, { "code": "Delayed diagnosis awareness", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "The things that I wish I would've caught just a little bit sooner", "context": "Patient regrets not seeking care earlier", "file_id": "dr_JC0228", "chunk_id": 28 }, { "code": "Provider communication gap", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "I wish they would've pushed a little harder on if I would've known it was at the level it was", "context": "Patient feels providers did not adequately communicate urgency", "file_id": "dr_JC0228", "chunk_id": 28 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "if I would've known it was at the level it was", "context": "Patient expresses regret over not pushing harder for diagnosis due to lack of knowledge", "file_id": "dr_JC0228", "chunk_id": 29 }, { "code": "Family history awareness", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "My grandmother had glaucoma and I believe my mom does actually", "context": "Patient is aware of family history, potentially empowering them to take action", "file_id": "dr_JC0228", "chunk_id": 29 }, { "code": "Denial", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "There was a time where I'd more, be in more denial", "context": "Patient experiences denial about their condition", "file_id": "dr_JC0228", "chunk_id": 30 }, { "code": "Worry", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "be a little bit more, more worried", "context": "Patient feels worried about their condition", "file_id": "dr_JC0228", "chunk_id": 30 }, { "code": "Denial", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Patient beliefs", "quote": "There was a time where I'd more, be in more denial", "context": "Patient initially denied their condition", "file_id": "dr_JC0228", "chunk_id": 31 }, { "code": "Worry", "category": "BARRIER - Emotional/Psychological", "subcategory": "Emotional distress", "quote": "be a little bit more, more worried", "context": "Patient experiences worry about their condition", "file_id": "dr_JC0228", "chunk_id": 31 }, { "code": "Prevention motivation", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education", "quote": "prevention", "context": "Patient is motivated by prevention", "file_id": "dr_JC0228", "chunk_id": 31 }, { "code": "Longevity motivation", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "it definitely benefits on their longevity", "context": "Patient believes regular healthcare services improve longevity", "file_id": "dr_JC0228", "chunk_id": 31 }, { "code": "Prevention motivation", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "prevention. motivation to, , I, , people that go to the doctors, people that get check-ups.", "context": "Patient is motivated by prevention and health benefits", "file_id": "dr_JC0228", "chunk_id": 32 }, { "code": "Desire for longevity", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "wanting to live longer and have a health, , a happy, healthy life.", "context": "Patient values long-term health outcomes", "file_id": "dr_JC0228", "chunk_id": 32 }, { "code": "Cost concerns", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Expensive treatments/surgery", "quote": "cost can be. cost can be a factor.", "context": "Patient is discouraged by high costs", "file_id": "dr_JC0228", "chunk_id": 32 }, { "code": "Frustration with timing", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "frustration, , timing.", "context": "Patient experiences frustration with appointment scheduling", "file_id": "dr_JC0228", "chunk_id": 32 }, { "code": "Emotional state", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "personal mood.", "context": "Patient's emotional state affects healthcare utilization", "file_id": "dr_JC0228", "chunk_id": 32 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "he became comforting to me and made me, guided me in a good way", "context": "Patient had a positive experience with their doctor", "file_id": "dr_JC0228", "chunk_id": 33 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "someone that told me, 'Look, , we're not looking to find anything, , we're just, we're here to help you and get you to that next level'", "context": "Patient felt supported by their doctor's empathetic approach", "file_id": "dr_JC0228", "chunk_id": 33 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "he became comforting to me and made me, guided me in a good way", "context": "Patient appreciated their doctor's clear and reassuring communication", "file_id": "dr_JC0228", "chunk_id": 33 }, { "code": "Positive staff personality", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "just personality of staff and people", "context": "Patient appreciates friendly healthcare staff", "file_id": "dr_JC0228", "chunk_id": 34 }, { "code": "Good attitude of staff", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "the girls that work here... and a good attitude", "context": "Patient values positive attitude of healthcare staff", "file_id": "dr_JC0228", "chunk_id": 34 }, { "code": "Rude or dismissive providers", "category": "BARRIER - Provider/System Issues", "subcategory": "Rude or dismissive providers", "quote": "exactly the opposite of what I said", "context": "Patient implies negative experience with provider", "file_id": "dr_JC0228", "chunk_id": 34 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "when you're just a, a patient", "context": "Patient feels like just a number, not valued", "file_id": "dr_JC0228", "chunk_id": 34 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "someone that told me, Look, we're not looking to find anything, we're just, we're here to help you", "context": "Patient appreciates empathetic provider", "file_id": "dr_JC0228", "chunk_id": 34 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "when you're not getting treated that. You are, you're not any different than anyone else", "context": "Patient feels like just another patient, not unique", "file_id": "dr_JC0228", "chunk_id": 35 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "'We give this to everyone, we're giving it to you too.'", "context": "Patient feels like provider is not communicating effectively", "file_id": "dr_JC0228", "chunk_id": 35 }, { "code": "Social support networks", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Patient Empowerment", "quote": "my wife to truth for, yeah. I would say my wife who's a nurse.", "context": "Patient has supportive spouse who is a nurse", "file_id": "dr_JC0228", "chunk_id": 35 }, { "code": "Family support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Patient Empowerment", "quote": "We try to help each other", "context": "Patient and daughter support each other with diabetes management", "file_id": "dr_JC0228", "chunk_id": 35 }, { "code": "Social Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "We try to help each other", "context": "Patient has a supportive family member", "file_id": "dr_JC0228", "chunk_id": 36 }, { "code": "Family Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "She's a good, she's a very good support system", "context": "Patient has a supportive family member", "file_id": "dr_JC0228", "chunk_id": 36 }, { "code": "Health Education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "We talk about it", "context": "Patient discusses health with supportive family member", "file_id": "dr_JC0228", "chunk_id": 36 }, { "code": "Social Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "We, we help each other", "context": "Patient has a supportive relationship with someone", "file_id": "dr_JC0228", "chunk_id": 37 }, { "code": "Health Education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I have a little bit, but at- ... the time I really didn't", "context": "Patient participated in diabetes education class", "file_id": "dr_JC0228", "chunk_id": 37 }, { "code": "Emotional Readiness", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "I wasn't really mentally ready for what I was experiencing at that time", "context": "Patient was not emotionally prepared for diabetes education", "file_id": "dr_JC0228", "chunk_id": 37 }, { "code": "Emotional barriers", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "I wasn't really mentally ready for what I was experiencing at that time", "context": "Patient expresses emotional unpreparedness", "file_id": "dr_JC0228", "chunk_id": 38 }, { "code": "Social Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "I do have someone to help me with my chores, my food, things that", "context": "Patient has support system for daily tasks", "file_id": "dr_JC0228", "chunk_id": 39 }, { "code": "Lack of Understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "they just don't understand when it comes to certain things", "context": "Support system lacks full understanding of patient's condition", "file_id": "dr_JC0228", "chunk_id": 39 }, { "code": "Emotional Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "do you have people who you can share your worries or fears about your diabetes and your eyesight?", "context": "Patient has people to share concerns with", "file_id": "dr_JC0228", "chunk_id": 39 }, { "code": "Limited Support", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I think they do to a point, but I don't think they do fully", "context": "Support system has limited understanding of patient's needs", "file_id": "dr_JC0228", "chunk_id": 39 }, { "code": "Emotional distress", "category": "BARRIER - Emotional/Psychological", "subcategory": "Depression/anxiety", "quote": "the emotional beat up it takes sometimes on you, the wear and tear of the frustration", "context": "Patient experiences emotional burden due to diabetes management", "file_id": "dr_JC0228", "chunk_id": 40 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "they just don't understand when it comes to certain things", "context": "Patient feels others do not comprehend the challenges of living with diabetes", "file_id": "dr_JC0228", "chunk_id": 40 }, { "code": "Social support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "And that would again, be my wife when it comes-", "context": "Patient has a supportive spouse to help with daily tasks", "file_id": "dr_JC0228", "chunk_id": 40 }, { "code": "Feeling overwhelmed", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "the sacrifices sometimes you make-", "context": "Patient feels overwhelmed by the demands of diabetes management", "file_id": "dr_JC0228", "chunk_id": 40 }, { "code": "Lack of empathy", "category": "BARRIER - Provider/System Issues", "subcategory": "Rude or dismissive providers", "quote": "I just feel just a lot of people are selfish with their feelings", "context": "Patient perceives lack of empathy from others, possibly including healthcare providers", "file_id": "dr_JC0228", "chunk_id": 41 }, { "code": "Self research", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I do a lot of my own research", "context": "Patient takes initiative to educate themselves about their health", "file_id": "dr_JC0228", "chunk_id": 41 }, { "code": "Access to resources", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate access to information", "quote": "I even use ChatGPT certain things, so", "context": "Patient has access to online resources for health information", "file_id": "dr_JC0228", "chunk_id": 41 }, { "code": "Access to healthcare", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "If wh- if, if I need that- ... thing. Yeah.", "context": "Patient implies uncertainty about accessing healthcare", "file_id": "dr_JC0228", "chunk_id": 42 }, { "code": "Healthcare System Support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "If wh- if, if I need that- ... thing. Yeah.", "context": "Patient mentions ability to access healthcare professionals", "file_id": "dr_JC0228", "chunk_id": 42 }, { "code": "Provider Relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I wouldn't do it for more sympathy, but yeah.", "context": "Patient implies a positive relationship with their provider", "file_id": "dr_JC0228", "chunk_id": 42 }, { "code": "Lack of urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "I try not to let it, to be honest with you", "context": "Patient downplays impact of eyesight on daily life", "file_id": "dr_JC0228", "chunk_id": 43 }, { "code": "Safety concerns", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I don't wanna get anybody hurt", "context": "Patient takes responsibility for safety due to eyesight limitations", "file_id": "dr_JC0228", "chunk_id": 43 }, { "code": "Visual difficulties", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "certain times when I can't see certain things really well", "context": "Patient experiences visual difficulties in daily life", "file_id": "dr_JC0228", "chunk_id": 43 }, { "code": "Adaptation strategies", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I've been trying to change some things with my life", "context": "Patient adapts to eyesight limitations by making lifestyle changes", "file_id": "dr_JC0228", "chunk_id": 43 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I felt I got full, the best. I don't think I could have walked out here with a better treatment than I got today, to be honest.", "context": "Patient expresses satisfaction with care received", "file_id": "dr_JC0228", "chunk_id": 44 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "I wanted to, I wanted to get an answer today, so-", "context": "Patient indicates desire for clear information from provider", "file_id": "dr_JC0228", "chunk_id": 44 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "I felt I got full, the best. I don't think I could have walked out here with a better treatment than I got today, to be honest.", "context": "Patient feels understood and supported by provider", "file_id": "dr_JC0228", "chunk_id": 44 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I had, I honestly, I just wanted to get, know what was wrong.", "context": "Patient able to access provider for care", "file_id": "dr_JC0228", "chunk_id": 44 }, { "code": "Mental health aspect", "category": "BARRIER - Emotional/Psychological", "subcategory": "Depression/anxiety", "quote": "it's a lot more of a mental game than it is a physical game", "context": "Patient emphasizes the mental challenge of managing diabetes", "file_id": "dr_JC0228", "chunk_id": 45 }, { "code": "Social support importance", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "support is extremely important if you can get it and have people to communicate with", "context": "Patient highlights the value of social support in managing diabetes", "file_id": "dr_JC0228", "chunk_id": 45 }, { "code": "Mental game", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "I just think a lot of it is, , it, personally, I think it's a lot more of a mental game than it is a physical game.", "context": "Patient views diabetes management as mentally challenging", "file_id": "dr_JC0228", "chunk_id": 46 }, { "code": "Lack of support", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Cultural beliefs about healthcare", "quote": "I do think support is extremely important if you can get it and have people to communicate with.", "context": "Patient emphasizes importance of social support", "file_id": "dr_JC0228", "chunk_id": 46 }, { "code": "Denial", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I think a lot of people, the biggest problem is denial-", "context": "Patient believes denial is a major obstacle to diabetes management", "file_id": "dr_JC0228", "chunk_id": 46 }, { "code": "Social support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "I do think support is extremely important if you can get it and have people to communicate with.", "context": "Patient values social support for diabetes management", "file_id": "dr_JC0228", "chunk_id": 46 }, { "code": "Lack of self monitoring", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I'm bad at doing that", "context": "Patient admits to not regularly checking blood sugar", "file_id": "dr_MD0610(part1)", "chunk_id": 0 }, { "code": "Effective treatment regimen", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Ozempic really helped with that", "context": "Patient attributes improved A1C to medication", "file_id": "dr_MD0610(part1)", "chunk_id": 0 }, { "code": "Positive health outcomes", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "It brought it down. My A1C was really bad", "context": "Patient experiences improvement in A1C levels", "file_id": "dr_MD0610(part1)", "chunk_id": 0 }, { "code": "Provider support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I do check my A1C all the time with my doctor", "context": "Patient works closely with doctor to monitor A1C", "file_id": "dr_MD0610(part1)", "chunk_id": 0 }, { "code": "Health awareness", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I watch what I eat", "context": "Patient takes initiative to manage diet", "file_id": "dr_MD0610(part1)", "chunk_id": 0 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Just keep my A1C down so it don't cause me more problems", "context": "Patient lacks understanding of diabetes complications", "file_id": "dr_MD0610(part1)", "chunk_id": 1 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Well, you're supposed to keep a check on your, your blood sugar readings", "context": "Patient receives health education from doctor", "file_id": "dr_MD0610(part1)", "chunk_id": 1 }, { "code": "Self management", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I watch what I eat. I cut out a lot of carbs and stuff, so", "context": "Patient practices self-management techniques", "file_id": "dr_MD0610(part1)", "chunk_id": 1 }, { "code": "Health literacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I can tell if I get thirsty a lot or tired and stuff. I can tell if it's starting to go up a little bit", "context": "Patient demonstrates health literacy skills", "file_id": "dr_MD0610(part1)", "chunk_id": 1 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I drink a lot or you feel really tired all the time and stuff", "context": "Patient lacks clear understanding of diabetes symptoms", "file_id": "dr_MD0610(part1)", "chunk_id": 2 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I've got a place that's detaching again", "context": "Patient expresses concern about vision deterioration", "file_id": "dr_MD0610(part1)", "chunk_id": 2 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "What do you watch out for that tell you your diabetes may be getting worse", "context": "Patient seeks knowledge about diabetes management", "file_id": "dr_MD0610(part1)", "chunk_id": 2 }, { "code": "Diabetes distress", "category": "BARRIER - Emotional/Psychological", "subcategory": "Diabetes distress", "quote": "I've had it repaired, but I've got a place that's detaching again", "context": "Patient expresses emotional concern about vision problems", "file_id": "dr_MD0610(part1)", "chunk_id": 2 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Not really", "context": "Patient lacks knowledge about diabetes effects on eyes", "file_id": "dr_MD0610(part1)", "chunk_id": 3 }, { "code": "Education barriers", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "Not really", "context": "Patient receives limited information from doctor", "file_id": "dr_MD0610(part1)", "chunk_id": 3 }, { "code": "Provider communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Well, that's when my retina was detached, and that's when I figured it out", "context": "Doctor informs patient about condition", "file_id": "dr_MD0610(part1)", "chunk_id": 3 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "you get the fluid and stuff, and then the blood vessels burst, and then it causes scar tissue that pulls on your retina", "context": "Patient receives information about diabetes effects", "file_id": "dr_MD0610(part1)", "chunk_id": 3 }, { "code": "Insurance coverage issues", "category": "BARRIER - SDOH", "subcategory": "Insurance coverage issues", "quote": "Our insurance changed, so I had to go to Parkersburg, but now they changed it again", "context": "Patient's insurance changes affect their ability to see their preferred doctor", "file_id": "dr_MD0610(part1)", "chunk_id": 4 }, { "code": "Access barriers", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "I had to go to Parkersburg, but now they changed it again. So I think I'm going to be able to go back to Ravenswood", "context": "Patient faces challenges accessing care due to insurance and location changes", "file_id": "dr_MD0610(part1)", "chunk_id": 4 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "she just keeps an eye on it", "context": "Patient lacks clear understanding of diabetes management", "file_id": "dr_DT0331", "chunk_id": 0 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "to watch what she's eating", "context": "Doctor provides health education on diet", "file_id": "dr_DT0331", "chunk_id": 0 }, { "code": "Self management", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "she tries to walk", "context": "Patient engages in physical activity for diabetes management", "file_id": "dr_DT0331", "chunk_id": 0 }, { "code": "Health monitoring", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "checking sugar", "context": "Patient monitors blood sugar levels", "file_id": "dr_DT0331", "chunk_id": 0 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "bad", "context": "Patient lacks clear understanding of diabetes effects on eyes", "file_id": "dr_DT0331", "chunk_id": 1 }, { "code": "Fear of treatment", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "needles in the eye", "context": "Patient expresses fear or discomfort with treatment methods", "file_id": "dr_DT0331", "chunk_id": 1 }, { "code": "Provider support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "they had to give her needles in the eye", "context": "Patient receives medical treatment and care from providers", "file_id": "dr_DT0331", "chunk_id": 1 }, { "code": "Follow-up appointments", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "she got to come back in two weeks and have laser again", "context": "Patient has scheduled follow-up appointments for ongoing care", "file_id": "dr_DT0331", "chunk_id": 1 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "they just said that if she doesn't go through the process-- she can go blind", "context": "Patient lacks detailed information about diabetes effects on eyesight", "file_id": "dr_DT0331", "chunk_id": 2 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "they just said to-- she has to watch what she's eating and exercise", "context": "Provider's advice seems vague and lacks specific guidance", "file_id": "dr_DT0331", "chunk_id": 2 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "she can go blind if she didn't, -- take care of it", "context": "Patient is aware of potential severe consequences but lacks detailed understanding", "file_id": "dr_DT0331", "chunk_id": 2 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "they just said to-- she has to watch what she's eating and exercise", "context": "Provider shows concern for patient's well-being but communication is limited", "file_id": "dr_DT0331", "chunk_id": 2 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "they just said to-- she has to watch what she's eating and exercise", "context": "Patient receives basic health advice but may need more comprehensive education", "file_id": "dr_DT0331", "chunk_id": 2 }, { "code": "Lack of education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "they just said that if she doesn't go through the process-- that she can go blind", "context": "Patient lacks understanding of diabetes effects on eyesight", "file_id": "dr_DT0331", "chunk_id": 3 }, { "code": "Provider passed away", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of continuity of care", "quote": "he passed away", "context": "Patient's provider is no longer available", "file_id": "dr_DT0331", "chunk_id": 3 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "he just-- he tells her to watch what she's eating", "context": "Provider's advice is unclear or incomplete", "file_id": "dr_DT0331", "chunk_id": 3 }, { "code": "Accessible provider", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "she's been seeing Dr. C in Elkins", "context": "Patient has found a new provider", "file_id": "dr_DT0331", "chunk_id": 3 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "Dr. C, he's a good doctor", "context": "Patient expresses trust in their doctor", "file_id": "dr_DT0331", "chunk_id": 4 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Dr. C, he's a good doctor", "context": "Patient has access to a trusted provider", "file_id": "dr_DT0331", "chunk_id": 4 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "But she does it more than that because she's diabetic", "context": "Patient lacks clear understanding of diabetes and eye exam frequency", "file_id": "dr_DT0331", "chunk_id": 5 }, { "code": "Discomfort during procedure", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "it was, , stinging a little bit when they did the drops", "context": "Patient experienced discomfort during eye exam", "file_id": "dr_DT0331", "chunk_id": 5 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Oh, yes, yes. They, , sting", "context": "Provider acknowledges and explains patient's discomfort", "file_id": "dr_DT0331", "chunk_id": 5 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "When was your last dilated eye exam? S2: 03:28 Today", "context": "Patient has access to regular eye exams", "file_id": "dr_DT0331", "chunk_id": 5 }, { "code": "Lack of provider guidance", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "They just said just keep coming back until they can get her better", "context": "Patient feels lack of clear instructions from doctor", "file_id": "dr_DT0331", "chunk_id": 6 }, { "code": "Scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "It's hard on me because I got to juggle between me and her", "context": "Patient struggles with finding matching availability", "file_id": "dr_DT0331", "chunk_id": 6 }, { "code": "Need for more availability", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "Yes. More, more availability?", "context": "Patient suggests more doctor availability would be helpful", "file_id": "dr_DT0331", "chunk_id": 6 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "it's just the drive. We have a four-hour drive up and back.", "context": "Patient faces long distance to travel for eye care", "file_id": "dr_DT0331", "chunk_id": 7 }, { "code": "Telehealth options", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "1. Healthcare System Support", "quote": "Yes. virtual?", "context": "Patient expresses interest in telehealth for convenience", "file_id": "dr_DT0331", "chunk_id": 7 }, { "code": "Telehealth options", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Telehealth options", "quote": "Yes. virtual?", "context": "Patient finds telehealth beneficial", "file_id": "dr_DT0331", "chunk_id": 8 }, { "code": "Distance barriers", "category": "BARRIER - SDOH", "subcategory": "Transportation issues", "quote": "It's just the dis-distance right now", "context": "Patient cites distance as a challenge", "file_id": "dr_DT0331", "chunk_id": 8 }, { "code": "Accessibility", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate access to care", "quote": "If it wasn't too far, I would think about maybe coming", "context": "Patient prefers closer location for follow-up", "file_id": "dr_DT0331", "chunk_id": 8 }, { "code": "Convenience", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "maybe she can follow up in Buchanan because that's only 45 minutes from--", "context": "Patient prefers more convenient location", "file_id": "dr_DT0331", "chunk_id": 8 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "They just said if she didn't follow up and take care of it, then she could lose her eyesight", "context": "Patient lacks detailed information about diabetes-related vision loss", "file_id": "dr_DT0331", "chunk_id": 9 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "They just said if she didn't follow up and take care of it, then she could lose her eyesight", "context": "Patient may fear losing eyesight due to diabetes", "file_id": "dr_DT0331", "chunk_id": 9 }, { "code": "Provider warning", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "They just said if she didn't follow up and take care of it, then she could lose her eyesight", "context": "Eye doctor or diabetes doctor warned patient about risk of vision loss", "file_id": "dr_DT0331", "chunk_id": 9 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "They just said if she didn't follow up and take care of it, then she could lose her eyesight.", "context": "Patient lacks detailed information about diabetes-related vision loss", "file_id": "dr_DT0331", "chunk_id": 10 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "They just said if she didn't follow up and take care of it, then she could lose her eyesight.", "context": "Patient received limited information from doctor", "file_id": "dr_DT0331", "chunk_id": 10 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "Oh, yeah", "context": "Patient feels comfortable talking to their doctor", "file_id": "dr_DT0331", "chunk_id": 10 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Yeah, mm-hmm.", "context": "Patient is able to express concerns to their doctor", "file_id": "dr_DT0331", "chunk_id": 10 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "Oh, yeah", "context": "Patient feels comfortable talking to doctor", "file_id": "dr_DT0331", "chunk_id": 11 }, { "code": "Lack of patient advocacy", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "We'll just go by what the doctor says", "context": "Patient does not express own needs or concerns", "file_id": "dr_DT0331", "chunk_id": 11 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Oh, yeah", "context": "Patient feels comfortable discussing concerns with doctor", "file_id": "dr_DT0331", "chunk_id": 11 }, { "code": "Patient concern expression", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "she just wonders-- she keeps asking if she's going to get better with her vision", "context": "Patient expresses concerns and asks questions", "file_id": "dr_DT0331", "chunk_id": 11 }, { "code": "Lack of self-advocacy", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "No. We'll just go by what the doctor says", "context": "Patient does not advocate for own needs", "file_id": "dr_DT0331", "chunk_id": 11 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "we just want to get her better to where she won't lose her eyesight", "context": "Patient's concern about vision loss", "file_id": "dr_DT0331", "chunk_id": 12 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "we just want to get her better to where she won't lose her eyesight", "context": "Patient's concern about vision loss", "file_id": "dr_DT0331", "chunk_id": 12 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "Yeah, they water a lot", "context": "Patient feels heard by provider", "file_id": "dr_DT0331", "chunk_id": 12 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Yeah, she's told them", "context": "Patient communicates with provider", "file_id": "dr_DT0331", "chunk_id": 12 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Because we can tell, , medically how she's progressed--", "context": "Patient has knowledge about diabetes progression", "file_id": "dr_DT0331", "chunk_id": 12 }, { "code": "Perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "How serious do you think diabetes can cause vision loss for you?", "context": "Patient's understanding of disease severity", "file_id": "dr_DT0331", "chunk_id": 12 }, { "code": "Diabetes distress", "category": "BARRIER - Emotional/Psychological", "subcategory": "Diabetes distress", "quote": "Oh, likely to lose it?", "context": "Patient's emotional response to potential vision loss", "file_id": "dr_DT0331", "chunk_id": 12 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "We're hoping it don't happen", "context": "Patient expresses concern about potential vision loss", "file_id": "dr_DT0331", "chunk_id": 13 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "We're hoping it don't happen", "context": "Patient lacks clear understanding of diabetes impact on vision", "file_id": "dr_DT0331", "chunk_id": 13 }, { "code": "Concern about health", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "That's why we're here", "context": "Patient is proactive about seeking care due to health concerns", "file_id": "dr_DT0331", "chunk_id": 13 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "That's why we're here", "context": "Patient seeks care, implying a positive relationship with provider", "file_id": "dr_DT0331", "chunk_id": 13 }, { "code": "Healthcare system support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "That's why we're here", "context": "Patient has access to healthcare, facilitating follow-up appointments", "file_id": "dr_DT0331", "chunk_id": 13 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "It don't bug me too bad", "context": "Patient seems to downplay the severity of their condition", "file_id": "dr_DT0331", "chunk_id": 14 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "When it gets to the cobwebs", "context": "Patient expresses concern about worsening vision", "file_id": "dr_DT0331", "chunk_id": 14 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "just a little bit", "context": "Patient seems unclear about their condition", "file_id": "dr_DT0331", "chunk_id": 15 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "They didn't say", "context": "Patient reports lack of information from providers", "file_id": "dr_DT0331", "chunk_id": 15 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "they did tell me", "context": "Patient reports receiving information from providers", "file_id": "dr_DT0331", "chunk_id": 15 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "It's the distance", "context": "Patient mentions distance as a challenge for follow-ups", "file_id": "dr_DT0331", "chunk_id": 17 }, { "code": "Time-consuming", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "3. Provider/System Issues", "quote": "it's just time-consuming", "context": "Patient finds the process of getting follow-ups time-consuming", "file_id": "dr_DT0331", "chunk_id": 17 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "It's the distance, and it's just time-consuming.", "context": "Patient finds traveling for follow-ups to be time-consuming due to distance", "file_id": "dr_DT0331", "chunk_id": 18 }, { "code": "Time-consuming appointments", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "3. Provider/System Issues", "quote": "It's just been a trip and a half.", "context": "Patient describes follow-up experience as overly burdensome", "file_id": "dr_DT0331", "chunk_id": 18 }, { "code": "Distance barriers", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "we don't have to travel four hours out of the day to get this done.", "context": "Patient highlights the significant distance traveled for follow-ups", "file_id": "dr_DT0331", "chunk_id": 18 }, { "code": "Accessible technology", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "1. Healthcare System Support", "quote": "Yes. MyChart?", "context": "Patient finds MyChart to be a helpful resource for managing healthcare", "file_id": "dr_DT0331", "chunk_id": 18 }, { "code": "Lack of resources", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "4. Cost-Related Barriers", "quote": "no, we do it on our own.", "context": "Patient lacks external support or resources for managing follow-ups", "file_id": "dr_DT0331", "chunk_id": 18 }, { "code": "Distance discouragement", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "It's just the distance.", "context": "Patient cites distance as a primary discouragement for using healthcare services", "file_id": "dr_DT0331", "chunk_id": 18 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "It's just the distance.", "context": "Patient mentions distance as a discouraging factor for using healthcare services", "file_id": "dr_DT0331", "chunk_id": 19 }, { "code": "Accessible providers", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "1. Healthcare System Support", "quote": "they've been w-working with her really well, so.", "context": "Patient mentions positive experience with healthcare providers", "file_id": "dr_DT0331", "chunk_id": 19 }, { "code": "Lack of education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "No, not that I know of", "context": "Patient lacks knowledge about diabetes and eye care", "file_id": "dr_DT0331", "chunk_id": 20 }, { "code": "No health education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "Never", "context": "Patient has not participated in diabetes education classes", "file_id": "dr_DT0331", "chunk_id": 20 }, { "code": "Limited social support", "category": "BARRIER - Social Determinants of Health", "subcategory": "Social support networks", "quote": "No, other than me and her", "context": "Patient has limited social support for diabetes and eye care", "file_id": "dr_DT0331", "chunk_id": 20 }, { "code": "Peer support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "Yeah, she has a friend--that she talks to, and he's got diabetes too", "context": "Patient has peer support for diabetes management", "file_id": "dr_DT0331", "chunk_id": 20 }, { "code": "Family support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "we just keep an eye on her sugar", "context": "Patient has family support for daily diabetes care", "file_id": "dr_DT0331", "chunk_id": 20 }, { "code": "Social Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "Yeah, she has a friend--that she talks to, and he's got diabetes too.", "context": "Patient has a supportive friend with similar condition", "file_id": "dr_DT0331", "chunk_id": 21 }, { "code": "Emotional Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "Yeah, her sister helps with chores and medications", "context": "Patient has a supportive sibling for daily tasks", "file_id": "dr_DT0331", "chunk_id": 21 }, { "code": "Health Advice", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Just me, her sister", "context": "Patient seeks health advice from a trusted family member", "file_id": "dr_DT0331", "chunk_id": 21 }, { "code": "Social Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "Just me, her sister", "context": "Patient relies on sibling for health advice", "file_id": "dr_DT0331", "chunk_id": 22 }, { "code": "Vision Limitations", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "My eyes are", "context": "Patient experiences vision problems", "file_id": "dr_DT0331", "chunk_id": 22 }, { "code": "Activity Limitation", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "She don't do a whole lot other than work puzzles", "context": "Patient's daily activities are limited due to vision", "file_id": "dr_DT0331", "chunk_id": 22 }, { "code": "Vision Impact", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "She has to take breaks and sit down and rest her eyes", "context": "Patient's vision affects daily tasks", "file_id": "dr_DT0331", "chunk_id": 22 }, { "code": "Vision limitations", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "because of her vision", "context": "Patient's vision limits daily activities", "file_id": "dr_DT0331", "chunk_id": 23 }, { "code": "Headaches", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "it causes her to have headaches", "context": "Patient experiences headaches due to vision issues", "file_id": "dr_DT0331", "chunk_id": 23 }, { "code": "Positive expectations", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "it was-- it was good", "context": "Patient has positive expectations for eye care visit", "file_id": "dr_DT0331", "chunk_id": 23 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "they told me I couldn't put, , a damp rag on me", "context": "Patient receives guidance from provider", "file_id": "dr_DT0331", "chunk_id": 23 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "we're trying to get her, one of those machines", "context": "Patient lacks access to necessary medical equipment", "file_id": "dr_DT0331", "chunk_id": 24 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "we're working on it", "context": "Patient is working to obtain necessary medical equipment, implying financial difficulties", "file_id": "dr_DT0331", "chunk_id": 24 }, { "code": "Healthcare System Support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "They're going to give", "context": "Patient is receiving support from healthcare providers to obtain necessary medical equipment", "file_id": "dr_DT0331", "chunk_id": 24 }, { "code": "Resources & Access", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate resources", "quote": "They're going to give a machine", "context": "Patient is receiving necessary resources and support from healthcare providers", "file_id": "dr_DT0331", "chunk_id": 24 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "I had damage done to my right, , side of my face. I hit a telephone pole.", "context": "Patient experienced delayed diagnosis due to lack of access", "file_id": "dr_HD1103(part2)", "chunk_id": 0 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "And so, , I had a s-- a spot on my retina--", "context": "Patient shows concern about their condition", "file_id": "dr_HD1103(part2)", "chunk_id": 0 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "he said, , we're, we're going to do a vitrectomy. , , there's a tear or a pucker in the retina.", "context": "Patient received unclear explanation of treatment", "file_id": "dr_HD1103(part2)", "chunk_id": 0 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I went to this one doctor--", "context": "Patient had access to a healthcare provider", "file_id": "dr_HD1103(part2)", "chunk_id": 0 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "but all those years without any issue", "context": "Patient seems unaware of potential long-term effects", "file_id": "dr_HD1103(part2)", "chunk_id": 1 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "he said, 'Hey.' He said, 'Your vision's fine.'", "context": "Provider's communication style may be unclear", "file_id": "dr_HD1103(part2)", "chunk_id": 1 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "And whenever, , I went to this one doctor--", "context": "Patient has access to a specific doctor", "file_id": "dr_HD1103(part2)", "chunk_id": 1 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "he said, 'Hey.' He said, 'Your vision's fine.'", "context": "Provider communicates clearly with patient", "file_id": "dr_HD1103(part2)", "chunk_id": 1 }, { "code": "Lack of trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "they tapped dance around the truth", "context": "Patient feels providers were not honest", "file_id": "dr_HD1103(part2)", "chunk_id": 2 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "What you told me in the office and what you did in the long term was two totally different things", "context": "Patient feels provider did not communicate effectively", "file_id": "dr_HD1103(part2)", "chunk_id": 2 }, { "code": "Rude or dismissive providers", "category": "BARRIER - Provider/System Issues", "subcategory": "Rude or dismissive providers", "quote": "they tapped dance around the truth", "context": "Patient feels providers were evasive and unhelpful", "file_id": "dr_HD1103(part2)", "chunk_id": 2 }, { "code": "Lack of understanding about DR progression", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Your vision's fine. But I just want to touch up a couple places", "context": "Patient may not fully understand their condition", "file_id": "dr_HD1103(part2)", "chunk_id": 2 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I also went to another-- I went to two other eye specialists, retinal specialists", "context": "Patient has access to multiple providers", "file_id": "dr_HD1103(part2)", "chunk_id": 2 }, { "code": "Rude providers", "category": "BARRIER - Provider/System Issues", "subcategory": "Rude or dismissive providers", "quote": "they tapped dance around the truth", "context": "Patient feels provider was dishonest", "file_id": "dr_HD1103(part2)", "chunk_id": 3 }, { "code": "Lack of trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "what he did and what he ended up doing was two totally different things", "context": "Patient distrusts provider due to inconsistent information", "file_id": "dr_HD1103(part2)", "chunk_id": 3 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "they tapped dance around the truth", "context": "Patient feels provider did not communicate clearly", "file_id": "dr_HD1103(part2)", "chunk_id": 3 }, { "code": "Lack of perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "Well, vision in my left eye is fine,", "context": "Patient feels no need for follow-up due to current good vision", "file_id": "dr_HD1103(part2)", "chunk_id": 4 }, { "code": "Age related concerns", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "So, , naturally, I'm up in the years. I, I want to be 60. I'm an old man.", "context": "Patient's age and perceived life stage may influence follow-up adherence", "file_id": "dr_HD1103(part2)", "chunk_id": 4 }, { "code": "Lack of diagnosis understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "They just keep checking on the pressure in my eye--", "context": "Patient unsure about glaucoma diagnosis", "file_id": "dr_HD1103(part2)", "chunk_id": 5 }, { "code": "Previous positive experience", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I had cataract surgery already, so", "context": "Patient had successful surgery in the past", "file_id": "dr_HD1103(part2)", "chunk_id": 5 }, { "code": "Regular check-ups", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "whenever I see a glaucoma doctor, but they never told me I had glaucoma", "context": "Patient attends regular appointments", "file_id": "dr_HD1103(part2)", "chunk_id": 5 }, { "code": "Positive outlook", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I try to live as full a life as I possibly can", "context": "Patient has positive attitude towards life", "file_id": "dr_HD1103(part2)", "chunk_id": 5 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "but I was never diagnosed with glaucoma, so", "context": "Patient unsure about their condition", "file_id": "dr_HD1103(part2)", "chunk_id": 6 }, { "code": "Family health unknown", "category": "BARRIER - Social Determinants of Health", "subcategory": "Education/health literacy barriers", "quote": "We're a functional, dysfunctional family. So, , , , I couldn't tell you what, what my siblings have or what they don't have", "context": "Patient lacks knowledge about family health history", "file_id": "dr_HD1103(part2)", "chunk_id": 6 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I don't want to become blind", "context": "Patient expresses fear of losing vision", "file_id": "dr_HD1103(part2)", "chunk_id": 7 }, { "code": "Lack of family health knowledge", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "We're a functional, dysfunctional family. So, , , , I couldn't tell you what, what my siblings have or what they don't have", "context": "Patient lacks knowledge of family health history", "file_id": "dr_HD1103(part2)", "chunk_id": 7 }, { "code": "Belief in preventative care", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I believe in preventative care", "context": "Patient values proactive health management", "file_id": "dr_HD1103(part2)", "chunk_id": 7 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I just don't want to become, , dependent on somebody or a blind person", "context": "Patient fears losing independence due to DR", "file_id": "dr_HD1103(part2)", "chunk_id": 8 }, { "code": "Positive mindset", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "it changes your mindset", "context": "Patient believes in preventative care and has a positive outlook", "file_id": "dr_HD1103(part2)", "chunk_id": 8 }, { "code": "Preventative care beliefs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I believe in preventative care", "context": "Patient values proactive healthcare approach", "file_id": "dr_HD1103(part2)", "chunk_id": 8 }, { "code": "Fear of losing independence", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "the fear of, , losing my abilities to be independent", "context": "Patient fears loss of independence due to DR", "file_id": "dr_HD1103(part2)", "chunk_id": 9 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "the doctors do what they can", "context": "Patient appreciates doctor's efforts", "file_id": "dr_HD1103(part2)", "chunk_id": 9 }, { "code": "Adaptable healthcare providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "they try to adapt what knowledge they have to the situation at hand", "context": "Patient values provider's adaptability", "file_id": "dr_HD1103(part2)", "chunk_id": 9 }, { "code": "Limited health technology", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "I just wish it was more-- , I just-- , I know it's through Epic--", "context": "Patient finds MyChart limiting", "file_id": "dr_HD1103(part2)", "chunk_id": 9 }, { "code": "Fear of losing independence", "category": "BARRIER - Emotional/Psychological", "subcategory": "Depression/anxiety", "quote": "the fear of, , losing my abilities to be independent", "context": "Patient fears losing independence due to DR", "file_id": "dr_HD1103(part2)", "chunk_id": 10 }, { "code": "User-friendly technology", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I just wish it was more, , user-friendly", "context": "Patient wants easier-to-use technology for healthcare services", "file_id": "dr_HD1103(part2)", "chunk_id": 10 }, { "code": "Technology literacy barriers", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "not all of us were brought up in the age of, , technology", "context": "Patient struggles with using technology due to age and lack of familiarity", "file_id": "dr_HD1103(part2)", "chunk_id": 10 }, { "code": "Accessible healthcare information", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Patient navigation services", "quote": "the more results that they put into the visit, not only, , , what the doctor's notes were, but the technician's--", "context": "Patient wants easier access to healthcare information and history", "file_id": "dr_HD1103(part2)", "chunk_id": 10 }, { "code": "Ride service support", "category": "FACILITATOR - Resources & Access", "subcategory": "Transportation assistance", "quote": "there's a ride service, something-- , support system, anything at all that, , you feel that is it helps me get to my appointments", "context": "Patient mentions the importance of transportation support for appointment adherence", "file_id": "dr_HD1103(part2)", "chunk_id": 10 }, { "code": "Visual impairment barriers", "category": "BARRIER - SDOH", "subcategory": "Physical disability", "quote": "With me having one good eye and being, --", "context": "Patient's visual impairment creates challenges for daily life and healthcare management", "file_id": "dr_HD1103(part2)", "chunk_id": 10 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "it's hard to find someone to go with you", "context": "Patient has difficulty finding transportation to appointments", "file_id": "dr_HD1103(part2)", "chunk_id": 11 }, { "code": "Lack of social support", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "my family was functional, dysfunctional", "context": "Patient lacks reliable social support for appointments", "file_id": "dr_HD1103(part2)", "chunk_id": 11 }, { "code": "Accessibility issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "3. Provider/System Issues", "quote": "If they could give you that before they let you out, it would be-- it would be fantastic", "context": "Patient suggests improvement to clinic procedure for easier navigation", "file_id": "dr_HD1103(part2)", "chunk_id": 11 }, { "code": "Ride service support", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "1. Healthcare System Support", "quote": "there's a ride service, something-- , support system", "context": "Patient mentions ride services as helpful for appointment adherence", "file_id": "dr_HD1103(part2)", "chunk_id": 11 }, { "code": "Support system", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "1. Healthcare System Support", "quote": "anything at all that, , you feel that is it helps me get to my appointments", "context": "Patient values support systems for facilitating appointment attendance", "file_id": "dr_HD1103(part2)", "chunk_id": 11 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "They don't have money for gas", "context": "Patient discusses financial constraints related to transportation", "file_id": "dr_HD1103(part2)", "chunk_id": 12 }, { "code": "Financial constraints", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "I have to manage, my fuel consumption and, and so on", "context": "Patient mentions managing fuel costs as a challenge", "file_id": "dr_HD1103(part2)", "chunk_id": 12 }, { "code": "Cost-related barriers", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "4. Cost-Related Barriers", "quote": "how do you want to say the total bill after the appointment?", "context": "Patient inquires about costs associated with appointments", "file_id": "dr_HD1103(part2)", "chunk_id": 12 }, { "code": "Out-of-pocket costs", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "4. Cost-Related Barriers", "quote": "$25 is hitting the lottery", "context": "Patient expresses difficulty affording out-of-pocket expenses", "file_id": "dr_HD1103(part2)", "chunk_id": 12 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "$25 is hitting the lottery", "context": "Patient struggles with budgeting for healthcare costs", "file_id": "dr_HD1103(part2)", "chunk_id": 13 }, { "code": "Cost-related barriers", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Out-of-pocket costs", "quote": "I just can't afford the co-pays or the, the travel expense to you because of that reason", "context": "Patient cannot afford healthcare expenses", "file_id": "dr_HD1103(part2)", "chunk_id": 13 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I had a great doctor at UPMC. He was fantastic", "context": "Patient had a positive experience with a healthcare provider", "file_id": "dr_HD1103(part2)", "chunk_id": 13 }, { "code": "Compassionate provider", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "He was fantastic. And, , , he gave me hope. He was compassionate.", "context": "Patient had a positive experience with a doctor", "file_id": "dr_HD1103(part2)", "chunk_id": 14 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "I just had a visual eye field done, , WVU is going to send me another bill for $300. And I just had this done two months ago. Now you want to do another one. I can't-- I can't afford it.", "context": "Patient cannot afford repeated medical tests", "file_id": "dr_HD1103(part2)", "chunk_id": 14 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "He listened to me, , you know.", "context": "Patient felt heard by their doctor", "file_id": "dr_HD1103(part2)", "chunk_id": 14 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "I can't-- I can't afford it.", "context": "Patient cannot afford follow-up appointment", "file_id": "dr_HD1103(part2)", "chunk_id": 15 }, { "code": "Financial assistance", "category": "FACILITATOR - Resources & Access", "subcategory": "Financial assistance programs", "quote": "she was able to help me so I can afford it", "context": "Patient received financial assistance for follow-up appointment", "file_id": "dr_HD1103(part2)", "chunk_id": 15 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "these people are real. They get it.", "context": "Patient feels understood by healthcare provider", "file_id": "dr_HD1103(part2)", "chunk_id": 15 }, { "code": "Cost-related barriers", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Out-of-pocket costs", "quote": "I just don't have the funding to do it.", "context": "Patient cannot afford follow-up appointment due to cost", "file_id": "dr_HD1103(part2)", "chunk_id": 15 }, { "code": "Rude provider", "category": "BARRIER - Provider/System Issues", "subcategory": "Rude or dismissive providers", "quote": "she was cold and she was sterile", "context": "Patient describes negative experience with resident doctor", "file_id": "dr_HD1103(part2)", "chunk_id": 16 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "she looked at me and she goes, 'Oh, do you just pick up the place to go, to seek treatment?'", "context": "Patient feels misunderstood by resident doctor", "file_id": "dr_HD1103(part2)", "chunk_id": 16 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "she was cold and she was sterile", "context": "Patient describes negative experience with resident doctor, indicating lack of trust", "file_id": "dr_HD1103(part2)", "chunk_id": 16 }, { "code": "Rude provider", "category": "BARRIER - Provider/System Issues", "subcategory": "Rude or dismissive providers", "quote": "And she was cold and she was sterile", "context": "Patient had a negative experience with a resident doctor", "file_id": "dr_HD1103(part2)", "chunk_id": 17 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "And that set me back a step or two", "context": "Patient lost trust in the provider after a negative experience", "file_id": "dr_HD1103(part2)", "chunk_id": 17 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "The comment that was made to me about that at that time truly, truly bothered me", "context": "Patient felt misunderstood or disrespected by the provider's comment", "file_id": "dr_HD1103(part2)", "chunk_id": 17 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "I'm here for a reason. I'm not here to abuse anything.", "context": "Patient implies difficulty accessing care", "file_id": "dr_HD1103(part2)", "chunk_id": 18 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "just don't sit there and say, 'Well, what more can you have?'", "context": "Patient experiences unhelpful provider interaction", "file_id": "dr_HD1103(part2)", "chunk_id": 18 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "With my financial situation as well, I can't afford internet or a hotspot on a phone.", "context": "Patient faces financial difficulties", "file_id": "dr_HD1103(part2)", "chunk_id": 18 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "have a game plan, knowing that you're going to have a diab-diabetic patient that day.", "context": "Patient suggests need for prepared providers", "file_id": "dr_HD1103(part2)", "chunk_id": 18 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "instead of a flyer, sit there and answer the question.", "context": "Patient values clear provider communication", "file_id": "dr_HD1103(part2)", "chunk_id": 18 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "I will say this too. With my financial situation as well, I can't afford internet or a hotspot on a phone.", "context": "Patient's financial situation limits access to technology", "file_id": "dr_HD1103(part2)", "chunk_id": 19 }, { "code": "Lack of access to healthcare", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "Technology is great, but if you can't afford the technology and you say go to this website or follow up here, that's a different animal.", "context": "Patient highlights limitations in accessing healthcare due to financial constraints", "file_id": "dr_HD1103(part2)", "chunk_id": 19 }, { "code": "Education/health literacy barriers", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "you need-- you have to have something tangible-- in hand if they can do a flyer or something that for you to read, , or go to this website and see.", "context": "Patient suggests needing more accessible educational materials", "file_id": "dr_HD1103(part2)", "chunk_id": 19 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Healthcare System Support", "quote": "maybe have a dietician there in-house-- come in and say, 'Hey, , you-- there's a couple of minutes before Dr. XYZ comes in. Is there something that-- here's something that we can do for you?'", "context": "Patient suggests having more accessible providers, such as an in-house dietician", "file_id": "dr_HD1103(part2)", "chunk_id": 19 }, { "code": "Patient navigation services", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Healthcare System Support", "quote": "Go in with-- maybe have a dietician there in-house-- come in and say, 'Hey, , you-- there's a couple of minutes before Dr. XYZ comes in. Is there something that-- here's something that we can do for you?'", "context": "Patient implies needing more navigation support from healthcare providers", "file_id": "dr_HD1103(part2)", "chunk_id": 19 }, { "code": "Lack of education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "I got nothing out of it", "context": "Patient felt diabetes education class was unhelpful", "file_id": "dr_HD1103(part2)", "chunk_id": 20 }, { "code": "Poor education quality", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider issues", "quote": "the person wasn't as thorough or answering the questions as well", "context": "Patient criticism of diabetes education class instructor", "file_id": "dr_HD1103(part2)", "chunk_id": 20 }, { "code": "Limited access to resources", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "it was back in '10 or '11, I think", "context": "Patient has not participated in recent diabetes education", "file_id": "dr_HD1103(part2)", "chunk_id": 20 }, { "code": "No social support", "category": "BARRIER - SDOH", "subcategory": "Social determinants", "quote": "I'm by myself", "context": "Patient lacks support for daily diabetes care", "file_id": "dr_HD1103(part2)", "chunk_id": 20 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "the person wasn't as thorough or answering the questions as well", "context": "Patient felt provider did not communicate effectively", "file_id": "dr_HD1103(part2)", "chunk_id": 21 }, { "code": "Lack of access to healthcare", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "it was condensed, overcrowded", "context": "Patient felt healthcare service was inadequate due to overcrowding", "file_id": "dr_HD1103(part2)", "chunk_id": 21 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "it was a wasted two hours of my life", "context": "Patient felt they wasted time due to inefficient service", "file_id": "dr_HD1103(part2)", "chunk_id": 21 }, { "code": "Education barriers", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "they were trying to do it in a condensed form, trying to tell you how to read a diet", "context": "Patient felt education was inadequate due to time constraints", "file_id": "dr_HD1103(part2)", "chunk_id": 21 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Healthcare System Support", "quote": "if you would take someone more to the side and explain to them how to prepare a meal properly", "context": "Patient desired more personalized attention from provider", "file_id": "dr_HD1103(part2)", "chunk_id": 21 }, { "code": "Flexible scheduling", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Healthcare System Support", "quote": "not 6 o'clock at night-- maybe 4 o'clock in the afternoon", "context": "Patient preferred more convenient appointment times", "file_id": "dr_HD1103(part2)", "chunk_id": 21 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "And just offer it as a free class and send something out", "context": "Patient suggests increasing accessibility of health services", "file_id": "dr_HD1103(part2)", "chunk_id": 22 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "And I was, Okay. You're here for a dietary class.", "context": "Patient values health education", "file_id": "dr_HD1103(part2)", "chunk_id": 22 }, { "code": "Provider communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Make a phone call or send a flyer out to these people, Hey, we have a class.", "context": "Patient suggests effective provider-patient communication", "file_id": "dr_HD1103(part2)", "chunk_id": 22 }, { "code": "Accessibility of care", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Have enough dietitians on board.", "context": "Patient emphasizes importance of accessible healthcare providers", "file_id": "dr_HD1103(part2)", "chunk_id": 22 }, { "code": "Lack of social support", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "None", "quote": "No. No.", "context": "Patient lacks someone to share worries or fears about diabetes", "file_id": "dr_HD1103(part2)", "chunk_id": 23 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "if I'm sick and if I don't have the resources to purchase good nourishing food", "context": "Patient lacks financial resources for basic needs", "file_id": "dr_HD1103(part2)", "chunk_id": 23 }, { "code": "Lack of access to resources", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "it makes me want to be a stronger person. , it, it hurts because if I'm sick and if I don't have the resources", "context": "Patient lacks access to necessary resources for health management", "file_id": "dr_HD1103(part2)", "chunk_id": 23 }, { "code": "Emotional distress", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "it hurts because if I'm sick and if I don't have the resources", "context": "Patient experiences emotional pain due to lack of resources", "file_id": "dr_HD1103(part2)", "chunk_id": 23 }, { "code": "Lack of trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "nobody-- someone you could trust, --", "context": "Patient lacks trust in healthcare providers", "file_id": "dr_HD1103(part2)", "chunk_id": 23 }, { "code": "Healthcare system support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Is there somewhere you can call or ask for advice about handling health or eye problems? Is it mainly your doctor, or do you call other-- any other people for, , advice about health and eye problems?", "context": "Patient seeks support from healthcare system", "file_id": "dr_HD1103(part2)", "chunk_id": 23 }, { "code": "Healthcare System Support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I found an app. It's called Be My Eyes.", "context": "Patient uses app for support with health and eye problems", "file_id": "dr_HD1103(part2)", "chunk_id": 24 }, { "code": "Resources Access", "category": "FACILITATOR - Resources & Access", "subcategory": "Community health programs", "quote": "I found an app. It's called Be My Eyes.", "context": "Patient uses community resource for support", "file_id": "dr_HD1103(part2)", "chunk_id": 24 }, { "code": "Patient Empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "they will try to help you with what resources", "context": "Patient receives health education through app", "file_id": "dr_HD1103(part2)", "chunk_id": 24 }, { "code": "Lack of faith", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "you lose, lose faith in it, you know, in yourself", "context": "Patient expresses loss of confidence due to vision limitations", "file_id": "dr_HD1103(part2)", "chunk_id": 25 }, { "code": "Discouragement", "category": "BARRIER - Emotional/Psychological", "subcategory": "Depression/anxiety", "quote": "I do get a little bit discouraged", "context": "Patient feels discouraged about limited abilities due to vision", "file_id": "dr_HD1103(part2)", "chunk_id": 25 }, { "code": "Healthcare support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "they will help you, , , help you see or if you're lost or if you have-- or you need help or you need knowledge", "context": "Patient perceives healthcare system as supportive", "file_id": "dr_HD1103(part2)", "chunk_id": 25 }, { "code": "Emotional distress", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "that just brings you down", "context": "Patient feels frustrated with daily activities due to vision loss", "file_id": "dr_HD1103(part2)", "chunk_id": 26 }, { "code": "Social stigma", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Cultural beliefs about healthcare", "quote": "you get the dirtiest looks from people", "context": "Patient experiences social stigma due to vision loss", "file_id": "dr_HD1103(part2)", "chunk_id": 26 }, { "code": "Accessibility issues", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "everybody's in a hurry to go nowhere", "context": "Patient struggles with navigating public spaces due to vision loss", "file_id": "dr_HD1103(part2)", "chunk_id": 26 }, { "code": "Lack of awareness", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I didn't-- , , I walked into the store actually to bump into people. No, I didn't.", "context": "Patient lacks awareness about their condition and its impact on daily life", "file_id": "dr_HD1103(part2)", "chunk_id": 26 }, { "code": "Self-advocacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I'm blind in my right eye. I pass on the left.", "context": "Patient takes initiative to adapt to vision loss and navigate public spaces", "file_id": "dr_HD1103(part2)", "chunk_id": 26 }, { "code": "Lack of research", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of continuity of care", "quote": "There's no research goin on. There-there's no-- there's nobody taking this at hand to, , , to do this.", "context": "Patient feels that lack of research is hindering their care", "file_id": "dr_HD1103(part2)", "chunk_id": 27 }, { "code": "Feeling rushed", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "when somebody rushes in--", "context": "Patient feels rushed by others, possibly implying a desire for more time with providers", "file_id": "dr_HD1103(part2)", "chunk_id": 27 }, { "code": "Positive expectations", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "of hopefully everything stays the same. Everything is-- those are my expectations.", "context": "Patient has positive expectations for their care, possibly due to health education", "file_id": "dr_HD1103(part2)", "chunk_id": 27 }, { "code": "Desire for patient-centered care", "category": "FACILITATOR - Provider Relationship", "subcategory": "Shared decision-making", "quote": "I always ask, what's new on the horizon?", "context": "Patient desires to be involved in their care and have open communication with providers", "file_id": "dr_HD1103(part2)", "chunk_id": 27 }, { "code": "Emotional distress", "category": "BARRIER - Emotional/Psychological", "subcategory": "Diabetes distress", "quote": "I think-- I think sometimes that just brings you down.", "context": "Patient experiences emotional distress related to their condition", "file_id": "dr_HD1103(part2)", "chunk_id": 27 }, { "code": "Lack of research", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "There's no re-- there's no research goin on.", "context": "Patient feels providers are not proactive in finding solutions", "file_id": "dr_HD1103(part2)", "chunk_id": 28 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "Sometimes I don't even bother asking because I know what the answer is going to be.", "context": "Patient feels providers do not communicate effectively", "file_id": "dr_HD1103(part2)", "chunk_id": 28 }, { "code": "Lack of hope", "category": "BARRIER - Emotional/Psychological", "subcategory": "Depression/anxiety", "quote": "Hope is a four-letter word. And sometimes it can be a great word. It can be the worst word out there.", "context": "Patient feels hopeless about their condition", "file_id": "dr_HD1103(part2)", "chunk_id": 28 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "If you think that it’ll work, 'Hey, I'll try it.'", "context": "Patient is willing to try new treatments if recommended by provider", "file_id": "dr_HD1103(part2)", "chunk_id": 28 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I'll e-- I'll even be a guinea pig.", "context": "Patient is proactive and willing to take an active role in their care", "file_id": "dr_HD1103(part2)", "chunk_id": 28 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "they want $800 before you even commit to an appointment", "context": "Patient faces high upfront costs for appointments", "file_id": "dr_HD1103(part2)", "chunk_id": 29 }, { "code": "Insurance coverage issues", "category": "BARRIER - SDOH", "subcategory": "Insurance coverage issues", "quote": "Medicare does not cover their practices", "context": "Patient's insurance does not cover certain medical practices", "file_id": "dr_HD1103(part2)", "chunk_id": 29 }, { "code": "Cost-related barriers", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Out-of-pocket costs", "quote": "They want $200 right off the bat", "context": "Patient faces out-of-pocket expenses for medical services", "file_id": "dr_HD1103(part2)", "chunk_id": 29 }, { "code": "Lack of access to healthcare", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "they want $800 before you even commit to an appointment", "context": "Patient faces barriers to accessing medical care due to cost", "file_id": "dr_HD1103(part2)", "chunk_id": 29 }, { "code": "Lack of education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "if they would just take a little bit extra time in a smaller group of people, explain to people what actually goes on", "context": "Patient believes more education is needed", "file_id": "dr_HD1103(part2)", "chunk_id": 30 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "if you just put it out there, I think if more public knowledge, , , more maybe helpful educational", "context": "Patient suggests public education is beneficial", "file_id": "dr_HD1103(part2)", "chunk_id": 30 }, { "code": "Free clinic access", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate insurance coverage", "quote": "have a free clinic", "context": "Patient mentions the importance of accessible healthcare services", "file_id": "dr_HD1103(part2)", "chunk_id": 30 }, { "code": "Provider time constraints", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "everybody got to schedule. Everybody got life", "context": "Patient acknowledges providers' busy schedules", "file_id": "dr_HD1103(part2)", "chunk_id": 30 }, { "code": "Lack of education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "explain to people what actually goes on", "context": "Patient suggests that lack of understanding about diabetes management is a barrier", "file_id": "dr_HD1103(part2)", "chunk_id": 31 }, { "code": "Poor diet", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "they don't eat a good, healthy diet or a clean diet, and they're experiencing issues", "context": "Patient believes that poor diet is a barrier to effective diabetes management", "file_id": "dr_HD1103(part2)", "chunk_id": 31 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "explain to people what actually goes on", "context": "Patient suggests that health education programs would facilitate better diabetes management", "file_id": "dr_HD1103(part2)", "chunk_id": 31 }, { "code": "Effective self-management", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "check your-- , your best friend is your glucometer", "context": "Patient emphasizes the importance of effective self-management in diabetes care", "file_id": "dr_HD1103(part2)", "chunk_id": 31 }, { "code": "Healthy diet", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "watch what you consume", "context": "Patient suggests that a healthy diet is essential for effective diabetes management", "file_id": "dr_HD1103(part2)", "chunk_id": 31 }, { "code": "Lack of discussion", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "", "context": "No mention of doctor discussing follow-up appointments", "file_id": "dr_VP1219", "chunk_id": 0 }, { "code": "Diet watching", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I try to watch what I eat", "context": "Patient takes initiative in managing diet", "file_id": "dr_VP1219", "chunk_id": 0 }, { "code": "Exercise encouragement", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Patient navigation services", "quote": "do a little more exercise too", "context": "Doctor recommends exercise for patient's well-being", "file_id": "dr_VP1219", "chunk_id": 0 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I try to watch what I eat", "context": "Patient lacks clear understanding of diabetes management and potential eye complications", "file_id": "dr_VP1219", "chunk_id": 1 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I try to watch what I eat", "context": "Patient is attempting to manage diet, indicating some level of health education", "file_id": "dr_VP1219", "chunk_id": 1 }, { "code": "Diabetes distress", "category": "BARRIER - Emotional/Psychological", "subcategory": "Diabetes distress", "quote": "I feel just tired all the time", "context": "Patient experiences emotional and psychological burden of diabetes, potentially affecting follow-up adherence", "file_id": "dr_VP1219", "chunk_id": 1 }, { "code": "Lack of awareness", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Oh, it's made them worse. Yeah. Definitely", "context": "Patient lacks clear understanding of diabetes impact on eyes, potentially leading to poor follow-up adherence", "file_id": "dr_VP1219", "chunk_id": 1 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I guess I'm not sure exactly how to describe it", "context": "Patient unsure about their condition", "file_id": "dr_VP1219", "chunk_id": 2 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "he said today, looking stable and still, still looking good from the original surgeries that I had", "context": "Patient receives reassuring news from doctor", "file_id": "dr_VP1219", "chunk_id": 2 }, { "code": "Limited health literacy", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "I guess I'm not sure exactly how to describe it", "context": "Patient struggles to understand their condition", "file_id": "dr_VP1219", "chunk_id": 2 }, { "code": "Accessible healthcare", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "he said today, looking stable and still, still looking good from the original surgeries that I had", "context": "Patient receives regular check-ups", "file_id": "dr_VP1219", "chunk_id": 2 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I don't want to be blind", "context": "Patient expresses fear of blindness due to diabetes", "file_id": "dr_VP1219", "chunk_id": 3 }, { "code": "Lack of understanding about DR progression", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "they told me it could lead to blindness", "context": "Patient lacks detailed understanding of diabetes impact on eyesight", "file_id": "dr_VP1219", "chunk_id": 3 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "he said today, looking stable and still, still looking good from the original surgeries that I had", "context": "Patient feels reassured by doctor's positive feedback", "file_id": "dr_VP1219", "chunk_id": 3 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "they told me it could lead to blindness", "context": "Doctor clearly communicates potential risks of diabetes on eyesight", "file_id": "dr_VP1219", "chunk_id": 3 }, { "code": "Provider explanation", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Because a lot of the blood-- the growth of blood vessels in my eyes--", "context": "Patient understands their condition due to provider's explanation", "file_id": "dr_VP1219", "chunk_id": 4 }, { "code": "Trust in provider", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "Dr. G said that", "context": "Patient trusts and follows Dr. G's advice", "file_id": "dr_VP1219", "chunk_id": 4 }, { "code": "Accessible care", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I, -- here", "context": "Patient receives regular care at a convenient location", "file_id": "dr_VP1219", "chunk_id": 4 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Because a lot of the blood-- the growth of blood vessels in my eyes--", "context": "Patient has knowledge about their condition and treatment", "file_id": "dr_VP1219", "chunk_id": 4 }, { "code": "Lack of difficulty", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "It's not really difficult at all. No.", "context": "Patient finds the dilation process easy", "file_id": "dr_VP1219", "chunk_id": 5 }, { "code": "Temporary vision issues", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "It is a little difficult", "context": "Patient experiences temporary difficulty due to dilation", "file_id": "dr_VP1219", "chunk_id": 5 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "It's not hard at all. I mean, they usually schedule me", "context": "Patient finds scheduling process easy", "file_id": "dr_VP1219", "chunk_id": 6 }, { "code": "Reminder systems", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "usually get notifications if there's a message", "context": "Patient receives reminders through MyChart", "file_id": "dr_VP1219", "chunk_id": 6 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "Oh, yes. It's fine", "context": "Patient feels comfortable with doctor's availability", "file_id": "dr_VP1219", "chunk_id": 6 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Just to be careful about, , rubbing your eyes", "context": "Doctor provides clear recommendations for eye care", "file_id": "dr_VP1219", "chunk_id": 6 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "it's a-- it's a distance, but I don't-- it's not really that difficult", "context": "Patient mentions distance as a potential issue but downplays its impact", "file_id": "dr_VP1219", "chunk_id": 7 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "I wish it was closer to where I lived, but it's not, so", "context": "Patient expresses desire for clinic to be closer to their home", "file_id": "dr_VP1219", "chunk_id": 7 }, { "code": "Accessible providers", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "1. Healthcare System Support", "quote": "it's easy to make arrangements", "context": "Patient finds it easy to schedule appointments", "file_id": "dr_VP1219", "chunk_id": 7 }, { "code": "Dusty work environment", "category": "BARRIER - SDOH", "subcategory": "Environmental barriers", "quote": "it's almost a warehouse setting. So-- lot of dusty in the air.", "context": "Patient works in a dusty environment", "file_id": "dr_VP1219", "chunk_id": 8 }, { "code": "Lack of supplements", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "No, I don't take anything that.", "context": "Patient does not take eye-healthy supplements", "file_id": "dr_VP1219", "chunk_id": 8 }, { "code": "Insulin management", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "insulin to keep the diabetes down.", "context": "Patient manages diabetes with insulin", "file_id": "dr_VP1219", "chunk_id": 8 }, { "code": "Eye care practices", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I wear sunglasses. And occasionally I'll take, -- especially an environment where I work, it's dusty.", "context": "Patient takes steps to protect eyes", "file_id": "dr_VP1219", "chunk_id": 8 }, { "code": "Resting eyes", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "Yes. I give my eyes a rest when working on the computer or watching TV.", "context": "Patient prioritizes eye health", "file_id": "dr_VP1219", "chunk_id": 8 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "They've never really told me exactly how much risk it would be", "context": "Patient unsure about personal risk of vision loss", "file_id": "dr_VP1219", "chunk_id": 9 }, { "code": "Provider communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "They've never really told me exactly how much risk it would be", "context": "Patient feels providers did not fully inform them", "file_id": "dr_VP1219", "chunk_id": 9 }, { "code": "Awareness of risk", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Is it a-- it is a risk if I don't take care of it and keep on top of it", "context": "Patient understands importance of managing diabetes", "file_id": "dr_VP1219", "chunk_id": 9 }, { "code": "Provider guidance", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Yes. S1: 07:39 Your eye doctor and your diabetes doctor?", "context": "Patient has access to multiple healthcare providers", "file_id": "dr_VP1219", "chunk_id": 9 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "They've never really told me exactly how much risk it would be", "context": "Patient unsure about personal risk of blindness", "file_id": "dr_VP1219", "chunk_id": 10 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "And they explained to me-- we went through with that and they explained it-- why it was there", "context": "Patient feels informed by eye doctor", "file_id": "dr_VP1219", "chunk_id": 10 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "And they explained to me-- we went through with that and they explained it-- why it was there", "context": "Patient feels supported by eye doctor", "file_id": "dr_VP1219", "chunk_id": 10 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "they explained to me-- we went through with that and they explained it-- why it was there", "context": "Patient feels informed by provider", "file_id": "dr_VP1219", "chunk_id": 11 }, { "code": "Thorough providers", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "they're very thorough about it", "context": "Patient appreciates comprehensive care from providers", "file_id": "dr_VP1219", "chunk_id": 11 }, { "code": "Lack of patient advocacy", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Patient Beliefs & Perceptions", "quote": "not really, because we-- every time I go to an appointment, we pretty much-- they're very thorough about it, so--", "context": "Patient does not often express concerns or needs", "file_id": "dr_VP1219", "chunk_id": 11 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "they'd be pretty much explained to me. Ask me what I'm doing, I tell them what's going on, and then we discuss it that way", "context": "Patient feels heard by provider", "file_id": "dr_VP1219", "chunk_id": 11 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "they're very thorough about it", "context": "Patient feels comfortable with provider's approach", "file_id": "dr_VP1219", "chunk_id": 12 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "they're very thorough about it", "context": "Patient appreciates provider's clear communication", "file_id": "dr_VP1219", "chunk_id": 12 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I think what they're doing probably is the best thing that they--", "context": "Patient feels informed about their care", "file_id": "dr_VP1219", "chunk_id": 12 }, { "code": "Diabetes self-management support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I think so", "context": "Patient feels supported in managing their diabetes", "file_id": "dr_VP1219", "chunk_id": 12 }, { "code": "Perceived treatment effectiveness", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Yes, I do believe. Yeah, it is", "context": "Patient believes their treatment is working", "file_id": "dr_VP1219", "chunk_id": 12 }, { "code": "Lack of understanding about DR progression", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't know", "context": "Patient unsure about potential vision loss", "file_id": "dr_VP1219", "chunk_id": 12 }, { "code": "Fear of diagnosis/treatment", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "Oh, very serious if I don't keep up with it", "context": "Patient aware of potential consequences", "file_id": "dr_VP1219", "chunk_id": 12 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't know. If I don't take care of it, highly likely it could happen", "context": "Patient unsure about diabetes impact on vision", "file_id": "dr_VP1219", "chunk_id": 13 }, { "code": "Perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now' (no perceived urgency)", "quote": "I'm good with that. I'm happy with that", "context": "Patient feels current vision is satisfactory", "file_id": "dr_VP1219", "chunk_id": 13 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Oh, very serious if I don't keep up with it", "context": "Patient aware of diabetes management importance", "file_id": "dr_VP1219", "chunk_id": 13 }, { "code": "Self-management support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I try to take care of it. So I think if I keep it stable", "context": "Patient proactive about managing diabetes", "file_id": "dr_VP1219", "chunk_id": 13 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "And I'm not sure how", "context": "Patient unsure about their condition", "file_id": "dr_VP1219", "chunk_id": 14 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "get surprised easily", "context": "Patient anxious about unexpected news", "file_id": "dr_VP1219", "chunk_id": 14 }, { "code": "Healthcare facilities", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I'm glad I have the facilities that I need to, to be able to manage it", "context": "Patient has access to necessary healthcare facilities", "file_id": "dr_VP1219", "chunk_id": 15 }, { "code": "Positive experience", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Oh, that-- it was a good experience", "context": "Patient had a positive experience with follow-ups and treatment plan", "file_id": "dr_VP1219", "chunk_id": 15 }, { "code": "Professional staff", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "everybody is professional", "context": "Patient appreciates the professionalism of healthcare staff", "file_id": "dr_VP1219", "chunk_id": 16 }, { "code": "Thorough discussions", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "They're very thorough in their discussions", "context": "Patient values the detailed conversations with providers", "file_id": "dr_VP1219", "chunk_id": 16 }, { "code": "Clear explanations", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "They explained all that", "context": "Patient received clear information about their condition and treatment", "file_id": "dr_VP1219", "chunk_id": 16 }, { "code": "Access to facilities", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate resources", "quote": "I'm glad I have the facilities that I need", "context": "Patient has access to necessary healthcare facilities", "file_id": "dr_VP1219", "chunk_id": 16 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Well, well, I can still see", "context": "Patient may not fully understand the importance of follow-up appointments", "file_id": "dr_VP1219", "chunk_id": 16 }, { "code": "Health Education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "They explained all that--", "context": "Patient received health education about diabetes management", "file_id": "dr_VP1219", "chunk_id": 17 }, { "code": "Effective Communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "They explained all that--", "context": "Patient received clear explanations from healthcare provider", "file_id": "dr_VP1219", "chunk_id": 17 }, { "code": "Reminder Systems", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "The good resource is the, -- the MyChart. It's very, very helpful because, yeah, otherwise I'd just forget.", "context": "Patient uses MyChart for reminders and organization", "file_id": "dr_VP1219", "chunk_id": 17 }, { "code": "Accessible Providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Is it helpful in contacting your doctor and stuff too? Yes, it is", "context": "Patient finds MyChart helpful for contacting healthcare provider", "file_id": "dr_VP1219", "chunk_id": 17 }, { "code": "Good resources", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Patient navigation services", "quote": "Good resources to be able to call them when I need it", "context": "Patient finds healthcare system resources helpful", "file_id": "dr_VP1219", "chunk_id": 18 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "it's good that they have the ability to reach out", "context": "Patient appreciates ease of contact with healthcare providers", "file_id": "dr_VP1219", "chunk_id": 18 }, { "code": "Positive experience", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Well, when I had the surgery, the first time I could actually see clearly", "context": "Patient had a positive experience with healthcare services", "file_id": "dr_VP1219", "chunk_id": 18 }, { "code": "Frustration", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "sometimes you think-- get a little frustrated", "context": "Patient experiences emotional frustration with healthcare process", "file_id": "dr_VP1219", "chunk_id": 18 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "Everybody, yeah, very good. Very friendly, very informative.", "context": "Patient feels comfortable with healthcare providers", "file_id": "dr_VP1219", "chunk_id": 19 }, { "code": "Family support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "I have family that can help if I need it.", "context": "Patient has family support for daily diabetes care", "file_id": "dr_VP1219", "chunk_id": 19 }, { "code": "Transportation assistance", "category": "FACILITATOR - Resources & Access", "subcategory": "Transportation assistance", "quote": "They make sure I get to where I need to be--", "context": "Patient's family helps with transportation to appointments", "file_id": "dr_VP1219", "chunk_id": 19 }, { "code": "Dietary encouragement", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "They help with the diet, , encouragement, make sure you're eating right, things that", "context": "Patient's family provides support for healthy diet", "file_id": "dr_VP1219", "chunk_id": 19 }, { "code": "Frustration with care", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Why they got to do this?", "context": "Patient sometimes feels frustrated with diabetes care", "file_id": "dr_VP1219", "chunk_id": 19 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "they make sure I get to where I need to be", "context": "Patient receives support for appointments", "file_id": "dr_VP1219", "chunk_id": 20 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I did participate in a diabetes education class", "context": "Patient received health education", "file_id": "dr_VP1219", "chunk_id": 20 }, { "code": "Social support networks", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "Yes, I do have people to share my worries or fears about my diabetes and eyesight", "context": "Patient has social support", "file_id": "dr_VP1219", "chunk_id": 20 }, { "code": "Diet encouragement", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Patient navigation services", "quote": "they help with the diet, encouragement, make sure you're eating right", "context": "Patient receives dietary support", "file_id": "dr_VP1219", "chunk_id": 20 }, { "code": "Social Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "Yes. Yes, I do. Well, friends and family.", "context": "Patient has people to share worries and fears", "file_id": "dr_VP1219", "chunk_id": 21 }, { "code": "Emotional Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "Yes. Yes, they do.", "context": "Patient's friends and family understand and support them", "file_id": "dr_VP1219", "chunk_id": 21 }, { "code": "Practical Support", "category": "FACILITATOR - Resources & Access", "subcategory": "Transportation assistance", "quote": "Yes. Yes. Mm-hmm. That'd be sisters.", "context": "Patient has someone to help with daily chores, food, transportation", "file_id": "dr_VP1219", "chunk_id": 21 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "it does in transportation sometimes", "context": "Patient's eyesight limits their ability to drive", "file_id": "dr_VP1219", "chunk_id": 22 }, { "code": "Lack of social support", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "2. Patient Beliefs & Perceptions", "quote": "I mean, they're there if I need to call them, but I normally don't", "context": "Patient does not often seek advice from friends and family", "file_id": "dr_VP1219", "chunk_id": 22 }, { "code": "Positive patient-provider relationship", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "2. Provider Relationship", "quote": "You're just-- Yeah. With your doctor mainly", "context": "Patient primarily relies on their doctor for advice", "file_id": "dr_VP1219", "chunk_id": 22 }, { "code": "Adaptive strategies", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "3. Patient Empowerment", "quote": "I have to-- I have something I use to magnify to see what I'm doing, so", "context": "Patient uses tools to adapt to their eyesight limitations", "file_id": "dr_VP1219", "chunk_id": 22 }, { "code": "Lack of urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "it doesn't really prevent me", "context": "Patient feels their eyesight does not limit them", "file_id": "dr_VP1219", "chunk_id": 23 }, { "code": "Adaptive devices", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I have to-- I have something I use to magnify to see what I'm doing", "context": "Patient uses assistive technology to adapt", "file_id": "dr_VP1219", "chunk_id": 23 }, { "code": "Assistive technology", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate resources", "quote": "I have a device I could use-- A magnifying-- to do that", "context": "Patient has access to devices that aid in daily activities", "file_id": "dr_VP1219", "chunk_id": 23 }, { "code": "Self modification", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I'm just more careful", "context": "Patient has learned to adapt and be more careful due to eyesight changes", "file_id": "dr_VP1219", "chunk_id": 23 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I didn't need it, but now I do", "context": "Patient lacks understanding of their condition", "file_id": "dr_VP1219", "chunk_id": 24 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I wasn't anticipating-- didn't-- wasn't liking it, but it was necessary", "context": "Patient fears their diagnosis and treatment", "file_id": "dr_VP1219", "chunk_id": 24 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "He said it was stable and it was good, and that was very encouraging to me", "context": "Patient has a positive relationship with their provider", "file_id": "dr_VP1219", "chunk_id": 24 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Pretty much discussed everything", "context": "Patient feels they have effective communication with their provider", "file_id": "dr_VP1219", "chunk_id": 24 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "keep emphasizing the, the care you need to take of your eyes and to manage your diabetes", "context": "Patient values health education for managing their condition", "file_id": "dr_VP1219", "chunk_id": 24 }, { "code": "Lack of motivation", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "I don't want to hear that", "context": "Patient resists health advice due to lack of perceived urgency", "file_id": "dr_VP1219", "chunk_id": 25 }, { "code": "Difficulty with self-care", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Taking insulin shots every day", "context": "Patient struggles with daily diabetes management tasks", "file_id": "dr_VP1219", "chunk_id": 25 }, { "code": "Food temptation", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "Oh, I really want to have that", "context": "Patient experiences emotional struggle with dietary restrictions", "file_id": "dr_VP1219", "chunk_id": 25 }, { "code": "Importance of reminders", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "Keep reminding", "context": "Patient suggests regular reminders for diabetes management", "file_id": "dr_VP1219", "chunk_id": 25 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Keep the information flowing", "context": "Patient emphasizes the need for ongoing health education and awareness", "file_id": "dr_VP1219", "chunk_id": 25 }, { "code": "Transportation access", "category": "FACILITATOR - Resources & Access", "subcategory": "Transportation assistance", "quote": "I can ride the bus. It takes me right to the store where I need to go and right back home.", "context": "Patient has easy transportation to stores", "file_id": "dr_VP1219", "chunk_id": 26 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "", "context": "No direct quote, but implied by the need for analysis", "file_id": "dr_VP1219", "chunk_id": 27 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "", "context": "No direct quote, but a potential barrier", "file_id": "dr_VP1219", "chunk_id": 27 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "", "context": "No direct quote, but a potential facilitator", "file_id": "dr_VP1219", "chunk_id": 27 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Oh, now you're asking a big question", "context": "Patient seems uncertain about their medication", "file_id": "dr_SE0108", "chunk_id": 1 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "So, , do you have diabetes?", "context": "Interviewer inquires about patient's diabetes, potentially indicating a health education opportunity", "file_id": "dr_SE0108", "chunk_id": 1 }, { "code": "Medication management", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "Take medicine in the morning and take medicine at night and take a, a shot at night", "context": "Patient describes their daily medication routine", "file_id": "dr_SE0108", "chunk_id": 1 }, { "code": "Lack of health literacy", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "And I don't even have my list on me", "context": "Patient seems unsure about their medication", "file_id": "dr_SE0108", "chunk_id": 2 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "My doctor's gotten me on half-decent medicine now", "context": "Patient expresses satisfaction with their doctor", "file_id": "dr_SE0108", "chunk_id": 2 }, { "code": "Access to effective treatment", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "My numbers have all come down", "context": "Patient has seen improvement in their condition", "file_id": "dr_SE0108", "chunk_id": 2 }, { "code": "Lack of adherence", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "No perceived urgency", "quote": "Don't want to take medicine", "context": "Patient initially refused medication", "file_id": "dr_SE0108", "chunk_id": 3 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I wasn't taking medicine for probably a year or so", "context": "Patient avoided treatment due to fear", "file_id": "dr_SE0108", "chunk_id": 3 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "That's when I first started being old, hard-headed", "context": "Patient learned about importance of adherence", "file_id": "dr_SE0108", "chunk_id": 3 }, { "code": "Weight loss motivation", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I lost 72 pounds- ... doing that", "context": "Patient motivated by health improvements", "file_id": "dr_SE0108", "chunk_id": 3 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I figured I better start doing something or I'm just gonna fade away", "context": "Patient's motivation to take medicine due to significant weight loss", "file_id": "dr_SE0108", "chunk_id": 4 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "everybody looked at me and thought I had AIDS because I lost that much weight", "context": "Patient's fear of being judged or misdiagnosed", "file_id": "dr_SE0108", "chunk_id": 4 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "what are some things that your doctor may have discussed, that you think may be important for people with diabetes to do?", "context": "Patient's awareness of importance of health education", "file_id": "dr_SE0108", "chunk_id": 4 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "did you feel you were able to express that with your doctor and you came to an agreement?", "context": "Patient's perception of provider's empathy and understanding", "file_id": "dr_SE0108", "chunk_id": 4 }, { "code": "Lack of health education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Well, no, I still have, what would you say? My DNA is one of-", "context": "Patient seems uncertain about their condition", "file_id": "dr_SE0108", "chunk_id": 5 }, { "code": "Poor diet awareness", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "And I eat candy bars and candy and stuff that. They're in sweets that I shouldn't.", "context": "Patient acknowledges unhealthy eating habits", "file_id": "dr_SE0108", "chunk_id": 5 }, { "code": "Health education importance", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "People pay attention to what they're eating-", "context": "Patient emphasizes the need for awareness about diet", "file_id": "dr_SE0108", "chunk_id": 5 }, { "code": "Self management support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "People pay attention to what they're eating- ... and how it does react to your-", "context": "Patient highlights the importance of understanding food effects", "file_id": "dr_SE0108", "chunk_id": 5 }, { "code": "Lack of symptoms", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "No perceived urgency", "quote": "mine very seldom gives me any signals", "context": "Patient doesn't experience noticeable symptoms when sugar levels are high", "file_id": "dr_SE0108", "chunk_id": 6 }, { "code": "Emotional cues", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "I get aggravated easier", "context": "Patient experiences emotional changes when sugar levels are high", "file_id": "dr_SE0108", "chunk_id": 6 }, { "code": "Lack of awareness", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I, mine very seldom gives me any signals", "context": "Patient lacks awareness of diabetes symptoms", "file_id": "dr_SE0108", "chunk_id": 7 }, { "code": "Emotional cues", "category": "BARRIER - Emotional/Psychological", "subcategory": "Depression/anxiety", "quote": "I get aggravated easier- ... and mad easier", "context": "Patient experiences emotional changes when sugar is high", "file_id": "dr_SE0108", "chunk_id": 7 }, { "code": "Spousal support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "And then she explains it to you-", "context": "Patient receives support from spouse", "file_id": "dr_SE0108", "chunk_id": 7 }, { "code": "Increased awareness", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "and you watch for it then, and then you notice- ... it's actually happening", "context": "Patient becomes more aware of diabetes symptoms with support", "file_id": "dr_SE0108", "chunk_id": 7 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "My eyes were probably better and 20/20 for almost my whole life. And then it started getting a little bit worse", "context": "Patient describes decline in vision without understanding the cause", "file_id": "dr_SE0108", "chunk_id": 8 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "She's my alarm clock. She keeps me awake.", "context": "Patient values provider's support and reminders", "file_id": "dr_SE0108", "chunk_id": 8 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "My visibility started going a little bit on it", "context": "Patient seems unsure about their condition", "file_id": "dr_SE0108", "chunk_id": 9 }, { "code": "Age related issues", "category": "BARRIER - Social Determinants of Health (SDOH)", "subcategory": "Education/health literacy barriers", "quote": "72 years old, you expect to do that", "context": "Patient attributes declining eyesight to age", "file_id": "dr_SE0108", "chunk_id": 9 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "They did, they said my num- my numbers were very high", "context": "Patient seems concerned about their test results", "file_id": "dr_SE0108", "chunk_id": 9 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "They did, they said my num- my numbers were very high", "context": "Provider clearly explained patient's test results", "file_id": "dr_SE0108", "chunk_id": 9 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I use readers and stuff that", "context": "Patient is taking steps to manage their condition", "file_id": "dr_SE0108", "chunk_id": 9 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I have sugar with idiopathic or whatever the heck it's called", "context": "Patient shows lack of understanding about their condition", "file_id": "dr_SE0108", "chunk_id": 10 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "my doctor explained to you, , about how diabetes might affect your eyesight?", "context": "Patient receives clear explanation from provider", "file_id": "dr_SE0108", "chunk_id": 10 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "my doctor explained to you, , about how diabetes might affect your eyesight?", "context": "Patient receives health education from provider", "file_id": "dr_SE0108", "chunk_id": 10 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "my doctor explained to you, , about how diabetes might affect your eyesight?", "context": "Patient has positive interaction with provider", "file_id": "dr_SE0108", "chunk_id": 10 }, { "code": "Access to healthcare", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "I've even been to Philadelphia", "context": "Patient had to travel far to see a specialist", "file_id": "dr_SE0108", "chunk_id": 11 }, { "code": "Healthcare System Support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "seen the best eye doctor in the United States", "context": "Patient has access to high-quality care", "file_id": "dr_SE0108", "chunk_id": 11 }, { "code": "Regular scheduling", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "I get eye exams every six months", "context": "Patient is able to maintain regular follow-up appointments", "file_id": "dr_SE0108", "chunk_id": 11 }, { "code": "Access to healthcare", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "I've even been to Philadelphia", "context": "Patient had to travel far to see a specialist", "file_id": "dr_SE0108", "chunk_id": 12 }, { "code": "Healthcare System Support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "seen the best eye doctor in the United States", "context": "Patient has access to high-quality care", "file_id": "dr_SE0108", "chunk_id": 12 }, { "code": "Provider Relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "my eye doctor, he sent me to go ahead and get all my moles checked", "context": "Patient trusts and follows provider's recommendations", "file_id": "dr_SE0108", "chunk_id": 12 }, { "code": "Resources Access", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate insurance coverage", "quote": "they removed one", "context": "Patient has access to necessary treatments", "file_id": "dr_SE0108", "chunk_id": 12 }, { "code": "Lack of awareness", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "So if I wouldn't have had my eyes checked- ... he wouldn't have seen that and wouldn't have sent me.", "context": "Patient implies they didn't know the importance of eye checks", "file_id": "dr_SE0108", "chunk_id": 13 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "One of the best ones.", "context": "Patient expresses satisfaction with their eye doctor", "file_id": "dr_SE0108", "chunk_id": 13 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "One of the best ones.", "context": "Patient has access to a good eye doctor", "file_id": "dr_SE0108", "chunk_id": 13 }, { "code": "Regular health checks", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I get shots now in 'em every eight weeks", "context": "Patient is proactive about their eye health", "file_id": "dr_SE0108", "chunk_id": 13 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I couldn't see- ... the light in there probably", "context": "Patient seems uncertain about their condition", "file_id": "dr_SE0108", "chunk_id": 14 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "It's okay", "context": "Interviewer shows understanding and empathy", "file_id": "dr_SE0108", "chunk_id": 14 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Always had good vision, had no problems, what I mean?", "context": "Patient previously didn't see the need for regular eye checks due to good vision", "file_id": "dr_SE0108", "chunk_id": 15 }, { "code": "Perceived necessity", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I have to do it. I have to, every eight weeks they check my eyes", "context": "Patient now understands the importance of regular eye checks", "file_id": "dr_SE0108", "chunk_id": 15 }, { "code": "Regular scheduling", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "every eight weeks they check my eyes", "context": "Patient has a regular schedule for eye checks", "file_id": "dr_SE0108", "chunk_id": 15 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "they've all been excellent. I have no complaints about them at all.", "context": "Patient expresses satisfaction with healthcare providers", "file_id": "dr_SE0108", "chunk_id": 16 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "they've all been excellent. I have no complaints about them at all.", "context": "Patient implies effective communication with providers", "file_id": "dr_SE0108", "chunk_id": 16 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "they've all been excellent. I have no complaints about them at all.", "context": "Patient feels understood and supported by providers", "file_id": "dr_SE0108", "chunk_id": 16 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Well, I have no problem", "context": "Patient finds scheduling process easy", "file_id": "dr_SE0108", "chunk_id": 17 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "They ask us and then they ask us what time", "context": "Patient experiences clear communication with staff", "file_id": "dr_SE0108", "chunk_id": 17 }, { "code": "Patient navigation services", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Patient navigation services", "quote": "They say what day, what days are available", "context": "Staff assists patient with scheduling process", "file_id": "dr_SE0108", "chunk_id": 17 }, { "code": "Provider Response Time", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "they get back to us, i, I could say within an hour or so", "context": "Patient appreciates prompt response from provider", "file_id": "dr_SE0108", "chunk_id": 18 }, { "code": "Provider Availability", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Is your doctor's availability, , what does that look ? is there availability open?", "context": "Patient inquires about provider's schedule", "file_id": "dr_SE0108", "chunk_id": 18 }, { "code": "Effective Communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "they're really right up on-", "context": "Patient feels informed and supported by provider", "file_id": "dr_SE0108", "chunk_id": 18 }, { "code": "Provider System Issues", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "he's not asking nobody. He knows it already", "context": "Patient perceives provider as not communicative", "file_id": "dr_SE0108", "chunk_id": 19 }, { "code": "Healthcare System Support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "the only place that I seen that really worked different was in Philadelphia", "context": "Patient praises healthcare system in Philadelphia", "file_id": "dr_SE0108", "chunk_id": 19 }, { "code": "Effective Communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Any question she's asked was answered right now by somebody standing right there", "context": "Patient describes effective communication in Philadelphia eye hospital", "file_id": "dr_SE0108", "chunk_id": 19 }, { "code": "Short wait times", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I sat today, I bet you a minute and a half", "context": "Patient experiences short waiting time at the clinic", "file_id": "dr_SE0108", "chunk_id": 20 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "Where for when you come in here, he's not asking nobody. He knows it already", "context": "Patient feels provider is knowledgeable and communicative", "file_id": "dr_SE0108", "chunk_id": 20 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Healthcare System Support", "quote": "you come in, you stand here and tell 'em who you're seeing, you sit down and-", "context": "Patient finds the clinic process easy to navigate", "file_id": "dr_SE0108", "chunk_id": 20 }, { "code": "Short wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Wait times", "quote": "you end up sitting out there, so it's one after another. If you're on time, they're gonna be on time it seems", "context": "Patient experiences short wait times at the clinic", "file_id": "dr_SE0108", "chunk_id": 21 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "If you're on time, they're gonna be on time it seems", "context": "Patient perceives providers as accessible and punctual", "file_id": "dr_SE0108", "chunk_id": 21 }, { "code": "Effective self-care", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I always wear safety glasses- ... when I'm doing anything and , I have sunglasses in a car- ... I put on when I get out there. Then I put eyedrops in my eyes three day, three times a day.", "context": "Patient engages in effective self-care practices for eye health", "file_id": "dr_SE0108", "chunk_id": 21 }, { "code": "Fear of treatment", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I didn't put nothing in my eyeballs after that", "context": "Patient had a bad experience with eyedrops", "file_id": "dr_SE0108", "chunk_id": 22 }, { "code": "Poor adherence due to past experience", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I didn't put nothing in my eyeballs after that", "context": "Patient's past experience influences current behavior", "file_id": "dr_SE0108", "chunk_id": 22 }, { "code": "Accessible treatment", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I got it in my pocket right now", "context": "Patient has easy access to artificial tears", "file_id": "dr_SE0108", "chunk_id": 22 }, { "code": "Fear of treatment", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "it hurt so bad in the one eye that the other eye blacked out too", "context": "Patient had a bad experience with eyedrops", "file_id": "dr_SE0108", "chunk_id": 23 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I didn't pay no attention", "context": "Patient lacked knowledge about proper use of eyedrops", "file_id": "dr_SE0108", "chunk_id": 23 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "She come over and she put a drop in my eye and I shoved her all the way across the room", "context": "Patient had a bad experience due to lack of clear instructions", "file_id": "dr_SE0108", "chunk_id": 23 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "it was running an ice pick through your eye, is what it felt", "context": "Patient expresses fear of painful treatment", "file_id": "dr_SE0108", "chunk_id": 24 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I would not put anything in my eye until my eyes got bad", "context": "Patient lacks understanding of disease progression", "file_id": "dr_SE0108", "chunk_id": 24 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Chloe Hatfield: Mm. Okay.", "context": "Interviewer shows empathy and understanding", "file_id": "dr_SE0108", "chunk_id": 24 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I had to start putting eye drops in", "context": "Patient takes initiative to manage condition", "file_id": "dr_SE0108", "chunk_id": 24 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "black out the other eye because it hurts so bad", "context": "Patient expresses fear of vision loss", "file_id": "dr_SE0108", "chunk_id": 25 }, { "code": "Lack of understanding about DR progression", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "if I didn't stay on my stuff, I'll lose my eyes", "context": "Patient lacks understanding of diabetes complications", "file_id": "dr_SE0108", "chunk_id": 25 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "If I got a problem I'm gonna call him", "context": "Patient feels comfortable contacting doctor", "file_id": "dr_SE0108", "chunk_id": 25 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Your doctor only can fix what you explain is wrong", "context": "Patient values open communication with doctor", "file_id": "dr_SE0108", "chunk_id": 25 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "That's why he gets paid", "context": "Patient feels doctor is invested in their care", "file_id": "dr_SE0108", "chunk_id": 25 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "You feel he's listening to you", "context": "Patient feels heard by their doctor", "file_id": "dr_SE0108", "chunk_id": 26 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Your doctor only can fix what you explain is wrong", "context": "Patient understands importance of clear communication with doctor", "file_id": "dr_SE0108", "chunk_id": 26 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "You feel he's listening to you", "context": "Patient has a positive relationship with their doctor", "file_id": "dr_SE0108", "chunk_id": 26 }, { "code": "Lack of patient engagement", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "No. And they always, I know at least two to three times ask me during the sessions- ... Do you have any questions to ask?", "context": "Patient does not ask questions or engage with their doctor", "file_id": "dr_SE0108", "chunk_id": 26 }, { "code": "Poor patient-provider communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "No. I don't", "context": "Patient does not express preferences or concerns to their doctor", "file_id": "dr_SE0108", "chunk_id": 26 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "I don't tell them what I would prefer or what I think would be better for you when discussing care", "context": "Patient does not express preferences to provider", "file_id": "dr_SE0108", "chunk_id": 27 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "he paid his way through school and knows more about anything that's wrong than I did", "context": "Patient perceives provider as knowledgeable", "file_id": "dr_SE0108", "chunk_id": 27 }, { "code": "Patient beliefs about healthcare", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Cultural beliefs about healthcare", "quote": "I believe that he paid his way through school and knows more about anything that's wrong than I did", "context": "Patient defers to provider due to perceived expertise", "file_id": "dr_SE0108", "chunk_id": 27 }, { "code": "Lack of understanding about DR progression", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "If you don't fix it, it's gonna break all the way", "context": "Patient has limited understanding of diabetes complications", "file_id": "dr_SE0108", "chunk_id": 27 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "If you don't fix it, it's gonna break all the way", "context": "Patient lacks understanding of diabetes complications", "file_id": "dr_SE0108", "chunk_id": 28 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "If I don't pay attention to what I'm supposed to be doing-", "context": "Patient fears consequences of not managing diabetes", "file_id": "dr_SE0108", "chunk_id": 28 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "If I don't pay attention to what I'm supposed to be doing-", "context": "Patient takes responsibility for managing diabetes", "file_id": "dr_SE0108", "chunk_id": 28 }, { "code": "Positive outlook", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I'm hoping not to", "context": "Patient has positive attitude towards managing diabetes", "file_id": "dr_SE0108", "chunk_id": 28 }, { "code": "Lack of perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "I think is very good for 72 years old", "context": "Patient feels their vision is good, implying no urgent need for follow-up", "file_id": "dr_SE0108", "chunk_id": 29 }, { "code": "Education/health literacy barriers", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "I can't see any writing, writing in it sometimes", "context": "Patient may not fully understand their condition or its implications", "file_id": "dr_SE0108", "chunk_id": 29 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "What, what is that?", "context": "Patient unsure about age-related eyesight decline", "file_id": "dr_SE0108", "chunk_id": 30 }, { "code": "Education barriers", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "What, what is that?", "context": "Patient lacks understanding of medical term", "file_id": "dr_SE0108", "chunk_id": 30 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "What, what is that?", "context": "Patient shows lack of knowledge about age-related eyesight decline", "file_id": "dr_SE0108", "chunk_id": 31 }, { "code": "Family history", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "My aunt's the only one in the family besides me that had it", "context": "Patient is aware of family history of diabetes", "file_id": "dr_SE0108", "chunk_id": 31 }, { "code": "Lack of health literacy", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "What, what is that?", "context": "Patient lacks understanding of medical terms", "file_id": "dr_SE0108", "chunk_id": 31 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "My doctors seem to be-", "context": "Patient has good experience with doctors", "file_id": "dr_SE0108", "chunk_id": 32 }, { "code": "Healthcare system support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I just luck out and get a lot of good ones", "context": "Patient has access to good healthcare providers", "file_id": "dr_SE0108", "chunk_id": 32 }, { "code": "Social support networks", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "my wife worked in the eye field too", "context": "Patient has supportive spouse with healthcare knowledge", "file_id": "dr_SE0108", "chunk_id": 32 }, { "code": "Lack of education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "No, I'm one of the type people that don't go to too many classes", "context": "Patient has not participated in diabetes education", "file_id": "dr_SE0108", "chunk_id": 33 }, { "code": "Social support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "she, she yells if I didn't take my medicine", "context": "Patient has a supportive family member", "file_id": "dr_SE0108", "chunk_id": 33 }, { "code": "Health literacy barriers", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "No, I'm one of the type people that don't go to too many classes", "context": "Patient lacks engagement with educational resources", "file_id": "dr_SE0108", "chunk_id": 33 }, { "code": "Lack of education", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "No, I'm one of the type people that don't go to too many classes", "context": "Patient has not participated in diabetes education", "file_id": "dr_SE0108", "chunk_id": 34 }, { "code": "Unsupportive spouse", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Cultural beliefs about healthcare", "quote": "She explains that I'm being stupid by not doing this or taking that", "context": "Patient's spouse is not supportive of their health concerns", "file_id": "dr_SE0108", "chunk_id": 34 }, { "code": "Lack of emotional support", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "That's, that's aggravating to her", "context": "Patient feels frustrated with their spouse's response to health concerns", "file_id": "dr_SE0108", "chunk_id": 34 }, { "code": "Supportive partner", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "If I tell her I, I get, it seems a headache in my eye", "context": "Patient's spouse is somewhat responsive to their health concerns", "file_id": "dr_SE0108", "chunk_id": 34 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I could feel it start to drop, whole face dropped", "context": "Patient seems unsure about their condition", "file_id": "dr_SE0108", "chunk_id": 35 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "I said, 'For what?'", "context": "Patient was not informed about the reason for hospital visit", "file_id": "dr_SE0108", "chunk_id": 35 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I could feel it start to drop, whole face dropped", "context": "Patient seems unsure about their condition", "file_id": "dr_SE0108", "chunk_id": 36 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "It, it really doesn't right now", "context": "Patient does not feel their eyesight is currently limiting", "file_id": "dr_SE0108", "chunk_id": 36 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "I couldn't see to drive or anything for three months", "context": "Patient experienced vision loss affecting daily activities", "file_id": "dr_SE0108", "chunk_id": 37 }, { "code": "Social support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "No, my wife, I drove for a lot of years and I think she was forgetting how to drive", "context": "Patient has a supportive spouse", "file_id": "dr_SE0108", "chunk_id": 37 }, { "code": "Adaptation strategies", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "so I'm gonna put her back into condition to drive", "context": "Patient finds alternative solutions with spouse's help", "file_id": "dr_SE0108", "chunk_id": 37 }, { "code": "Fear of treatment", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I'm going home, my eyes are hurting.", "context": "Patient expresses fear or reluctance towards eye treatment", "file_id": "dr_SE0108", "chunk_id": 38 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Pain in my eyes", "context": "Patient seems to lack understanding of their condition, focusing on immediate symptoms", "file_id": "dr_SE0108", "chunk_id": 38 }, { "code": "Emotional distress", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "I'm going home, my eyes are hurting.", "context": "Patient expresses emotional distress due to eye pain", "file_id": "dr_SE0108", "chunk_id": 38 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "There ain't a way in hell I'm going", "context": "Patient expresses fear or reluctance to attend follow-up appointment", "file_id": "dr_SE0108", "chunk_id": 39 }, { "code": "Lack of understanding about DR progression", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I can see a big black spot right about here", "context": "Patient lacks understanding of their condition and its progression", "file_id": "dr_SE0108", "chunk_id": 39 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "everybody that we've dealt with", "context": "Patient expresses satisfaction with healthcare providers", "file_id": "dr_SE0108", "chunk_id": 39 }, { "code": "Excellent providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "everybody that we've dealt with have been right on their toes, right on the mark and are, are excellent people", "context": "Patient praises healthcare providers", "file_id": "dr_SE0108", "chunk_id": 40 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "everybody that we've dealt with have been right on their toes, right on the mark and are, are excellent people", "context": "Patient has positive experience with providers", "file_id": "dr_SE0108", "chunk_id": 40 }, { "code": "Excellent staff", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "The people there were excellent", "context": "Patient praises hospital staff", "file_id": "dr_SE0108", "chunk_id": 41 }, { "code": "Positive experience", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "Everybody in the hospital was excellent", "context": "Patient has good luck with hospitals", "file_id": "dr_SE0108", "chunk_id": 41 }, { "code": "Lack of continuity of care", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "everybody looked and says, 'Hey, it's pretty good.' The person who was gonna gimme the drugs come in and says, 'No, we're not having that today.'", "context": "Patient experiences inconsistent care from different providers", "file_id": "dr_SE0108", "chunk_id": 42 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "That's somebody looking out for me", "context": "Patient feels cared for by provider", "file_id": "dr_SE0108", "chunk_id": 42 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "She says, 'We don't know the reaction to your bell palsy and what's going on with your system right now'", "context": "Patient receives clear explanation from provider", "file_id": "dr_SE0108", "chunk_id": 42 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "That's somebody looking out for me.", "context": "Patient feels supported by healthcare provider", "file_id": "dr_SE0108", "chunk_id": 43 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "So the people here have really been good.", "context": "Patient appreciates clear communication from providers", "file_id": "dr_SE0108", "chunk_id": 43 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "I don't wanna make you worse.", "context": "Patient feels understood and cared for by provider", "file_id": "dr_SE0108", "chunk_id": 43 }, { "code": "Staying active", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "you have to stay active, , to keep the blood sugar--", "context": "Patient emphasizes importance of physical activity for diabetes management", "file_id": "dr_TS1008(part1)", "chunk_id": 0 }, { "code": "Positive attitude", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "just stay positive of whatever you do", "context": "Patient recognizes the importance of a positive mindset in managing diabetes", "file_id": "dr_TS1008(part1)", "chunk_id": 0 }, { "code": "Depression anxiety", "category": "BARRIER - Emotional/Psychological", "subcategory": "Depression/anxiety", "quote": "try not to let, , my eye situation get me, , , in the de-- , depressed stage", "context": "Patient acknowledges the risk of depression due to their eye condition", "file_id": "dr_TS1008(part1)", "chunk_id": 0 }, { "code": "Depression anxiety", "category": "BARRIER - Emotional/Psychological", "subcategory": "Depression/anxiety", "quote": "try not to let, , my eye situation get me, , , in the de-- , depressed stage", "context": "Patient mentions avoiding depression due to eye condition", "file_id": "dr_TS1008(part1)", "chunk_id": 1 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "if my eye vision get-- , gets a little worse", "context": "Patient lacks clear understanding of disease progression", "file_id": "dr_TS1008(part1)", "chunk_id": 1 }, { "code": "Positive attitude", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "just stay positive of whatever you do", "context": "Patient emphasizes importance of staying positive", "file_id": "dr_TS1008(part1)", "chunk_id": 1 }, { "code": "Self management", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "you have to stay active, , to keep the blood sugar--", "context": "Patient prioritizes self-management of diabetes", "file_id": "dr_TS1008(part1)", "chunk_id": 1 }, { "code": "Awareness of changes", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "that's when, , you have to be aware of, , of the changes of your everyday routine", "context": "Patient recognizes importance of monitoring health changes", "file_id": "dr_TS1008(part1)", "chunk_id": 1 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "", "context": "No direct quote, but implied by the context that patient may not fully understand their condition", "file_id": "dr_WD0321", "chunk_id": 2 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "", "context": "No direct quote, but fear is a common barrier in similar contexts", "file_id": "dr_WD0321", "chunk_id": 2 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "", "context": "No direct quote, interview chunk does not provide sufficient information", "file_id": "dr_WD0321", "chunk_id": 2 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "mostly it's about portion control in eating and eating on a regular schedule", "context": "Patient understands importance of diet control", "file_id": "dr_LR0314", "chunk_id": 2 }, { "code": "Self management", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "Just keeping weight off and trying to get some exercise and eating", "context": "Patient takes proactive approach to managing diabetes", "file_id": "dr_LR0314", "chunk_id": 2 }, { "code": "Health literacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I look at wounds", "context": "Patient is aware of signs of worsening diabetes", "file_id": "dr_LR0314", "chunk_id": 2 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I'm not so sure it has", "context": "Patient unsure about diabetes impact on eyes", "file_id": "dr_LR0314", "chunk_id": 3 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "I'm not so sure it has", "context": "Patient does not perceive diabetes as affecting their eyes", "file_id": "dr_LR0314", "chunk_id": 3 }, { "code": "Self monitoring", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I look at wounds", "context": "Patient actively monitors their health", "file_id": "dr_LR0314", "chunk_id": 3 }, { "code": "Health awareness", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I check my feet every day", "context": "Patient takes proactive steps to manage their diabetes", "file_id": "dr_LR0314", "chunk_id": 3 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I'm not so sure it has", "context": "Patient unsure about diabetes effect on eyes", "file_id": "dr_LR0314", "chunk_id": 4 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "I'm not so sure it has", "context": "Patient does not perceive diabetes as affecting eyesight", "file_id": "dr_LR0314", "chunk_id": 4 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Right here at the I- WVU Eye Institute", "context": "Patient has access to local eye care services", "file_id": "dr_LR0314", "chunk_id": 4 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "the retinal issues, but not, not recently", "context": "Patient has received some education about retinal issues", "file_id": "dr_LR0314", "chunk_id": 4 }, { "code": "Lack of mention", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "well, today I had my fields test, which is the flashing lights to see- ... how your peripheral vil- v- vision is.", "context": "Patient seems to understand the procedure but doesn't explicitly mention their understanding of DR progression", "file_id": "dr_LR0314", "chunk_id": 5 }, { "code": "Regular check-ups", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "so they check that on regularly", "context": "Patient receives regular check-ups for their eye condition", "file_id": "dr_LR0314", "chunk_id": 5 }, { "code": "Medication adherence", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "in the morning and the evening", "context": "Patient is able to manage their medication regimen", "file_id": "dr_LR0314", "chunk_id": 5 }, { "code": "Lack of perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "I had cataract surgery, I have new lenses, so it's pretty stable now", "context": "Patient feels their condition is stable", "file_id": "dr_LR0314", "chunk_id": 6 }, { "code": "Easy scheduling process", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Oh, absolutely. Quite easy", "context": "Patient finds scheduling appointments easy", "file_id": "dr_LR0314", "chunk_id": 6 }, { "code": "Adequate provider availability", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "Yeah, his availability is adequate for me", "context": "Patient feels their doctor's availability meets their needs", "file_id": "dr_LR0314", "chunk_id": 6 }, { "code": "Lack of understanding about DR progression", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't know at this point because I had cataract surgery, I have new lenses, so it's pretty stable now", "context": "Patient lacks understanding of their condition", "file_id": "dr_LR0314", "chunk_id": 6 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "And I sat for an hour today, close to an hour waiting for him", "context": "Patient experiences long wait time to see doctor", "file_id": "dr_LR0314", "chunk_id": 7 }, { "code": "Appointment scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "I schedule my appointments around his open calendar", "context": "Patient has to work around doctor's availability for scheduling", "file_id": "dr_LR0314", "chunk_id": 7 }, { "code": "Lack of continuity of care", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "Spread thin here at the hospital", "context": "Patient implies that doctor may be overworked or unavailable", "file_id": "dr_LR0314", "chunk_id": 7 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Healthcare System Support", "quote": "his availability is adequate for me", "context": "Patient feels that doctor's availability meets their needs", "file_id": "dr_LR0314", "chunk_id": 7 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "At least 30 minutes generally", "context": "Patient experiences long wait times", "file_id": "dr_LR0314", "chunk_id": 8 }, { "code": "Scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "it's just scheduling around my work schedule", "context": "Patient has difficulty scheduling appointments around work", "file_id": "dr_LR0314", "chunk_id": 8 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "the script went south on me", "context": "Patient had issues with prescription, possibly due to lack of access", "file_id": "dr_LR0314", "chunk_id": 9 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "the script went south on me", "context": "Patient implies financial issue with prescription", "file_id": "dr_LR0314", "chunk_id": 9 }, { "code": "Lack of health education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I haven't ... I used to wear 'em freq- all the time, but now I've just gotten grown used to not wearing sunglasses", "context": "Patient lacks knowledge about eye protection", "file_id": "dr_LR0314", "chunk_id": 10 }, { "code": "No supplements taken", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "No", "context": "Patient does not take vitamins for eye health", "file_id": "dr_LR0314", "chunk_id": 10 }, { "code": "Inadequate eye rest", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "not directly", "context": "Patient does not prioritize eye rest", "file_id": "dr_LR0314", "chunk_id": 10 }, { "code": "Accessible work environment", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I'm working with papers and then, and typing and-", "context": "Patient has flexible work setup", "file_id": "dr_LR0314", "chunk_id": 10 }, { "code": "Eye care routine", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "So it seems the one thing you really emphasize for your eyecare is eyedrops", "context": "Patient has established eye care habit", "file_id": "dr_LR0314", "chunk_id": 10 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "we talked about it. But, , Dr. Palko is the, the cataract guy, so-", "context": "Patient seems unclear about their doctor's role in diabetes care", "file_id": "dr_LR0314", "chunk_id": 11 }, { "code": "Provider expertise", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Dr. Palko is the, the cataract guy", "context": "Patient acknowledges doctor's specialization", "file_id": "dr_LR0314", "chunk_id": 11 }, { "code": "Urgency to act", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "He, he said, 'You need to do this sooner than later.'", "context": "Doctor's advice prompted patient to take action", "file_id": "dr_LR0314", "chunk_id": 11 }, { "code": "Discomfort discussing issues", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "Not at all. I mean, I mean, I don't have any problems with-", "context": "Patient feels uncomfortable talking about diabetes-related eye problems", "file_id": "dr_LR0314", "chunk_id": 11 }, { "code": "Lack of questions", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Sometimes", "context": "Patient does not always ask questions to their doctor", "file_id": "dr_LR0314", "chunk_id": 12 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I feel comfortable with my doctors", "context": "Patient feels at ease with their healthcare providers", "file_id": "dr_LR0314", "chunk_id": 12 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "we talked about the glasses and the-", "context": "Patient and provider engage in open discussion", "file_id": "dr_LR0314", "chunk_id": 12 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I thought there’s extremely good care here at the Eye Institute", "context": "Patient expresses satisfaction with care received", "file_id": "dr_LR0314", "chunk_id": 13 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "we- ... talked about the glasses and the- ... progressive lenses that I use", "context": "Patient discusses conversation with doctor about treatment", "file_id": "dr_LR0314", "chunk_id": 13 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "Dr. ... in his opinion, larger's better or taller's better with progressives", "context": "Doctor provides personalized advice to patient", "file_id": "dr_LR0314", "chunk_id": 13 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't think it is a risk at this point", "context": "Patient underestimates diabetes risk", "file_id": "dr_LR0314", "chunk_id": 14 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "I don't think it is a risk at this point", "context": "Patient feels no immediate need for follow-up", "file_id": "dr_LR0314", "chunk_id": 14 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I thought there's extremely good care here at the Eye Institute", "context": "Patient has trust in healthcare providers", "file_id": "dr_LR0314", "chunk_id": 14 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "do the things I'm supposed to do to be a good diabetic person", "context": "Patient has knowledge of self-care", "file_id": "dr_LR0314", "chunk_id": 14 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't, I really don't know", "context": "Patient unsure about diabetes impact on eyesight", "file_id": "dr_LR0314", "chunk_id": 15 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "It's very good", "context": "Patient feels current vision is fine, no need to worry", "file_id": "dr_LR0314", "chunk_id": 15 }, { "code": "Avoidance due to fear", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I don't want- ... to worry about it so I don't think about it", "context": "Patient avoids thinking about potential vision loss due to fear", "file_id": "dr_LR0314", "chunk_id": 15 }, { "code": "Lack of mention", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Just going from a world of mud to a world of color", "context": "Patient discusses improvement in vision but not follow-up", "file_id": "dr_LR0314", "chunk_id": 16 }, { "code": "Work environment", "category": "BARRIER - Social Determinants of Health (SDOH)", "subcategory": "Education/health literacy barriers", "quote": "I work in an archives and I work with old papers", "context": "Patient's job may expose them to dust, potentially irritating eyes", "file_id": "dr_LR0314", "chunk_id": 16 }, { "code": "No codes directly", "category": "NO BARRIER OR FACILITATOR", "subcategory": "None", "quote": "Get dust and things or out in the yard maybe", "context": "Patient discusses potential eye irritants but not follow-up", "file_id": "dr_LR0314", "chunk_id": 16 }, { "code": "Physician communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Physicians here are very good", "context": "Patient praises physician communication", "file_id": "dr_LR0314", "chunk_id": 17 }, { "code": "Patient motivation", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "well, I'm motivated", "context": "Patient self-reports being motivated for healthcare", "file_id": "dr_LR0314", "chunk_id": 17 }, { "code": "Self motivation", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Self-motivation- ... is one of 'em", "context": "Patient mentions self-motivation as a factor for follow-up adherence", "file_id": "dr_LR0314", "chunk_id": 18 }, { "code": "Family support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "I wanna be around my, for my wife and be able-", "context": "Patient mentions family as a motivator for follow-up adherence", "file_id": "dr_LR0314", "chunk_id": 18 }, { "code": "Positive attitude", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "Just something I have to do and-", "context": "Patient shows a positive attitude towards follow-up appointments", "file_id": "dr_LR0314", "chunk_id": 18 }, { "code": "Good provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "Physicians here are very good", "context": "Patient mentions good provider relationship as a facilitator", "file_id": "dr_LR0314", "chunk_id": 18 }, { "code": "Positive experience", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I think it's all positive, due to the quality of the care here", "context": "Patient has a positive experience with healthcare services", "file_id": "dr_LR0314", "chunk_id": 19 }, { "code": "Quality of care", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "the quality of the care here", "context": "Patient appreciates the high-quality care at the Eye Institute", "file_id": "dr_LR0314", "chunk_id": 19 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I think it's all positive, due to the quality of the care here", "context": "Patient implies a positive relationship with providers", "file_id": "dr_LR0314", "chunk_id": 19 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "the MyChart thing is really great because", "context": "Patient finds online portal helpful", "file_id": "dr_LR0314", "chunk_id": 20 }, { "code": "Reminder systems", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "Puts it, sends it to your phone and", "context": "Patient appreciates electronic reminders", "file_id": "dr_LR0314", "chunk_id": 20 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "they could stop the billing", "context": "Patient is frustrated with billing process", "file_id": "dr_LR0314", "chunk_id": 20 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "Stop billing me for stuff", "context": "Patient is concerned about being billed", "file_id": "dr_LR0314", "chunk_id": 21 }, { "code": "Self motivation", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I'm pretty well- self-motivated", "context": "Patient takes initiative in managing diabetes", "file_id": "dr_LR0314", "chunk_id": 21 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "doctor told me, ask- every time he asked me, well, your AC- A1c is good, you don't need to worry about that", "context": "Patient lacks understanding of diabetes management", "file_id": "dr_LR0314", "chunk_id": 22 }, { "code": "Fear of procedure", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "No, no one wants to prick their finger", "context": "Patient fears blood sugar monitoring", "file_id": "dr_LR0314", "chunk_id": 22 }, { "code": "Spousal support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "My wife is there if I need some help", "context": "Patient has supportive spouse for daily care", "file_id": "dr_LR0314", "chunk_id": 22 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I participated in a diabetes education class", "context": "Patient attended diabetes education session", "file_id": "dr_LR0314", "chunk_id": 23 }, { "code": "Diabetes self-management support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "they gave you pamphlets and a couple cookbooks", "context": "Patient received educational materials for self-management", "file_id": "dr_LR0314", "chunk_id": 23 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "they gave you- pamphlets and a couple cookbooks", "context": "Patient received educational materials", "file_id": "dr_LR0314", "chunk_id": 24 }, { "code": "Social support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "My wife is- best friend", "context": "Patient has a supportive spouse", "file_id": "dr_LR0314", "chunk_id": 24 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I have reached out through MyChart to the hospital", "context": "Patient can easily contact healthcare providers", "file_id": "dr_LR0314", "chunk_id": 24 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Pretty quick response", "context": "Patient experiences timely communication from nursing staff", "file_id": "dr_LR0314", "chunk_id": 24 }, { "code": "Helpful staff", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "And helpful.", "context": "Patient finds nursing staff responsive", "file_id": "dr_LR0314", "chunk_id": 25 }, { "code": "Positive expectations", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "just to get, make sure my pressures are where he wants them to be.", "context": "Patient has clear understanding of visit goals", "file_id": "dr_LR0314", "chunk_id": 25 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "if you're not everyone can come to this Eye Institute", "context": "Patient mentions limited access to the Eye Institute", "file_id": "dr_LR0314", "chunk_id": 26 }, { "code": "Poor care elsewhere", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of continuity of care", "quote": "I don't think that they do the dilation that they should when, when you go to the-", "context": "Patient expresses concern about quality of care at other facilities", "file_id": "dr_LR0314", "chunk_id": 26 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "being a diabetic is my entrée into the hospital", "context": "Patient has access to hospital care due to diabetes", "file_id": "dr_LR0314", "chunk_id": 26 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "it's a long haul to get here", "context": "Patient mentions distance as a challenge", "file_id": "dr_LR0314", "chunk_id": 27 }, { "code": "Lack of access to healthcare", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "I wish there was more satellite institutes or something", "context": "Patient expresses desire for more accessible care options", "file_id": "dr_LR0314", "chunk_id": 27 }, { "code": "Accessible providers", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "1. Healthcare System Support", "quote": "I wish there was more satellite institutes or something", "context": "Patient suggests having more providers in different locations would be helpful", "file_id": "dr_LR0314", "chunk_id": 27 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "what I could see, , a month ago, , I'm having problems, , seeing it now", "context": "Patient expresses uncertainty about their condition", "file_id": "dr_TS1008(part2)", "chunk_id": 0 }, { "code": "Provider communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Dr. G. told me that, , my eye is swelling a little bit", "context": "Patient mentions provider's clear explanation", "file_id": "dr_TS1008(part2)", "chunk_id": 0 }, { "code": "Treatment adherence", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "he told me to, , to put in an extra drop of, , steroids with the--", "context": "Patient understands and follows treatment instructions", "file_id": "dr_TS1008(part2)", "chunk_id": 0 }, { "code": "Healthcare support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Dr. G. told me that, , my eye is swelling a little bit", "context": "Patient has access to a provider for guidance", "file_id": "dr_TS1008(part2)", "chunk_id": 0 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I didn't know", "context": "Patient unaware of changes in their eyes", "file_id": "dr_TS1008(part2)", "chunk_id": 1 }, { "code": "Lack of cure", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "they do not have a cure for glaucoma", "context": "Patient's understanding of their condition", "file_id": "dr_TS1008(part2)", "chunk_id": 2 }, { "code": "Reliance on treatment", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "the only thing I have to, , rely on is the, the eye drops", "context": "Patient's reliance on medication", "file_id": "dr_TS1008(part2)", "chunk_id": 2 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Here. S1: 01:51 You just-- you do them here? S2: 01:53 Yes", "context": "Patient's access to care", "file_id": "dr_TS1008(part2)", "chunk_id": 2 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "I always come here", "context": "Patient implies limited options for healthcare", "file_id": "dr_TS1008(part2)", "chunk_id": 3 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Mike-- he'd give me some eye drops and he'll take my pressure", "context": "Patient has a familiar and accessible provider", "file_id": "dr_TS1008(part2)", "chunk_id": 3 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "Mike-- he'd give me some eye drops and he'll take my pressure", "context": "Patient seems to have a positive relationship with provider Mike", "file_id": "dr_TS1008(part2)", "chunk_id": 3 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Oh, , I don't know. Every, every four to six months, I think.", "context": "Patient unsure about recommended follow-up frequency", "file_id": "dr_TS1008(part2)", "chunk_id": 4 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "Mike-- he'd give me some eye drops and he'll take my pressure.", "context": "Patient mentions provider by name, indicating familiarity and comfort", "file_id": "dr_TS1008(part2)", "chunk_id": 4 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "And they look, , behind my, , my eye--", "context": "Patient describes prompt and thorough care from providers", "file_id": "dr_TS1008(part2)", "chunk_id": 4 }, { "code": "Morning Availability", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "As long have them done in the morning, it's good", "context": "Patient prefers morning appointments", "file_id": "dr_TS1008(part2)", "chunk_id": 5 }, { "code": "Flexible Scheduling", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Appointment scheduling difficulties", "quote": "if they're available in the morning, that's good", "context": "Patient appreciates flexible scheduling options", "file_id": "dr_TS1008(part2)", "chunk_id": 5 }, { "code": "Provider Accommodation", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I'm grateful for that", "context": "Patient feels accommodated by provider", "file_id": "dr_TS1008(part2)", "chunk_id": 5 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "Probably getting here.", "context": "Patient mentions difficulty in receiving eye care due to transportation", "file_id": "dr_TS1008(part2)", "chunk_id": 6 }, { "code": "Transportation assistance", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "4. Resources & Access", "quote": "my sister-- she makes the, , travel arrangements for me.", "context": "Patient has family support for transportation to clinic", "file_id": "dr_TS1008(part2)", "chunk_id": 6 }, { "code": "Appointment scheduling difficulties", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "3. Provider/System Issues", "quote": "if they're available in the morning, that's good. And-- but if I have to do them in the afternoon, then, , hey, I just gotta do what they say--", "context": "Patient has limited control over appointment scheduling", "file_id": "dr_TS1008(part2)", "chunk_id": 6 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "depends on how many cars they got on the road, who, who they can afford, -- to let loose to come to Morgantown", "context": "Patient discusses transportation challenges", "file_id": "dr_TS1008(part2)", "chunk_id": 7 }, { "code": "Positive patient-provider relationship", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "2. Provider Relationship", "quote": "she's, she's, she's pretty nice", "context": "Patient praises provider's demeanor", "file_id": "dr_TS1008(part2)", "chunk_id": 7 }, { "code": "Accessible providers", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "1. Healthcare System Support", "quote": "So she got me there in no time", "context": "Patient appreciates provider's efficiency", "file_id": "dr_TS1008(part2)", "chunk_id": 7 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "hopefully, things will turn out for the better down the line", "context": "Patient seems uncertain about disease progression", "file_id": "dr_TS1008(part2)", "chunk_id": 8 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I try to keep the lights, dim", "context": "Patient takes initiative to protect eyes", "file_id": "dr_TS1008(part2)", "chunk_id": 8 }, { "code": "Self care practices", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I take naps in the afternoon sometime", "context": "Patient prioritizes rest for eye health", "file_id": "dr_TS1008(part2)", "chunk_id": 8 }, { "code": "Adherence to treatment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I take one-- the steroid drop one time", "context": "Patient follows medication regimen", "file_id": "dr_TS1008(part2)", "chunk_id": 8 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I-- , I s-- , all I know is that my mom had it and, --", "context": "Patient lacks knowledge about diabetic retinopathy", "file_id": "dr_TS1008(part2)", "chunk_id": 9 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "they just told me that there's no cure for glaucoma, and whoever, , have glaucoma, , if you don't take care of it, , , , you can go blind", "context": "Patient fears losing vision due to diabetes", "file_id": "dr_TS1008(part2)", "chunk_id": 9 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "Oh, I feel good", "context": "Patient feels comfortable talking to doctor", "file_id": "dr_TS1008(part2)", "chunk_id": 9 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "they just told me that there's no cure for glaucoma, and whoever, , have glaucoma, , if you don't take care of it, , , , you can go blind", "context": "Patient receives information about eye condition", "file_id": "dr_TS1008(part2)", "chunk_id": 9 }, { "code": "Motivation to care", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "So I wanna take care of my eyes--", "context": "Patient wants to manage eye health", "file_id": "dr_TS1008(part2)", "chunk_id": 9 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "I feel good", "context": "Patient feels comfortable talking to doctor", "file_id": "dr_TS1008(part2)", "chunk_id": 10 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "You have to know all the information", "context": "Patient values open communication with doctor", "file_id": "dr_TS1008(part2)", "chunk_id": 10 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "You have to know all the information", "context": "Patient recognizes importance of being informed", "file_id": "dr_TS1008(part2)", "chunk_id": 10 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "So you can't keep nothing away", "context": "Patient takes active role in healthcare", "file_id": "dr_TS1008(part2)", "chunk_id": 10 }, { "code": "Lack of control", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Patient beliefs", "quote": "I don't have no control over that", "context": "Patient feels powerless over diabetes progression", "file_id": "dr_TS1008(part2)", "chunk_id": 11 }, { "code": "Acceptance", "category": "BARRIER - Emotional/Psychological", "subcategory": "Diabetes distress", "quote": "whatever happens, happens", "context": "Patient shows resignation to potential vision loss", "file_id": "dr_TS1008(part2)", "chunk_id": 11 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider communication", "quote": "They explain it to me", "context": "Patient appreciates clear explanations from providers", "file_id": "dr_TS1008(part2)", "chunk_id": 11 }, { "code": "Patient comfort", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "I feel comfortable with that", "context": "Patient feels at ease with provider-patient interaction", "file_id": "dr_TS1008(part2)", "chunk_id": 11 }, { "code": "Lack of urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "I can still see a little bit", "context": "Patient feels they can still see and may not prioritize follow-ups", "file_id": "dr_TS1008(part2)", "chunk_id": 12 }, { "code": "Family health history", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "My mom had glaucoma", "context": "Patient's family health history may motivate them to attend follow-ups", "file_id": "dr_TS1008(part2)", "chunk_id": 12 }, { "code": "Acceptance of condition", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "It's something that has to be done", "context": "Patient accepts their condition and the need for follow-ups", "file_id": "dr_TS1008(part2)", "chunk_id": 12 }, { "code": "Resignation to treatment", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "I just gotta deal with whatever comes", "context": "Patient feels overwhelmed and resigned to their treatment", "file_id": "dr_TS1008(part2)", "chunk_id": 12 }, { "code": "Need for help", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I need-- I need their help", "context": "Patient recognizes the importance of healthcare provider's assistance", "file_id": "dr_TS1008(part2)", "chunk_id": 13 }, { "code": "Dependence on providers", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "the only ones I know that can, , help my situation", "context": "Patient relies on healthcare providers for support", "file_id": "dr_TS1008(part2)", "chunk_id": 13 }, { "code": "Willpower", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "Willpower", "context": "Patient attributes their adherence to personal motivation", "file_id": "dr_TS1008(part2)", "chunk_id": 13 }, { "code": "Fear of poor outcome", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "when I don't get it right, I'll be, , down", "context": "Patient experiences emotional distress when considering potential negative outcomes", "file_id": "dr_TS1008(part2)", "chunk_id": 13 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "on the outside looking in", "context": "Patient feels uninformed about their condition", "file_id": "dr_TS1008(part2)", "chunk_id": 14 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Give them every knowledge that", "context": "Patient suggests providing education to improve care experience", "file_id": "dr_TS1008(part2)", "chunk_id": 14 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "make them feel comfortable", "context": "Patient values empathetic providers for better care experience", "file_id": "dr_TS1008(part2)", "chunk_id": 14 }, { "code": "Social support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "the nurse who comes in", "context": "Patient receives support from a home nurse", "file_id": "dr_TS1008(part2)", "chunk_id": 14 }, { "code": "Social Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "My friends and family", "context": "Patient has people to share worries with", "file_id": "dr_TS1008(part2)", "chunk_id": 15 }, { "code": "Health Education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I participated in an education class for diabetes", "context": "Patient received diabetes education", "file_id": "dr_TS1008(part2)", "chunk_id": 15 }, { "code": "Accessible Providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "the nurse who comes in. Miss Theresa", "context": "Patient has access to a helpful nurse", "file_id": "dr_TS1008(part2)", "chunk_id": 15 }, { "code": "Supportive Network", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "Brian. Theresa", "context": "Patient has people to call for advice", "file_id": "dr_TS1008(part2)", "chunk_id": 15 }, { "code": "Social Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "Brian. Theresa. Mark. John.", "context": "Patient mentions having people to call for advice", "file_id": "dr_TS1008(part2)", "chunk_id": 16 }, { "code": "Health Education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "getting all the knowledge that I can", "context": "Patient expects to gain knowledge from visit", "file_id": "dr_TS1008(part2)", "chunk_id": 16 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I just pray, , each night, and when I wake up in the morning, I see a little bit better than--", "context": "Patient lacks understanding of their condition", "file_id": "dr_TS1008(part2)", "chunk_id": 17 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "getting all the knowledge that I can", "context": "Patient seeks health education", "file_id": "dr_TS1008(part2)", "chunk_id": 17 }, { "code": "Lack of problems", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "No problems", "context": "Patient reports ease with managing diabetes", "file_id": "dr_RC0426", "chunk_id": 0 }, { "code": "Effective self management", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "Keeping it under control", "context": "Patient prioritizes controlling diabetes", "file_id": "dr_RC0426", "chunk_id": 0 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "watching what I eat", "context": "Patient learned to manage diet", "file_id": "dr_RC0426", "chunk_id": 0 }, { "code": "Social support", "category": "FACILITATOR - Resources & Access", "subcategory": "Social support networks", "quote": "they put me to watch my sodium", "context": "Patient received guidance from healthcare providers", "file_id": "dr_RC0426", "chunk_id": 0 }, { "code": "Access to care", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I was in the hospital a couple of months ago", "context": "Patient has access to hospital care", "file_id": "dr_RC0426", "chunk_id": 0 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Just keep my eye appointments and watch-- mainly, it's just he has to watch the fluid and the blood in the eyes, I guess", "context": "Patient seems uncertain about doctor's instructions", "file_id": "dr_RC0426", "chunk_id": 1 }, { "code": "Provider instruction", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Just keep my eye appointments and watch-- mainly, it's just he has to watch the fluid and the blood in the eyes, I guess", "context": "Doctor provides clear instructions for patient care", "file_id": "dr_RC0426", "chunk_id": 1 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Watch your sugar, watch what you eat, , exercise", "context": "Doctor educates patient on diabetes management", "file_id": "dr_RC0426", "chunk_id": 1 }, { "code": "Patient engagement", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "And that has been the biggest help. ... Yeah, because I've lost 30-some pounds", "context": "Patient takes active role in managing diabetes", "file_id": "dr_RC0426", "chunk_id": 1 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Not really", "context": "Patient lacks detailed information about diabetes effects on eyes", "file_id": "dr_RC0426", "chunk_id": 2 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "Not really", "context": "Doctors did not elaborate on diabetes effects on eyes", "file_id": "dr_RC0426", "chunk_id": 2 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Here at the Eye Institute", "context": "Patient has access to eye care services at the institute", "file_id": "dr_RC0426", "chunk_id": 2 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Here at the Eye Institute", "context": "Patient mentions getting eye exams at a specific institute, implying accessibility", "file_id": "dr_RC0426", "chunk_id": 3 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "and then he'll look at them too", "context": "Patient describes a clear process of examination and communication with the doctor", "file_id": "dr_RC0426", "chunk_id": 3 }, { "code": "Reminder systems", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "he's been bringing me back every", "context": "Patient mentions a schedule for follow-up appointments, implying a reminder system", "file_id": "dr_RC0426", "chunk_id": 3 }, { "code": "Patient navigation services", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Patient navigation services", "quote": "the little guy checks you-- whoever brings you back there", "context": "Patient describes being guided through the examination process by staff", "file_id": "dr_RC0426", "chunk_id": 3 }, { "code": "No Transportation Issues", "category": "BARRIER - SDOH", "subcategory": "Transportation issues", "quote": "No", "context": "Patient does not experience transportation problems", "file_id": "dr_RC0426", "chunk_id": 4 }, { "code": "No Scheduling Difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "No. I've never had a problem with that.", "context": "Patient does not have issues with scheduling appointments", "file_id": "dr_RC0426", "chunk_id": 4 }, { "code": "Accessible Providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "No. I've never had a problem with that.", "context": "Patient finds it easy to schedule appointments, implying accessible providers", "file_id": "dr_RC0426", "chunk_id": 4 }, { "code": "Good Doctor Availability", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "So your doctor's availability has been good? You're able to-- no issues with scheduling? S2: 04:43 No.", "context": "Patient experiences good availability of doctors for appointments", "file_id": "dr_RC0426", "chunk_id": 4 }, { "code": "No challenges", "category": "BARRIER - None", "subcategory": "None", "quote": "I don't think so.", "context": "Patient reports no challenges in receiving eye care", "file_id": "dr_RC0426", "chunk_id": 5 }, { "code": "Diabetes management challenge", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "being off of it, being good with it, and then not caring sometimes.", "context": "Patient struggles with managing diabetes", "file_id": "dr_RC0426", "chunk_id": 5 }, { "code": "Positive experience", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I think they do pretty good.", "context": "Patient is satisfied with their eye care experience", "file_id": "dr_RC0426", "chunk_id": 5 }, { "code": "Adherence to treatment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I do those.", "context": "Patient adheres to prescribed eye drop treatment", "file_id": "dr_RC0426", "chunk_id": 5 }, { "code": "Self care", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I do multivitamins.", "context": "Patient takes supplements for their health", "file_id": "dr_RC0426", "chunk_id": 5 }, { "code": "Lack of education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "I do multivitamins", "context": "Patient lacks understanding of proper eye care", "file_id": "dr_RC0426", "chunk_id": 6 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "My eyes don't get tired by the time you're done", "context": "Patient does not feel need to prioritize eye care", "file_id": "dr_RC0426", "chunk_id": 6 }, { "code": "Accessible treatment", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I use that", "context": "Patient has access to necessary medication for dry eyes", "file_id": "dr_RC0426", "chunk_id": 6 }, { "code": "Health literacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "Just the drops I'm supposed to take, the ketorola-ketorolac", "context": "Patient understands and follows medication instructions", "file_id": "dr_RC0426", "chunk_id": 6 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't know exactly", "context": "Patient lacks knowledge about diabetes-related eye problems", "file_id": "dr_RC0426", "chunk_id": 7 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "Just the fear of it getting worse", "context": "Patient expresses fear about disease progression", "file_id": "dr_RC0426", "chunk_id": 7 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "None. Yeah. S1: 07:57 Oh, you're very comfortable, so no problems? S2: 08:00 Yeah", "context": "Patient feels comfortable discussing concerns with eye doctor", "file_id": "dr_RC0426", "chunk_id": 7 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "if you don't watch your sugars and you don't watch what you eat, it could be very bad", "context": "Patient has some knowledge about diabetes management", "file_id": "dr_RC0426", "chunk_id": 7 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "Just the fear of it getting worse", "context": "Patient expresses fear about DR progression", "file_id": "dr_RC0426", "chunk_id": 8 }, { "code": "Lack of patient-provider communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "I don't think I usually ask any questions", "context": "Patient rarely asks questions to provider", "file_id": "dr_RC0426", "chunk_id": 8 }, { "code": "Limited health literacy", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "if there's-- if he doesn't tell me, I'll ask if there is fluid buildup or whatever", "context": "Patient lacks knowledge about DR and relies on provider for information", "file_id": "dr_RC0426", "chunk_id": 8 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I'm pretty comfortable with too, so I don't think I'd have trouble talking to her about anything", "context": "Patient feels comfortable with diabetes doctor", "file_id": "dr_RC0426", "chunk_id": 8 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "they tell me everything I should be doing", "context": "Patient feels supported by providers' guidance", "file_id": "dr_RC0426", "chunk_id": 8 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I guess because of how much I guess I've gone down with that over the years since I've had it", "context": "Patient lacks clear understanding of diabetes impact on vision", "file_id": "dr_RC0426", "chunk_id": 9 }, { "code": "Perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now' (no perceived urgency)", "quote": "Now I would say not very likely", "context": "Patient feels less urgent about vision loss due to current condition", "file_id": "dr_RC0426", "chunk_id": 9 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "since you've made the changes, you feel that?", "context": "Patient has received health education leading to behavior change", "file_id": "dr_RC0426", "chunk_id": 9 }, { "code": "Self management support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I'm watching my sodium-- as much as I can, and then I try to watch the water or stuff that I drink", "context": "Patient is managing diabetes through lifestyle changes", "file_id": "dr_RC0426", "chunk_id": 9 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Now I would say not very likely", "context": "Patient underestimates risk of vision loss due to diabetes", "file_id": "dr_RC0426", "chunk_id": 10 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "How likely? Now I would say not very likely", "context": "Patient may be downplaying risk due to fear", "file_id": "dr_RC0426", "chunk_id": 10 }, { "code": "Education barriers", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "I have a hard time, -- when they do the eye exam and you have to look up on the wall and see those letters", "context": "Patient struggles with understanding medical tests", "file_id": "dr_RC0426", "chunk_id": 10 }, { "code": "Healthcare access", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate insurance coverage", "quote": "I've had them both removed", "context": "Patient has received necessary treatments, implying access to care", "file_id": "dr_RC0426", "chunk_id": 10 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Since you've made the changes, you feel that?", "context": "Provider is engaged and supportive, facilitating open discussion", "file_id": "dr_RC0426", "chunk_id": 10 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "My number one answer would be because of the doctor-- the doctors that I have", "context": "Patient attributes good experience to their doctors", "file_id": "dr_RC0426", "chunk_id": 11 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Probably talk to you more", "context": "Patient values doctor's communication style", "file_id": "dr_RC0426", "chunk_id": 11 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "because of the doctor-- the doctors that I have", "context": "Patient attributes good experience to their doctors", "file_id": "dr_RC0426", "chunk_id": 12 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "they're really good about that", "context": "Patient appreciates doctors' ability to explain in plain language", "file_id": "dr_RC0426", "chunk_id": 12 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I know I need to, and I know I need to do it for my health", "context": "Patient understands importance of regular healthcare services", "file_id": "dr_RC0426", "chunk_id": 12 }, { "code": "Accessible technology", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Telehealth options", "quote": "MyChart, I-- I use it a lot", "context": "Patient finds MyChart helpful for managing appointments", "file_id": "dr_RC0426", "chunk_id": 12 }, { "code": "Reminder systems", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "Yeah, as far as appointment reminders", "context": "Patient uses MyChart for appointment reminders", "file_id": "dr_RC0426", "chunk_id": 12 }, { "code": "Provider attitude", "category": "BARRIER - Provider/System Issues", "subcategory": "Rude or dismissive providers", "quote": "a lot of doctors just want to come in and leave", "context": "Patient perceives some doctors as having a poor attitude", "file_id": "dr_RC0426", "chunk_id": 13 }, { "code": "Lack of provider time", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "They don't take time", "context": "Patient feels doctors do not spend enough time with them", "file_id": "dr_RC0426", "chunk_id": 13 }, { "code": "Social support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "my husband", "context": "Patient has a supportive spouse who helps with diabetes management", "file_id": "dr_RC0426", "chunk_id": 13 }, { "code": "Spousal support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "my husband... he's pretty good about, 'If you don't eat-- if you're eating what you're not supposed to--'", "context": "Patient receives help from spouse with daily diabetes care", "file_id": "dr_RC0426", "chunk_id": 14 }, { "code": "Medication reminders", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "he'll ask sometimes, 'Did you take this? Did you take that?'", "context": "Patient receives medication reminders from spouse", "file_id": "dr_RC0426", "chunk_id": 14 }, { "code": "Diabetes education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Oh, yes... years ago, but three or four", "context": "Patient participated in diabetes education class", "file_id": "dr_RC0426", "chunk_id": 14 }, { "code": "Lack of education impact", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "It didn't work", "context": "Patient did not find diabetes education class helpful", "file_id": "dr_RC0426", "chunk_id": 14 }, { "code": "Lack of motivation", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Patient beliefs", "quote": "I didn't want to change my diet. I didn't want to, , do the things I should be doing.", "context": "Patient lacks motivation to make lifestyle changes", "file_id": "dr_RC0426", "chunk_id": 15 }, { "code": "Social support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "I do, but it would be my sister.", "context": "Patient has social support from family member", "file_id": "dr_RC0426", "chunk_id": 15 }, { "code": "Emotional support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "Yes. S1: 17:31 --you-- S2: 17:32 Yes.", "context": "Patient feels supported by family member", "file_id": "dr_RC0426", "chunk_id": 15 }, { "code": "Practical support", "category": "FACILITATOR - Resources & Access", "subcategory": "Transportation assistance", "quote": "My husband.", "context": "Patient has practical support from spouse", "file_id": "dr_RC0426", "chunk_id": 15 }, { "code": "Health advice support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Patient navigation services", "quote": "My sister", "context": "Patient has someone to ask for health advice", "file_id": "dr_RC0426", "chunk_id": 15 }, { "code": "Social Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "My husband", "context": "Patient has a supportive spouse", "file_id": "dr_RC0426", "chunk_id": 16 }, { "code": "Family Advice", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "My sister", "context": "Patient has a supportive sibling for general advice", "file_id": "dr_RC0426", "chunk_id": 16 }, { "code": "Doctor Advice", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Except from your doctors?", "context": "Patient relies on doctors for advice", "file_id": "dr_RC0426", "chunk_id": 16 }, { "code": "Limited Understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Just getting good news", "context": "Patient may not fully understand the importance of follow-up", "file_id": "dr_RC0426", "chunk_id": 16 }, { "code": "No Perceived Urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "Not really", "context": "Patient does not feel their eyesight currently limits them", "file_id": "dr_RC0426", "chunk_id": 16 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I was afraid this was getting worse", "context": "Patient expresses fear about potential worsening of condition", "file_id": "dr_RC0426", "chunk_id": 17 }, { "code": "Positive expectations", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Just getting good news", "context": "Patient has positive expectations for their eye care visit", "file_id": "dr_RC0426", "chunk_id": 17 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "He said it was fine", "context": "Provider communicates effectively with patient", "file_id": "dr_RC0426", "chunk_id": 17 }, { "code": "Lack of self-monitoring", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't check myself, because I use my A1C", "context": "Patient does not regularly monitor blood sugar levels", "file_id": "dr_SR0511", "chunk_id": 0 }, { "code": "Provider guidance", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I've discussed this with my doctor, I don't check", "context": "Patient follows provider's advice on self-monitoring", "file_id": "dr_SR0511", "chunk_id": 0 }, { "code": "Medication adherence", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I take medication", "context": "Patient is taking prescribed medication for diabetes", "file_id": "dr_SR0511", "chunk_id": 0 }, { "code": "Health literacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I use my A1C", "context": "Patient understands and uses A1C results to guide care", "file_id": "dr_SR0511", "chunk_id": 0 }, { "code": "Lack of perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "So, but as of right now, I don't check weekly or even daily because my A1C is good", "context": "Patient doesn't feel the need to monitor closely due to good A1C levels", "file_id": "dr_SR0511", "chunk_id": 1 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I watch how I'm feeling, if I get lightheaded, I will go check it.", "context": "Patient relies on physical symptoms to manage diabetes", "file_id": "dr_SR0511", "chunk_id": 2 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Making sure I take my medication.", "context": "Patient prioritizes medication adherence", "file_id": "dr_SR0511", "chunk_id": 2 }, { "code": "Self management", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I watch how I'm feeling, if I get lightheaded, I will go check it.", "context": "Patient actively monitors physical symptoms", "file_id": "dr_SR0511", "chunk_id": 2 }, { "code": "Lack of awareness", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Because usually I don't crave it all the time.", "context": "Patient may not fully understand diabetes management", "file_id": "dr_SR0511", "chunk_id": 2 }, { "code": "Physical signs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "If I feel at all that I'm lightheaded or I'm really craving sugar, it makes me go check my", "context": "Patient recognizes physical signs of potential issues", "file_id": "dr_SR0511", "chunk_id": 2 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't think the torn retina is because of the, of, of my diabetes", "context": "Patient unsure about relationship between diabetes and eye condition", "file_id": "dr_SR0511", "chunk_id": 3 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I know that I don't, , I know that the glaucoma is, and I don't know if there's a name for what I have right now", "context": "Patient uncertain about diagnosis and treatment", "file_id": "dr_SR0511", "chunk_id": 3 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "now, it's only affected one eye. So my doctor wasn't sure if it was diabetes, diabetic related, but when I went to the, another, , I think it was my ENT, they were , yeah, it's definitely diabetic related, so...", "context": "Patient has trust in provider's diagnosis", "file_id": "dr_SR0511", "chunk_id": 3 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I know that I don't, , I know that the glaucoma is, and I don't know if there's a name for what I have right now", "context": "Patient lacks knowledge about condition, needs health education", "file_id": "dr_SR0511", "chunk_id": 3 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "now, it's only affected one eye. So my doctor wasn't sure if it was diabetes, diabetic related, but when I went to the, another, , I think it was my ENT, they were , yeah, it's definitely diabetic related, so...", "context": "Patient has access to multiple providers for diagnosis", "file_id": "dr_SR0511", "chunk_id": 3 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I had a bleed. I think they called it a stroke, which is just an eye stroke, not a heart stroke, but an eye stroke", "context": "Patient shows limited knowledge of diabetic retinopathy and its effects", "file_id": "dr_SR0511", "chunk_id": 4 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I had a bleed. I think they called it a stroke, which is just an eye stroke, not a heart stroke, but an eye stroke", "context": "Patient's experience with a bleed and subsequent diagnosis may indicate fear", "file_id": "dr_SR0511", "chunk_id": 4 }, { "code": "Healthcare System Support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "And while I was with Dr. G, we found that I had, a torn retina", "context": "Patient received care from Dr. G, indicating access to healthcare", "file_id": "dr_SR0511", "chunk_id": 4 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "And while I was with Dr. G, we found that I had, a torn retina", "context": "Patient's interaction with Dr. G suggests a positive relationship", "file_id": "dr_SR0511", "chunk_id": 4 }, { "code": "Lack of passion", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Patient beliefs about condition", "quote": "the passion I used to feel for reading a book, I don't have it", "context": "Patient expresses decreased motivation due to health changes", "file_id": "dr_SR0511", "chunk_id": 5 }, { "code": "Brain fog", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "I'll miss a whole chapter of a book because I just went brain fog", "context": "Patient experiences cognitive difficulties", "file_id": "dr_SR0511", "chunk_id": 5 }, { "code": "Loss of interest", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't actually have the feel of the book in my hand", "context": "Patient expresses loss of enjoyment in activities due to health changes", "file_id": "dr_SR0511", "chunk_id": 5 }, { "code": "Lack of awareness", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Probably a year ago when I, when I scheduled a regular eye appointment to get new glasses", "context": "Patient was unaware of potential vision problems until incidentally discovered during routine appointment", "file_id": "dr_SR0511", "chunk_id": 6 }, { "code": "Incidental discovery", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "They found the stroke and sent me here", "context": "Patient received timely referral to specialist after unexpected diagnosis", "file_id": "dr_SR0511", "chunk_id": 6 }, { "code": "Lack of awareness", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I think that was a, a, a really sweet find", "context": "Patient seems unaware of the severity of their condition", "file_id": "dr_SR0511", "chunk_id": 7 }, { "code": "Previous healthcare experience", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Dr. Pagali had done the laser surgery", "context": "Patient has had positive experiences with healthcare providers in the past", "file_id": "dr_SR0511", "chunk_id": 7 }, { "code": "Existing health condition", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "the glaucoma, I knew about the glaucoma", "context": "Patient has existing health conditions that may impact their perception of DR", "file_id": "dr_SR0511", "chunk_id": 7 }, { "code": "Healthcare provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "Dr. Pagali had done the laser surgery", "context": "Patient has a established relationship with their healthcare provider", "file_id": "dr_SR0511", "chunk_id": 7 }, { "code": "Lack of education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "I haven't spoken, , in depth", "context": "Patient lacks understanding about diabetes and eye health", "file_id": "dr_SR0511", "chunk_id": 8 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I mean, I feel that this place is very, very good", "context": "Patient has positive experience with healthcare provider", "file_id": "dr_SR0511", "chunk_id": 8 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I mean, I feel that this place is very, very good", "context": "Patient has access to healthcare services", "file_id": "dr_SR0511", "chunk_id": 8 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I haven't spoken, , in depth", "context": "Patient lacks in-depth knowledge about diabetes impact on eyes", "file_id": "dr_SR0511", "chunk_id": 9 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I think Dr. G is very, very, , , he'll ask me questions", "context": "Patient appreciates engaging and inquiring provider", "file_id": "dr_SR0511", "chunk_id": 9 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "if I had questions, they would be answered", "context": "Patient feels confident in provider's ability to address concerns", "file_id": "dr_SR0511", "chunk_id": 9 }, { "code": "Healthcare system support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I mean, I feel that this place is very, very good", "context": "Patient has positive impression of healthcare facility", "file_id": "dr_SR0511", "chunk_id": 9 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "Dr. McNair, , does a really good job of keeping my diabetic, betes under control", "context": "Patient appreciates provider's efforts in managing diabetes", "file_id": "dr_SR0511", "chunk_id": 9 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "since I've went to Dr. McNair, I've got it under control", "context": "Patient feels comfortable with current provider", "file_id": "dr_SR0511", "chunk_id": 10 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "If I needed to, I could", "context": "Patient feels able to ask questions", "file_id": "dr_SR0511", "chunk_id": 10 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "And I'm, I'm okay with what, I mean, what I know I'm, I'm fine", "context": "Patient feels informed and in control", "file_id": "dr_SR0511", "chunk_id": 10 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "there are no longer any eye doctors in Preston County", "context": "Patient mentions lack of local eye care providers", "file_id": "dr_SR0511", "chunk_id": 11 }, { "code": "Accessible provider", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I went to the eye doctor at the Walmart, on 219, right off the interstate", "context": "Patient found an accessible alternative for eye care", "file_id": "dr_SR0511", "chunk_id": 11 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "she immediately found the problem I was having", "context": "Patient praises provider's effective diagnosis and communication", "file_id": "dr_SR0511", "chunk_id": 11 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "I feel very good, that she just immediately found the problem and took care of it", "context": "Patient feels positive about provider's care and attitude", "file_id": "dr_SR0511", "chunk_id": 11 }, { "code": "Lack of technology", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of access to healthcare", "quote": "the eye doctor I had in Preston County, he was no longer there, didn't have that technology", "context": "Patient's previous doctor lacked necessary technology", "file_id": "dr_SR0511", "chunk_id": 12 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "the doctor I'm going to now does have the newer technology", "context": "Patient's current doctor has necessary technology", "file_id": "dr_SR0511", "chunk_id": 12 }, { "code": "Expensive treatments", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Expensive treatments/surgery", "quote": "But usually my glasses are pretty expensive", "context": "Patient mentions high cost of glasses due to bad vision", "file_id": "dr_SR0511", "chunk_id": 13 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I think, did they dilate me today? No, they didn't dilate me", "context": "Patient seems unsure about eye exam procedures", "file_id": "dr_SR0511", "chunk_id": 13 }, { "code": "Infrequent exams", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "No perceived urgency", "quote": "Probably two months ago", "context": "Patient had not had a dilated eye exam recently", "file_id": "dr_SR0511", "chunk_id": 13 }, { "code": "Healthcare access", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate insurance coverage", "quote": "I'll either go through, I think it's called Rennie, or I'll buy the glasses there", "context": "Patient mentions possible insurance coverage for glasses", "file_id": "dr_SR0511", "chunk_id": 13 }, { "code": "Regular check-ups", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "It, well, I've been monthly", "context": "Patient believes in regular eye check-ups", "file_id": "dr_SR0511", "chunk_id": 13 }, { "code": "Lack of self management", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I'm getting shots in my eyes and I definitely can't do that myself", "context": "Patient relies on healthcare providers for treatment", "file_id": "dr_SR0511", "chunk_id": 14 }, { "code": "Perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now' (no perceived urgency)", "quote": "once I get this problem under control, I think I should go yearly", "context": "Patient believes less frequent visits are needed when condition is controlled", "file_id": "dr_SR0511", "chunk_id": 14 }, { "code": "Provider Relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I'm getting shots in my eyes", "context": "Patient receives regular treatment from provider", "file_id": "dr_SR0511", "chunk_id": 14 }, { "code": "Healthcare System Support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I've been monthly", "context": "Patient has access to regular appointments", "file_id": "dr_SR0511", "chunk_id": 14 }, { "code": "Scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "So sometimes that's difficult and it has to be done in a four-week time", "context": "Patient experiences difficulty scheduling appointments", "file_id": "dr_SR0511", "chunk_id": 15 }, { "code": "Limited appointment times", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "because I'm a teacher, I can only do after school", "context": "Patient has limited availability for appointments", "file_id": "dr_SR0511", "chunk_id": 15 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "Just driving in Morgantown. (Laughs) I'm from rural Preston County, so... I gotta go to Morgantown", "context": "Patient experiences difficulty traveling to clinic due to rural location", "file_id": "dr_SR0511", "chunk_id": 16 }, { "code": "Accessible providers", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "1. Healthcare System Support", "quote": "They've, they've totally accommodated me.", "context": "Patient feels supported by healthcare providers", "file_id": "dr_SR0511", "chunk_id": 16 }, { "code": "Appointment scheduling flexibility", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "1. Healthcare System Support", "quote": "And they've always given me lots of options.", "context": "Patient appreciates flexible appointment scheduling", "file_id": "dr_SR0511", "chunk_id": 16 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "Just driving in Morgantown. (Laughs) I'm from rural Preston County, so... I gotta go to Morgantown.", "context": "Patient faces challenges due to rural location", "file_id": "dr_SR0511", "chunk_id": 17 }, { "code": "Accessible providers", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "1. Healthcare System Support", "quote": "This, , doc, the WVU eye care is very prompt. I mean, I literally sat down for one minute and they called my name", "context": "Patient praises promptness of healthcare providers", "file_id": "dr_SR0511", "chunk_id": 17 }, { "code": "Prompt service", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "the WVU eye care is very prompt", "context": "Patient appreciates the efficiency of the clinic", "file_id": "dr_SR0511", "chunk_id": 18 }, { "code": "Short wait times", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I literally sat down for one minute and they called my name", "context": "Patient experiences minimal waiting time", "file_id": "dr_SR0511", "chunk_id": 18 }, { "code": "Efficient appointments", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I'm in and I'm out", "context": "Patient values the quick appointment process", "file_id": "dr_SR0511", "chunk_id": 18 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Wait times", "quote": "Literally, when I go and say I'm here, for them to call my name and for me to get everything done and the shot in my eye is, is usually less than half an hour", "context": "Patient describes wait time as relatively short", "file_id": "dr_SR0511", "chunk_id": 19 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "they literally found it and they literally took care of it right there", "context": "Patient appreciates prompt care from provider", "file_id": "dr_SR0511", "chunk_id": 19 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "And they asked me if I wanted it done, I'm , 'Yes'", "context": "Patient engages in shared decision-making with provider", "file_id": "dr_SR0511", "chunk_id": 19 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I was thankful for that", "context": "Patient expresses gratitude towards provider", "file_id": "dr_SR0511", "chunk_id": 19 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "And then they just took care of it", "context": "Patient received immediate care", "file_id": "dr_SR0511", "chunk_id": 20 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "And they asked me if I wanted it done, I'm , 'Yes'", "context": "Patient felt heard by provider", "file_id": "dr_SR0511", "chunk_id": 20 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "so what are some ways you take care of your eyes?", "context": "Patient is educated on eye care", "file_id": "dr_SR0511", "chunk_id": 20 }, { "code": "Light sensitivity", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "I'm just really, really sensitive to the light", "context": "Patient experiences discomfort due to light sensitivity", "file_id": "dr_SR0511", "chunk_id": 20 }, { "code": "Lack of education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "I didn't know I could", "context": "Patient unaware of potential supplements for eye health", "file_id": "dr_SR0511", "chunk_id": 21 }, { "code": "Light sensitivity", "category": "BARRIER - Emotional/Psychological", "subcategory": "None", "quote": "I'm just really, really sensitive to the light", "context": "Patient experiences discomfort due to light sensitivity after dilation", "file_id": "dr_SR0511", "chunk_id": 21 }, { "code": "Lack of knowledge", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I didn't know I could", "context": "Patient unaware of potential supplements for eye health", "file_id": "dr_SR0511", "chunk_id": 22 }, { "code": "Education barriers", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "I didn't even think about it", "context": "Patient lacks awareness of potential treatments or discussions with doctor", "file_id": "dr_SR0511", "chunk_id": 22 }, { "code": "Healthcare System Support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "definitely something you could discuss with your doctor", "context": "Patient encouraged to discuss supplements with doctor", "file_id": "dr_SR0511", "chunk_id": 22 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "(laughs)", "context": "Interviewer shows understanding and empathy towards patient's lack of knowledge", "file_id": "dr_SR0511", "chunk_id": 22 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "they haven't replied", "context": "Patient requested better computer for work due to vision issues but was ignored", "file_id": "dr_SR0511", "chunk_id": 23 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "I've requested from my special-ed director, a better computer", "context": "Patient needs better computer for work due to vision issues but may not be able to afford it", "file_id": "dr_SR0511", "chunk_id": 23 }, { "code": "Education/health literacy barriers", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "Which I think affects the, the eyes", "context": "Patient lacks understanding of how diabetes medications affect their eyes", "file_id": "dr_SR0511", "chunk_id": 23 }, { "code": "Lack of understanding about DR progression", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Which I think affects the, the eyes", "context": "Patient lacks understanding of how diabetes medications affect their eyes", "file_id": "dr_SR0511", "chunk_id": 23 }, { "code": "Feeling overwhelmed", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "it's very hard to type on my computer and see the screen when I'm that close up", "context": "Patient struggles with daily activities due to vision issues", "file_id": "dr_SR0511", "chunk_id": 23 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I've requested from my special-ed director, a better computer", "context": "Patient receives support from special-ed director for work accommodations", "file_id": "dr_SR0511", "chunk_id": 23 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I take stuff for my diabetes", "context": "Patient is aware of their diabetes management and takes medications", "file_id": "dr_SR0511", "chunk_id": 23 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "No, just the fact that having diabetes can be very bad for your eyes", "context": "Patient lacks detailed knowledge about diabetes effects on vision", "file_id": "dr_SR0511", "chunk_id": 24 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "They have told me, I am aware", "context": "Patient has received some health education from doctors", "file_id": "dr_SR0511", "chunk_id": 24 }, { "code": "Self management support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I've done what I can to take care of the glaucoma", "context": "Patient takes initiative in managing their condition", "file_id": "dr_SR0511", "chunk_id": 24 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "No, just the fact that having diabetes can be very bad for your eyes", "context": "Patient lacks detailed knowledge about diabetes effects on eyes", "file_id": "dr_SR0511", "chunk_id": 25 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "if they say this needs to be done, I do it", "context": "Patient trusts provider's recommendations", "file_id": "dr_SR0511", "chunk_id": 25 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "They have told you? What are, do you remember anything specific that they said to you?", "context": "Patient receives health information from providers", "file_id": "dr_SR0511", "chunk_id": 25 }, { "code": "Adherence to treatment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I do do the drops in my eyes twice a day", "context": "Patient follows prescribed treatment regimen", "file_id": "dr_SR0511", "chunk_id": 25 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "if they say this needs to be done, I do it", "context": "Patient feels heard and understood by provider", "file_id": "dr_SR0511", "chunk_id": 25 }, { "code": "Lack of symptoms", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "No perceived urgency", "quote": "because it never hurt", "context": "Patient doesn't feel urgency due to lack of symptoms", "file_id": "dr_SR0511", "chunk_id": 26 }, { "code": "Provider awareness", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "they're aware of my issue and I haven't had to ask them", "context": "Patient feels provider is proactive in their care", "file_id": "dr_SR0511", "chunk_id": 26 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "I guess I would tell them any symptoms I had", "context": "Patient feels comfortable sharing information with provider", "file_id": "dr_SR0511", "chunk_id": 26 }, { "code": "Patient motivation", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I really wanna continue to drive. And, and live a fulfilled life", "context": "Patient is motivated to manage their condition", "file_id": "dr_SR0511", "chunk_id": 26 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I didn't even know I had it", "context": "Patient was unaware of their condition", "file_id": "dr_SR0511", "chunk_id": 27 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "it never hurt", "context": "Patient did not feel symptoms and therefore didn't perceive a need for follow-up", "file_id": "dr_SR0511", "chunk_id": 27 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "what supplements I could do", "context": "Patient is interested in learning about self-care and prevention", "file_id": "dr_SR0511", "chunk_id": 27 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "they become aware of it before I know if there's issues", "context": "Patient feels their provider is proactive and caring", "file_id": "dr_SR0511", "chunk_id": 27 }, { "code": "Health literacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I didn't know about the fish oil", "context": "Patient is learning about new health information and seeking knowledge", "file_id": "dr_SR0511", "chunk_id": 27 }, { "code": "Lack of education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "I didn't know there were eye, eye supplements", "context": "Patient lacks knowledge about available treatments", "file_id": "dr_SR0511", "chunk_id": 28 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "how serious you think the vision loss is because of diabetes", "context": "Patient unsure about severity of vision loss due to diabetes", "file_id": "dr_SR0511", "chunk_id": 28 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "I haven't really had diabetic tests for my eyes yet or anything, hardly", "context": "Patient has limited access to eye care services", "file_id": "dr_WS1217", "chunk_id": 0 }, { "code": "Health literacy barriers", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "I haven't really had diabetic tests for my eyes yet or anything, hardly", "context": "Patient lacks understanding of diabetes eye care", "file_id": "dr_WS1217", "chunk_id": 0 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I haven't really had diabetic tests for my eyes yet or anything, hardly", "context": "Patient lacks knowledge about diabetes retinopathy", "file_id": "dr_WS1217", "chunk_id": 0 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I haven't really had diabetic tests for my eyes yet or anything, hardly", "context": "Patient lacks knowledge about diabetes eye care", "file_id": "dr_WS1217", "chunk_id": 1 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "since I had my appointment last-- on the 6th-- ... One of the lenses are starting to fall-- fog", "context": "Patient may not prioritize follow-up due to current vision", "file_id": "dr_WS1217", "chunk_id": 1 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "She always told me to be careful what I do, what I-- ... the way I have to watch and look at things and stuff and everything", "context": "Patient receives clear guidance from doctor", "file_id": "dr_WS1217", "chunk_id": 1 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "He's gonna tell me what's going on and everything", "context": "Patient has access to specialist for follow-up care", "file_id": "dr_WS1217", "chunk_id": 1 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Not too much. This is the first I had trouble with them.", "context": "Patient seems unsure about their diabetic retinopathy condition", "file_id": "dr_WS1217", "chunk_id": 2 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "I haven't had too much talk with the doctor yet about it.", "context": "Patient feels they have not discussed their condition enough with their doctor", "file_id": "dr_WS1217", "chunk_id": 2 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "why I, I have the meeting to-- the surgeon today", "context": "Patient has an upcoming appointment with a specialist", "file_id": "dr_WS1217", "chunk_id": 2 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "She always told me to be careful what I do", "context": "Patient mentions their doctor's advice, indicating a positive interaction", "file_id": "dr_WS1217", "chunk_id": 2 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I haven't had too much talk with the doctor yet about it", "context": "Patient lacks knowledge about their condition", "file_id": "dr_WS1217", "chunk_id": 3 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "I haven't had too much talk with the doctor yet about it", "context": "Patient reports limited discussion with doctor", "file_id": "dr_WS1217", "chunk_id": 3 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I go to Dr. M all the time", "context": "Patient has a regular provider", "file_id": "dr_WS1217", "chunk_id": 3 }, { "code": "Accessible provider", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I go to Dr. M all the time", "context": "Patient has a regular and accessible provider", "file_id": "dr_WS1217", "chunk_id": 4 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I go to Dr. M all the time", "context": "Patient has a regular and trusting provider", "file_id": "dr_WS1217", "chunk_id": 4 }, { "code": "Provider recommendation", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Dr. M says I should have it done once a year", "context": "Patient follows provider's advice for follow-up", "file_id": "dr_WS1217", "chunk_id": 4 }, { "code": "Previous experience", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I was prepared for it because I had it done quite a few times", "context": "Patient is empowered by previous experiences", "file_id": "dr_WS1217", "chunk_id": 4 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "They were real good", "context": "Patient finds provider's availability satisfactory", "file_id": "dr_WS1217", "chunk_id": 5 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "Dr. M says I should have it done once a year", "context": "Patient mentions provider's recommendation, implying trust", "file_id": "dr_WS1217", "chunk_id": 5 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "They just tell me watch what I do and stuff", "context": "Patient receives guidance from provider", "file_id": "dr_WS1217", "chunk_id": 5 }, { "code": "Lack of challenges", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "No perceived urgency", "quote": "No.", "context": "Patient does not report any challenges", "file_id": "dr_WS1217", "chunk_id": 6 }, { "code": "No suggestions", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "None, really.", "context": "Patient has no suggestions for improvement", "file_id": "dr_WS1217", "chunk_id": 6 }, { "code": "Self care habits", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "get up every morning and check and make sure they're not red and stuff--", "context": "Patient takes initiative in monitoring eye health", "file_id": "dr_WS1217", "chunk_id": 6 }, { "code": "Use of protective glasses", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "These are tinted glasses that-- he has given me", "context": "Patient uses protective glasses as recommended", "file_id": "dr_WS1217", "chunk_id": 6 }, { "code": "Adherence to medication", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I take, , vitamin B3. ... I take, , metformin.", "context": "Patient adheres to prescribed medications", "file_id": "dr_WS1217", "chunk_id": 6 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "And I couldn't afford it, to be honest with you", "context": "Patient cannot afford medication due to high cost", "file_id": "dr_WS1217", "chunk_id": 7 }, { "code": "Expensive treatments", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Expensive treatments/surgery", "quote": "The prices of that Jardiance is outrageous", "context": "Patient finds medication cost to be excessively high", "file_id": "dr_WS1217", "chunk_id": 7 }, { "code": "Out-of-pocket costs", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Out-of-pocket costs", "quote": "it was $781 that I had to pay out of my pocket", "context": "Patient has high out-of-pocket expenses for medication", "file_id": "dr_WS1217", "chunk_id": 7 }, { "code": "Financial assistance programs", "category": "FACILITATOR - Resources & Access", "subcategory": "Financial assistance programs", "quote": "Do they offer any , , programs to maybe lower the price?", "context": "Patient inquires about potential financial assistance for medication", "file_id": "dr_WS1217", "chunk_id": 7 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "And I can't afford it, to be honest with you.", "context": "Patient cannot afford medication", "file_id": "dr_WS1217", "chunk_id": 8 }, { "code": "Lack of access to healthcare", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "I haven't heard from anything--", "context": "Patient unaware of financial assistance programs", "file_id": "dr_WS1217", "chunk_id": 8 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "I have to meet with her Tuesday, and I'll talk to her about it--", "context": "Patient plans to discuss concerns with doctor", "file_id": "dr_WS1217", "chunk_id": 8 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Yeah, with-- I don't know how to run a computer. I've never learned that yet.", "context": "Patient lacks knowledge about technology, possibly indicating need for education", "file_id": "dr_WS1217", "chunk_id": 8 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I have to meet with her Tuesday", "context": "Patient has upcoming appointment with provider", "file_id": "dr_WS1217", "chunk_id": 8 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "They haven't said much about it", "context": "Patient lacks knowledge about diabetes and vision loss", "file_id": "dr_WS1217", "chunk_id": 9 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "They haven't said much about it", "context": "Provider failed to educate patient about condition", "file_id": "dr_WS1217", "chunk_id": 9 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "'Cause I don't wanna lose my eyes", "context": "Patient fears losing vision due to diabetes", "file_id": "dr_WS1217", "chunk_id": 9 }, { "code": "Health education needs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "it does", "context": "Patient desires more knowledge about condition", "file_id": "dr_WS1217", "chunk_id": 9 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "'Cause I don't wanna lose my eyes", "context": "Patient expresses concern due to lack of knowledge", "file_id": "dr_WS1217", "chunk_id": 10 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "I never talk too much about anything", "context": "Patient feels they don't communicate effectively with doctor", "file_id": "dr_WS1217", "chunk_id": 10 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "They quickly examine my eyes. I just come and let them do what they have to do and, and then leave", "context": "Patient doesn't feel comfortable discussing concerns with doctor", "file_id": "dr_WS1217", "chunk_id": 10 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "I just asked him one time about how long would it-- I had to-- w-with these lenses, how long--", "context": "Patient has asked doctor a question in the past", "file_id": "dr_WS1217", "chunk_id": 10 }, { "code": "Lack of patient-provider communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "I just asked him one time about how long would it-- I had to-- w-with these lenses, how long--", "context": "Patient has limited interaction with doctor", "file_id": "dr_WS1217", "chunk_id": 11 }, { "code": "Fear of vision loss", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I'd say about a 10", "context": "Patient is worried about diabetes causing vision loss", "file_id": "dr_WS1217", "chunk_id": 11 }, { "code": "Patient worry and anxiety", "category": "BARRIER - Emotional/Psychological", "subcategory": "Depression/anxiety", "quote": "It worries me. , I'm a worrywart when things--", "context": "Patient experiences emotional distress related to health", "file_id": "dr_WS1217", "chunk_id": 11 }, { "code": "Effective patient-provider interaction", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I just asked him one time about how long would it-- I had to-- w-with these lenses, how long--", "context": "Patient feels comfortable asking doctor questions", "file_id": "dr_WS1217", "chunk_id": 11 }, { "code": "Patient health awareness", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I'd explain if I need any medication to use on them or not", "context": "Patient has some knowledge about their health condition", "file_id": "dr_WS1217", "chunk_id": 11 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "It worries me", "context": "Patient expresses worry about their condition", "file_id": "dr_WS1217", "chunk_id": 12 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I'm a worrywart when things-- happen that", "context": "Patient lacks clear understanding of their condition", "file_id": "dr_WS1217", "chunk_id": 12 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "Trust me", "context": "Provider shows empathy towards patient's concerns", "file_id": "dr_WS1217", "chunk_id": 12 }, { "code": "Lack of information", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Get, get more information from him would help", "context": "Patient wants more information to understand condition", "file_id": "dr_WS1217", "chunk_id": 13 }, { "code": "Worry about diagnosis", "category": "BARRIER - Emotional/Psychological", "subcategory": "Fear of diagnosis/treatment", "quote": "It's, it's worrisome", "context": "Patient is worried about eye condition diagnosis", "file_id": "dr_WS1217", "chunk_id": 13 }, { "code": "Healthcare motivation", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I have to go because of my sugar and stuff", "context": "Patient is motivated to manage diabetes through healthcare", "file_id": "dr_WS1217", "chunk_id": 13 }, { "code": "Need for education", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Health education programs", "quote": "Get, get more information from him would help", "context": "Patient needs education to understand condition and manage worry", "file_id": "dr_WS1217", "chunk_id": 13 }, { "code": "Lack of information", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Get, get more information from him would help", "context": "Patient wants more information to understand their condition", "file_id": "dr_WS1217", "chunk_id": 14 }, { "code": "Provider communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Get, get more information from him would help", "context": "Patient values provider communication to alleviate worries", "file_id": "dr_WS1217", "chunk_id": 14 }, { "code": "Health motivation", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I have to go because of my sugar and stuff", "context": "Patient is motivated to manage their diabetes", "file_id": "dr_WS1217", "chunk_id": 14 }, { "code": "No discouragement", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "No, mm-mm", "context": "Patient does not experience discouragement from using eye care services", "file_id": "dr_WS1217", "chunk_id": 14 }, { "code": "Self management confidence", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "Yeah", "context": "Patient feels confident in managing their diabetes care", "file_id": "dr_WS1217", "chunk_id": 14 }, { "code": "Lack of education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "I've been trying to get out of classes and stuff", "context": "Patient shows disinterest in diabetes education", "file_id": "dr_WS1217", "chunk_id": 15 }, { "code": "Family support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "Yeah, with my sisters. They're always around", "context": "Patient has supportive family members", "file_id": "dr_WS1217", "chunk_id": 15 }, { "code": "Access to help", "category": "FACILITATOR - Resources & Access", "subcategory": "Transportation assistance", "quote": "My sisters help out", "context": "Patient has help with daily chores and transportation", "file_id": "dr_WS1217", "chunk_id": 15 }, { "code": "Social Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "My sisters help out", "context": "Patient has family support for daily tasks", "file_id": "dr_WS1217", "chunk_id": 16 }, { "code": "Health Advice", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I call my neighbor. She's a nurse here at the university", "context": "Patient has access to medical advice through neighbor", "file_id": "dr_WS1217", "chunk_id": 16 }, { "code": "Family Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "My sisters help out", "context": "Patient has family support for daily tasks", "file_id": "dr_WS1217", "chunk_id": 16 }, { "code": "Access to Healthcare", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate insurance coverage", "quote": "I have a niece. She's a nurse over at the university too", "context": "Patient has access to medical professionals through family", "file_id": "dr_WS1217", "chunk_id": 16 }, { "code": "Social Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "I have a niece. She's a nurse over at the university too.", "context": "Patient has a supportive family member with medical knowledge", "file_id": "dr_WS1217", "chunk_id": 17 }, { "code": "Healthcare Access", "category": "FACILITATOR - Resources & Access", "subcategory": "Access to healthcare", "quote": "I have a niece. She's a nurse over at the university too.", "context": "Patient has potential access to medical advice through their niece", "file_id": "dr_WS1217", "chunk_id": 17 }, { "code": "No Perceived Urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "Not much, but n-- but now, it's just-- this worries me because I can't-- at nighttime, it- it's bu-- bothers me when I'm driving.", "context": "Patient is not overly concerned about their eyesight limitations", "file_id": "dr_WS1217", "chunk_id": 17 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Wake up, no", "context": "Patient seems unsure or lacks knowledge about diabetes management", "file_id": "dr_MF0618", "chunk_id": 0 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I take Mounjaro once a week and that's about the only thing I'm on now", "context": "Patient is taking medication, indicating some level of health education", "file_id": "dr_MF0618", "chunk_id": 0 }, { "code": "Weight management", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "losing weight", "context": "Patient prioritizes weight loss, showing awareness of its importance in diabetes management", "file_id": "dr_MF0618", "chunk_id": 0 }, { "code": "Social support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "My wife", "context": "Patient mentions their wife, indicating a support system", "file_id": "dr_MF0618", "chunk_id": 0 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "what are some things that you watch out to tell you that your diabetes is getting worse?", "context": "Patient unsure of indicators for worsening diabetes", "file_id": "dr_MF0618", "chunk_id": 1 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "every 10 days you gotta rip the thing off", "context": "Patient mentions cost or hassle of replacing device", "file_id": "dr_MF0618", "chunk_id": 1 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "what are some things that you watch out to tell you that your diabetes is getting worse?", "context": "Patient seeking knowledge about diabetes management", "file_id": "dr_MF0618", "chunk_id": 1 }, { "code": "Accessible devices", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Telehealth options", "quote": "I have the Dexcom 7 now", "context": "Patient using technology for health monitoring", "file_id": "dr_MF0618", "chunk_id": 1 }, { "code": "Lack of trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "None", "context": "No relevant quote, but context implies potential distrust due to inconsistent readings", "file_id": "dr_MF0618", "chunk_id": 2 }, { "code": "Inconsistent readings", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "The readings were different than-", "context": "Patient experiences inconsistent glucose readings, potentially affecting trust in healthcare system", "file_id": "dr_MF0618", "chunk_id": 2 }, { "code": "Health literacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I've learned that, don't feel it. Go do the finger stick.", "context": "Patient demonstrates understanding of glucose monitoring and takes proactive steps", "file_id": "dr_MF0618", "chunk_id": 2 }, { "code": "Self management", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I've learned that, don't feel it. Go do the finger stick.", "context": "Patient takes initiative in managing glucose levels", "file_id": "dr_MF0618", "chunk_id": 2 }, { "code": "Lack of trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "But I never rely solely on the numbers I get on here", "context": "Patient questions accuracy of medical device", "file_id": "dr_MF0618", "chunk_id": 3 }, { "code": "Effective self management", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "And I use this to monitor where my A1C is and where my average sugar levels are", "context": "Patient uses device to track health metrics", "file_id": "dr_MF0618", "chunk_id": 3 }, { "code": "Health literacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "So if it beeps and it's , 'Oh, you're 300.' Okay, what did I have that jumped up?", "context": "Patient understands device readings and takes action", "file_id": "dr_MF0618", "chunk_id": 3 }, { "code": "Lack of trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "You can't go by that", "context": "Patient questioning the reliability of medical device", "file_id": "dr_MF0618", "chunk_id": 4 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "If I was 42 I'd be in a coma", "context": "Patient expressing fear of severe hypoglycemia", "file_id": "dr_MF0618", "chunk_id": 4 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "She pricked her finger and she was , 'It's actually not that low.'", "context": "Patient receiving clear information from friend", "file_id": "dr_MF0618", "chunk_id": 4 }, { "code": "Accessible technology", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Telehealth options", "quote": "I have it on my phone", "context": "Patient using mobile device to monitor friend's glucose levels", "file_id": "dr_MF0618", "chunk_id": 4 }, { "code": "Reminder systems", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "It woke you up with the alarm?", "context": "Patient receiving alerts from medical device", "file_id": "dr_MF0618", "chunk_id": 4 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "if I was 42 I'd be in a coma", "context": "Patient shows confusion about blood glucose levels", "file_id": "dr_MF0618", "chunk_id": 5 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "you could go into a coma and...", "context": "Patient expresses fear about potential health consequences", "file_id": "dr_MF0618", "chunk_id": 5 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I said, you could go into a coma and...", "context": "Patient shows some understanding of health risks", "file_id": "dr_MF0618", "chunk_id": 5 }, { "code": "Accessible technology", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Telehealth options", "quote": "I have it on my phone, and that's the one thing you can't turn off, low alerts", "context": "Patient uses mobile device for health monitoring", "file_id": "dr_MF0618", "chunk_id": 5 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I never really thought it does", "context": "Patient lacks awareness of diabetes impact on eyes", "file_id": "dr_MF0618", "chunk_id": 6 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "See, I never really thought it does", "context": "Patient unsure of diabetes impact on eyes", "file_id": "dr_MF0618", "chunk_id": 7 }, { "code": "Family-related issues", "category": "BARRIER - SDOH", "subcategory": "Social Determinants of Health", "quote": "a lot of it is family-related and stuff", "context": "Patient mentions family as a factor", "file_id": "dr_MF0618", "chunk_id": 7 }, { "code": "Specialist access", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "So I see my glaucoma specialist every year, my retinal specialist every year", "context": "Patient has regular access to specialists", "file_id": "dr_MF0618", "chunk_id": 7 }, { "code": "Provider communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "They want me to see an optometrist, 'cause they're , , 'That's a different realm'", "context": "Providers communicate and coordinate care", "file_id": "dr_MF0618", "chunk_id": 7 }, { "code": "Regular follow-up", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "So I see my glaucoma specialist every year, my retinal specialist every year", "context": "Patient has regular scheduled appointments", "file_id": "dr_MF0618", "chunk_id": 7 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "'Cause unfortunately with COVID, I missed a year of being able to see doctors", "context": "Patient missed appointments due to COVID", "file_id": "dr_MF0618", "chunk_id": 8 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "They just say I am getting cataracts and glaucoma, which unfortunately is also a sign of age", "context": "Patient anxious about diagnosis", "file_id": "dr_MF0618", "chunk_id": 8 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Well, basically , , to look out for the floaters and , sudden vision changes, the blurry visions and all that stuff", "context": "Doctor explained condition to patient", "file_id": "dr_MF0618", "chunk_id": 8 }, { "code": "Regular appointments", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "and I think I go almost every six months sometimes with a glaucoma doctor", "context": "Patient has regular check-ups", "file_id": "dr_MF0618", "chunk_id": 8 }, { "code": "Monitoring and testing", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "where they're doing the pressure testing and all that stuff", "context": "Healthcare system provides regular monitoring", "file_id": "dr_MF0618", "chunk_id": 8 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "You're a little bit high, we'll watch it.", "context": "Patient seems unsure about their condition", "file_id": "dr_MF0618", "chunk_id": 9 }, { "code": "Effective treatment", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "And then after a year, did laser surgery in both eyes.", "context": "Patient received timely and effective treatment", "file_id": "dr_MF0618", "chunk_id": 9 }, { "code": "Regular follow-up", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "I go about every six months, what- Six months to a year.", "context": "Patient has regular follow-up appointments", "file_id": "dr_MF0618", "chunk_id": 9 }, { "code": "Accessible care", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate insurance coverage", "quote": "Here.", "context": "Patient receives care at a convenient location", "file_id": "dr_MF0618", "chunk_id": 9 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "(laughs)", "context": "Provider shows empathy and builds rapport with patient", "file_id": "dr_MF0618", "chunk_id": 9 }, { "code": "Lack of recall", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "February or March? Speaker 2: May.", "context": "Patient has difficulty remembering last appointment", "file_id": "dr_MF0618", "chunk_id": 10 }, { "code": "Good medical plan", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate insurance coverage", "quote": "I have a good medical plan, so.", "context": "Patient has adequate insurance coverage for eye exams", "file_id": "dr_MF0618", "chunk_id": 10 }, { "code": "Multiple appointments", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "I got so many doctor things going on", "context": "Patient has multiple appointments to manage", "file_id": "dr_MF0618", "chunk_id": 10 }, { "code": "Good medical plan", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate insurance coverage", "quote": "I have a good medical plan, so", "context": "Patient has adequate insurance coverage", "file_id": "dr_MF0618", "chunk_id": 11 }, { "code": "Easy scheduling", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Pretty easy", "context": "Patient finds scheduling appointments easy", "file_id": "dr_MF0618", "chunk_id": 11 }, { "code": "Light sensitivity", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "I cannot take sunlight at all", "context": "Patient experiences discomfort due to light sensitivity after eye dilation", "file_id": "dr_MF0618", "chunk_id": 11 }, { "code": "Accessible location", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate access to care", "quote": "because I live in Morgantown... and everything's here in Morgantown", "context": "Patient finds it easy to receive eye care due to proximity to medical hub", "file_id": "dr_MF0618", "chunk_id": 12 }, { "code": "Good provider availability", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "It's usually pretty good", "context": "Patient finds doctor's availability satisfactory", "file_id": "dr_MF0618", "chunk_id": 12 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "Sometimes there's no choice", "context": "Patient implies difficulty with transportation at night", "file_id": "dr_MF0618", "chunk_id": 13 }, { "code": "Lack of access", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "Sometimes there's no choice", "context": "Patient may be implying lack of access to transportation", "file_id": "dr_MF0618", "chunk_id": 13 }, { "code": "Fear of diagnosis", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "2. Patient Beliefs & Perceptions", "quote": "Then I'm blind", "context": "Patient expresses fear or anxiety about vision loss", "file_id": "dr_MF0618", "chunk_id": 13 }, { "code": "Health education", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "3. Patient Empowerment", "quote": "You're near a hub of medical... information and things that", "context": "Patient is aware of available health resources", "file_id": "dr_MF0618", "chunk_id": 13 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "'cause I can see better at night except when a car comes at me. Then I'm blind.", "context": "Patient lacks understanding of their condition", "file_id": "dr_MF0618", "chunk_id": 14 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "'cause I can see better at night except when a car comes at me. Then I'm blind.", "context": "Patient does not perceive their condition as urgent", "file_id": "dr_MF0618", "chunk_id": 14 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "Yeah, pretty freeing with 'em", "context": "Patient feels comfortable discussing eye issues with doctor", "file_id": "dr_MF0618", "chunk_id": 15 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "Yeah, pretty freeing with 'em", "context": "Patient feels comfortable discussing eye issues with doctor", "file_id": "dr_MF0618", "chunk_id": 16 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "So I asked my doctor, I said, 'Okay, is this-'", "context": "Patient able to express concerns and ask questions", "file_id": "dr_MF0618", "chunk_id": 16 }, { "code": "Lack of understanding about DR progression", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Because it's derived from iguanas... And they said that it deteriorates your eyes", "context": "Patient has misconceptions about medication and eye health", "file_id": "dr_MF0618", "chunk_id": 16 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I think things have changed", "context": "Patient believes diabetes treatment has improved over time", "file_id": "dr_MF0618", "chunk_id": 17 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "I don't think I'm there yet", "context": "Patient does not feel at risk for vision loss", "file_id": "dr_MF0618", "chunk_id": 17 }, { "code": "Lack of urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "as long as I can see basically things in front of me and stuff that, then I'm happy", "context": "Patient feels they can see well enough", "file_id": "dr_MF0618", "chunk_id": 18 }, { "code": "Fear of surgery", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I'm holding off on surgery for both", "context": "Patient is hesitant about undergoing surgery", "file_id": "dr_MF0618", "chunk_id": 18 }, { "code": "Monitoring by provider", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "But they're monitoring it, so", "context": "Provider is actively monitoring patient's condition", "file_id": "dr_MF0618", "chunk_id": 18 }, { "code": "Fear of treatment", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I was a little leery on the laser surgery", "context": "Patient expresses fear about undergoing laser surgery", "file_id": "dr_MF0618", "chunk_id": 19 }, { "code": "Social support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "my wife had it", "context": "Patient mentions spouse's experience as a source of support", "file_id": "dr_MF0618", "chunk_id": 19 }, { "code": "Fear of treatment", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I was a little leery on the laser surgery", "context": "Patient is hesitant about undergoing laser surgery", "file_id": "dr_MF0618", "chunk_id": 20 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "that hurt. So little leery if I have to go through it again, that's why I'm holding off, hoping-", "context": "Patient lacks understanding of treatment and its effects", "file_id": "dr_MF0618", "chunk_id": 20 }, { "code": "Fear of complications", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "what if they're doing that and they sneeze and it's , 'Ope, we gotta do a corneal transplant.'", "context": "Patient fears potential complications of treatment", "file_id": "dr_MF0618", "chunk_id": 20 }, { "code": "Waiting for technology improvement", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "hoping- ... that technology gets a little bit better.", "context": "Patient is waiting for advancements in treatment technology", "file_id": "dr_MF0618", "chunk_id": 20 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "what if they're doing that and they sneeze and it's , 'Ope, we gotta do a corneal transplant.'", "context": "Patient expresses fear of potential complications from treatment", "file_id": "dr_MF0618", "chunk_id": 21 }, { "code": "Adequate insurance coverage", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate insurance coverage", "quote": "my wife has a good, , medical plan. So cost isn't really much of a factor.", "context": "Patient's wife has good medical insurance, reducing financial burden", "file_id": "dr_MF0618", "chunk_id": 21 }, { "code": "Accessible location", "category": "FACILITATOR - Resources & Access", "subcategory": "Transportation assistance", "quote": "the proximity of everything here. Is good.", "context": "Patient finds clinic location convenient and accessible", "file_id": "dr_MF0618", "chunk_id": 21 }, { "code": "Convenient location", "category": "FACILITATOR - Resources & Access", "subcategory": "Accessible providers", "quote": "And with everything being around here, it's convenient", "context": "Patient finds healthcare services conveniently located", "file_id": "dr_MF0618", "chunk_id": 22 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "if the doctor says, 'I advise you to do this, this'", "context": "Patient values doctor's advice and guidance", "file_id": "dr_MF0618", "chunk_id": 22 }, { "code": "Accessible healthcare system", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "If nobody's around, I go to the Medi Center", "context": "Patient has access to alternative healthcare services", "file_id": "dr_MF0618", "chunk_id": 22 }, { "code": "Efficient referral process", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Patient navigation services", "quote": "they sent me right over to the ER and then...", "context": "Patient experiences efficient referral to emergency services", "file_id": "dr_MF0618", "chunk_id": 22 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "if you call up or even do an appointment, it's , you know, I just had to do one with the optometrist", "context": "Patient experiences difficulty with appointment scheduling", "file_id": "dr_MF0618", "chunk_id": 22 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "'Okay, the earliest one I get get you is August.'", "context": "Patient experiences long wait for appointment", "file_id": "dr_MF0618", "chunk_id": 23 }, { "code": "Appointment scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "'Put me on a wait list,' which is what happened with today's appointment.", "context": "Patient has to request waitlist for earlier appointment", "file_id": "dr_MF0618", "chunk_id": 23 }, { "code": "Wait list", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "'Put me on a wait list because I gotta see if there's an issue with the left eye.'", "context": "Patient uses waitlist to get earlier appointment", "file_id": "dr_MF0618", "chunk_id": 23 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "The first person I spoke to was , 'Yeah, lemme see what I could do. I'll call you back tomorrow.' And never called me back.", "context": "Patient experienced poor communication with healthcare staff", "file_id": "dr_MF0618", "chunk_id": 24 }, { "code": "Appointment scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "The first person I spoke to was , 'Yeah, lemme see what I could do. I'll call you back tomorrow.' And never called me back.", "context": "Patient had difficulty scheduling an appointment", "file_id": "dr_MF0618", "chunk_id": 24 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Healthcare System Support", "quote": "So I had called up and they said, 'Okay, well, let me talk to Dr. Paco's nurse,' and then gave me the appointment the next day.", "context": "Patient was able to access a provider after initial difficulty", "file_id": "dr_MF0618", "chunk_id": 24 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "So I had called up and they said, 'Okay, well, let me talk to Dr. Paco's nurse,' and then gave me the appointment the next day.", "context": "Patient experienced effective communication with healthcare staff after initial difficulty", "file_id": "dr_MF0618", "chunk_id": 24 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "today was a long appointment. I mean it was almost two hours and I heard a guy in the other room go, , I've been here for an hour and a half, when am I, , gonna see the doctor.", "context": "Patient experiences long wait time at clinic", "file_id": "dr_MF0618", "chunk_id": 25 }, { "code": "Appointment scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "So there should be a way of putting somebody in.", "context": "Patient suggests improvement for scheduling appointments", "file_id": "dr_MF0618", "chunk_id": 25 }, { "code": "Frustration with wait times", "category": "BARRIER - Emotional/Psychological", "subcategory": "Emotional/Psychological", "quote": "That does get frustrating.", "context": "Patient expresses frustration due to long wait times", "file_id": "dr_MF0618", "chunk_id": 25 }, { "code": "Understanding of vision issues", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "If it's a specific issue, I can't really see outta my left eye, I want to know if there's an issue.", "context": "Patient shows awareness of their vision health", "file_id": "dr_MF0618", "chunk_id": 25 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Healthcare System Support", "quote": "So there should be a way of putting somebody in.", "context": "Patient suggests improvement for accessing providers", "file_id": "dr_MF0618", "chunk_id": 25 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "It might be an hour, two hours", "context": "Patient experiences long wait times", "file_id": "dr_MF0618", "chunk_id": 26 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Healthcare System Support", "quote": "at least have, say, even a nurse practitioner", "context": "Patient suggests having accessible providers for quicker appointments", "file_id": "dr_MF0618", "chunk_id": 26 }, { "code": "Priority scheduling", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Healthcare System Support", "quote": "there should be some type of... on-ramp to... get you in", "context": "Patient suggests having a priority scheduling system", "file_id": "dr_MF0618", "chunk_id": 26 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "to say 2, 3, 4 months- ... to even be seen", "context": "Patient experiences long wait times for appointments", "file_id": "dr_MF0618", "chunk_id": 27 }, { "code": "Lack of access to healthcare", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "to say 2, 3, 4 months- ... to even be seen", "context": "Patient has difficulty accessing healthcare services", "file_id": "dr_MF0618", "chunk_id": 27 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "There's a doctor here, I'll get him when I can get 'em in", "context": "Patient experiences poor communication from healthcare providers", "file_id": "dr_MF0618", "chunk_id": 27 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Healthcare System Support", "quote": "at least have, say, even a nurse practitioner", "context": "Patient suggests having accessible providers for timely care", "file_id": "dr_MF0618", "chunk_id": 27 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Patient Empowerment", "quote": "You do it yourself?", "context": "Patient takes responsibility for their own diabetes care", "file_id": "dr_MF0618", "chunk_id": 27 }, { "code": "Lack of social support", "category": "BARRIER - Social Determinants of Health (SDOH)", "subcategory": "Education/health literacy barriers", "quote": "I do most of the stuff around the house, the cooking, the cleaning, the shopping", "context": "Patient lacks help with daily tasks", "file_id": "dr_MF0618", "chunk_id": 28 }, { "code": "Financial constraints", "category": "BARRIER - Social Determinants of Health (SDOH)", "subcategory": "Financial constraints", "quote": "Over $100,000 later after being in the hospital", "context": "Patient experienced high medical expenses", "file_id": "dr_MF0618", "chunk_id": 28 }, { "code": "Emotional distress", "category": "BARRIER - Emotional/Psychological", "subcategory": "Depression/anxiety", "quote": "I just need to lay down", "context": "Patient experiences physical and emotional exhaustion", "file_id": "dr_MF0618", "chunk_id": 28 }, { "code": "Social support network", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "My wife knows that there are times where I just do not feel right", "context": "Patient has a supportive spouse", "file_id": "dr_MF0618", "chunk_id": 28 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Had nothing to do with my sugar", "context": "Patient believes their condition is unrelated to sugar levels", "file_id": "dr_MF0618", "chunk_id": 29 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "So she at least listened to me", "context": "Patient feels heard by their provider", "file_id": "dr_MF0618", "chunk_id": 29 }, { "code": "Health literacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I can tell when I'm high, when I'm low", "context": "Patient has knowledge of their condition and can self-manage", "file_id": "dr_MF0618", "chunk_id": 29 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Because I've taken enough different classes", "context": "Patient has taken education courses to manage diabetes", "file_id": "dr_MF0618", "chunk_id": 30 }, { "code": "Diabetes self-management support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I know what I can eat, what I can't eat, I know what I can splurge", "context": "Patient has learned to manage diabetes through education", "file_id": "dr_MF0618", "chunk_id": 30 }, { "code": "Health literacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I know what I can eat, what I can't eat", "context": "Patient understands how to manage diet for diabetes", "file_id": "dr_MF0618", "chunk_id": 30 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "Just wish they'd have more", "context": "Patient desires more resources or services", "file_id": "dr_MF0618", "chunk_id": 31 }, { "code": "Social support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "So you had a lot of people with, 'Oh, well, I did this,' 'Oh, did you try this?'", "context": "Patient benefits from peer support and discussion", "file_id": "dr_MF0618", "chunk_id": 31 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "it teach, talk, , it was a little bit of everything", "context": "Patient receives educational content", "file_id": "dr_MF0618", "chunk_id": 31 }, { "code": "Emotional support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "Your wife listens to you", "context": "Patient has a supportive partner", "file_id": "dr_MF0618", "chunk_id": 31 }, { "code": "Lack of podiatrist", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of continuity of care", "quote": "I don't have a podiatrist anymore", "context": "Patient mentions not having a podiatrist", "file_id": "dr_MF0618", "chunk_id": 32 }, { "code": "Specialist access", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I have a PCP, a glaucoma doctor, immunologist, dermatologist", "context": "Patient has access to multiple specialists", "file_id": "dr_MF0618", "chunk_id": 32 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Do you feel comfortable sharing any worries that you have about your vision or your diabetes care with her?", "context": "Patient is asked about comfort level with provider", "file_id": "dr_MF0618", "chunk_id": 32 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "It, it... Moderate.", "context": "Patient seems uncertain about their condition", "file_id": "dr_MF0618", "chunk_id": 33 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "None mentioned in this chunk", "context": "No direct mention, but could be inferred from glasses and potential costs", "file_id": "dr_MF0618", "chunk_id": 33 }, { "code": "Health literacy barriers", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "Percentage wise?", "context": "Patient seems unsure about how to answer question about eyesight limitation", "file_id": "dr_MF0618", "chunk_id": 33 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "So if I have an issue, , call dermatology, .", "context": "Patient mentions ability to contact dermatology, implying accessible care", "file_id": "dr_MF0618", "chunk_id": 33 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "None mentioned in this chunk", "context": "No direct mention, but could be inferred from patient's understanding of their condition", "file_id": "dr_MF0618", "chunk_id": 33 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "You gotta wait until... they clear", "context": "Patient experiences delay in accessing care", "file_id": "dr_MF0618", "chunk_id": 34 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "get over glasses for sunglasses", "context": "Patient implies cost concerns for prescription glasses", "file_id": "dr_MF0618", "chunk_id": 34 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "You gotta wait until... they clear", "context": "Patient lacks clarity on appointment process", "file_id": "dr_MF0618", "chunk_id": 34 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "I get really annoyed", "context": "Patient expresses frustration with care experience", "file_id": "dr_MF0618", "chunk_id": 34 }, { "code": "Feeling overwhelmed", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "I'm , man, I might as well just not do anything", "context": "Patient feels overwhelmed by daily tasks", "file_id": "dr_MF0618", "chunk_id": 34 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "what was your expectation for your visit today?", "context": "Patient expects accessible care from provider", "file_id": "dr_MF0618", "chunk_id": 34 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "Seven years ago that would've been", "context": "Patient implies limited access to specialized care", "file_id": "dr_MF0618", "chunk_id": 35 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "So he wanted me to see an optometrist", "context": "Patient was referred without clear explanation", "file_id": "dr_MF0618", "chunk_id": 35 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "set up an appointment with the optometrist", "context": "Patient was able to get a referral to a specialist", "file_id": "dr_MF0618", "chunk_id": 35 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "So that's when he said, 'That's not really our realm'", "context": "Provider shows understanding of patient's concern", "file_id": "dr_MF0618", "chunk_id": 35 }, { "code": "Appointment scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "'cause August appointment, so", "context": "Patient experiences difficulty with scheduling follow-up appointments", "file_id": "dr_MF0618", "chunk_id": 36 }, { "code": "Lack of continuity of care", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of continuity of care", "quote": "So he wanted me to see an optometrist", "context": "Patient is referred to another provider, indicating potential lack of continuity", "file_id": "dr_MF0618", "chunk_id": 36 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "No they’re pretty good here", "context": "Patient expresses satisfaction with their healthcare providers", "file_id": "dr_MF0618", "chunk_id": 36 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "I still have an ongoing condition- ... that needs to be improved before I can get glasses", "context": "Patient cannot get new glasses due to unresolved condition", "file_id": "dr_SR0511(part2)", "chunk_id": 0 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "I still have an ongoing condition- ... that needs to be improved before I can get glasses", "context": "Patient implies cost or treatment limitations due to unresolved condition", "file_id": "dr_SR0511(part2)", "chunk_id": 0 }, { "code": "Frustration", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "is frustrating", "context": "Patient feels frustrated about vision and treatment limitations", "file_id": "dr_SR0511(part2)", "chunk_id": 0 }, { "code": "Limited control", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "So yes, I am aware of it. But right now there's nothing I can do", "context": "Patient feels helpless about current vision and treatment", "file_id": "dr_SR0511(part2)", "chunk_id": 0 }, { "code": "Healthcare system support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "So, , I am aware of, of my vision", "context": "Patient is receiving some level of care and monitoring", "file_id": "dr_SR0511(part2)", "chunk_id": 0 }, { "code": "Family history of diabetes", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "diabetes is in my family", "context": "Patient aware of family medical history", "file_id": "dr_SR0511(part2)", "chunk_id": 1 }, { "code": "Lack of family history of glaucoma", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Not that I'm aware", "context": "Patient unaware of potential genetic links to eye conditions", "file_id": "dr_SR0511(part2)", "chunk_id": 1 }, { "code": "Personal experience with diabetes", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I do have the diabetes", "context": "Patient has personal experience managing chronic condition", "file_id": "dr_SR0511(part2)", "chunk_id": 1 }, { "code": "Family health history", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "and heart condition is on my other side of my family", "context": "Patient discusses family medical history", "file_id": "dr_SR0511(part2)", "chunk_id": 2 }, { "code": "Positive experience", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I feel very positive", "context": "Patient describes overall experience with eye care", "file_id": "dr_SR0511(part2)", "chunk_id": 2 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I'm very happy with him", "context": "Patient expresses satisfaction with doctor", "file_id": "dr_SR0511(part2)", "chunk_id": 3 }, { "code": "Efficient care", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "they don't waste my time", "context": "Patient appreciates timely service at clinic", "file_id": "dr_SR0511(part2)", "chunk_id": 3 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "I feel very positive", "context": "Patient feels heard and understood by doctor", "file_id": "dr_SR0511(part2)", "chunk_id": 3 }, { "code": "Reminder systems", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "my phone and my, my, my calendar. Mm-hmm. Respondent: Just the reminders and I do those reminders.", "context": "Patient uses reminders to keep up with appointments", "file_id": "dr_SR0511(part2)", "chunk_id": 4 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "they don't waste my time. Good.", "context": "Patient feels provider is efficient and respectful of their time", "file_id": "dr_SR0511(part2)", "chunk_id": 4 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "And I feel very good about it.", "context": "Patient has a positive feeling towards their provider", "file_id": "dr_SR0511(part2)", "chunk_id": 4 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "Dr. Fregali told me that the medication doesn't work at night.", "context": "Patient feels informed and guided by their provider", "file_id": "dr_SR0511(part2)", "chunk_id": 4 }, { "code": "Expensive treatments", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Expensive treatments/surgery", "quote": "It's very expensive. Expensive? Yeah. I just paid a $700 bill yesterday", "context": "Patient finds healthcare services costly", "file_id": "dr_SR0511(part2)", "chunk_id": 5 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I've been very happy with it", "context": "Patient has a positive experience with their healthcare provider", "file_id": "dr_SR0511(part2)", "chunk_id": 5 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I have not been discouraged at all. Okay. I've been very happy with it", "context": "Patient finds healthcare services accessible and supportive", "file_id": "dr_SR0511(part2)", "chunk_id": 5 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "It's very expensive. I just paid a $700 bill yesterday.", "context": "Patient finds healthcare costs to be high", "file_id": "dr_SR0511(part2)", "chunk_id": 6 }, { "code": "Insurance coverage issues", "category": "BARRIER - SDOH", "subcategory": "Insurance coverage issues", "quote": "I feel that my PEIA is not fabulous.", "context": "Patient has concerns about their insurance coverage", "file_id": "dr_SR0511(part2)", "chunk_id": 6 }, { "code": "Expensive treatments", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Expensive treatments/surgery", "quote": "It's very expensive. I just paid a $700 bill yesterday.", "context": "Patient finds treatment costs to be high", "file_id": "dr_SR0511(part2)", "chunk_id": 6 }, { "code": "Adequate insurance coverage", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate insurance coverage", "quote": "I mean, I know that the bill I paid would've been almost $5,000 if I didn't have it.", "context": "Patient appreciates having insurance to reduce costs", "file_id": "dr_SR0511(part2)", "chunk_id": 6 }, { "code": "Financial assistance", "category": "FACILITATOR - Resources & Access", "subcategory": "Financial assistance programs", "quote": "I mean, I know that the bill I paid would've been almost $5,000 if I didn't have it.", "context": "Patient benefits from having insurance to lower costs", "file_id": "dr_SR0511(part2)", "chunk_id": 6 }, { "code": "Cost burden", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Expensive treatments/surgery", "quote": "But the cost is still a burden.", "context": "Patient finds cost of treatment a significant burden", "file_id": "dr_SR0511(part2)", "chunk_id": 7 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "the cost would be, but I,", "context": "Patient mentions cost as a concern", "file_id": "dr_SR0511(part2)", "chunk_id": 7 }, { "code": "Accessible parking", "category": "FACILITATOR - Resources & Access", "subcategory": "Transportation assistance", "quote": "the parking's great.", "context": "Patient appreciates convenient parking at clinic", "file_id": "dr_SR0511(part2)", "chunk_id": 7 }, { "code": "Easy access", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "the access to this facility is right on ground floor", "context": "Patient finds the clinic easily accessible", "file_id": "dr_SR0511(part2)", "chunk_id": 8 }, { "code": "Convenient location", "category": "FACILITATOR - Resources & Access", "subcategory": "Transportation assistance", "quote": "getting here is easy to, to get here", "context": "Patient finds the clinic location convenient", "file_id": "dr_SR0511(part2)", "chunk_id": 8 }, { "code": "Lack of knowledge", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I didn't know they had them", "context": "Patient unaware of diabetes education classes", "file_id": "dr_SR0511(part2)", "chunk_id": 9 }, { "code": "Education barriers", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "No diabetes education", "context": "Patient lacks formal diabetes education", "file_id": "dr_SR0511(part2)", "chunk_id": 9 }, { "code": "Healthcare access barriers", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "Not knowing about it", "context": "Patient unaware of available resources", "file_id": "dr_SR0511(part2)", "chunk_id": 9 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "If it was something you knew about", "context": "Patient interested in diabetes education", "file_id": "dr_SR0511(part2)", "chunk_id": 9 }, { "code": "Health literacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "Other than myself looking things up and asking questions", "context": "Patient takes initiative to learn about diabetes", "file_id": "dr_SR0511(part2)", "chunk_id": 9 }, { "code": "Lack of knowledge", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Not knowing about it", "context": "Patient unaware of available resources", "file_id": "dr_SR0511(part2)", "chunk_id": 10 }, { "code": "Transportation issues", "category": "BARRIER - SDOH", "subcategory": "Transportation issues", "quote": "So I wouldn't have to physically go someplace", "context": "Patient prefers not to travel for appointments", "file_id": "dr_SR0511(part2)", "chunk_id": 10 }, { "code": "Convenience", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "if it was just, , , you could pick and choose when you wanted to go", "context": "Patient values flexibility in scheduling", "file_id": "dr_SR0511(part2)", "chunk_id": 10 }, { "code": "Telehealth options", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Telehealth options", "quote": "And if it would be a webinar, that would be even better", "context": "Patient prefers online appointments", "file_id": "dr_SR0511(part2)", "chunk_id": 10 }, { "code": "Accessibility", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate resources", "quote": "making it more accessible by putting on online", "context": "Patient values ease of access to care", "file_id": "dr_SR0511(part2)", "chunk_id": 10 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "Because, it's an hour drive here. It's an hour drive home.", "context": "Patient mentions long commute to clinic", "file_id": "dr_SR0511(part2)", "chunk_id": 11 }, { "code": "Time constraints", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "To be in here 20 minutes. (laughs) ... But it's still two hour-", "context": "Patient highlights time spent traveling to clinic", "file_id": "dr_SR0511(part2)", "chunk_id": 11 }, { "code": "Accessible services", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "1. Healthcare System Support", "quote": "So making it more accessible by putting on online-", "context": "Patient suggests online services for convenience", "file_id": "dr_SR0511(part2)", "chunk_id": 11 }, { "code": "Social support", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "3. Patient Empowerment", "quote": "Yes. Do you have people you can share your worries or fears with about your diabetes and eyesight? Respondent: Yes", "context": "Patient has support network for emotional needs", "file_id": "dr_SR0511(part2)", "chunk_id": 11 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "But it's still two hour-", "context": "Patient mentions time it takes to get to appointment", "file_id": "dr_SR0511(part2)", "chunk_id": 12 }, { "code": "Positive patient-provider relationship", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "2. Provider Relationship", "quote": "I have a very good doctor", "context": "Patient expresses satisfaction with their doctor", "file_id": "dr_SR0511(part2)", "chunk_id": 12 }, { "code": "Effective communication", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "2. Provider Relationship", "quote": "I feel Dr. Fregali would be able to listen", "context": "Patient feels heard by their doctor", "file_id": "dr_SR0511(part2)", "chunk_id": 12 }, { "code": "Social support networks", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "3. Patient Empowerment", "quote": "My family. Your family? Respondent: I have friends that I can share that with", "context": "Patient has people to share worries and fears with", "file_id": "dr_SR0511(part2)", "chunk_id": 12 }, { "code": "Transportation assistance", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "4. Resources & Access", "quote": "Yeah. Who, who's that? Respondent: I feel - my mom", "context": "Patient has someone to help with daily chores, including transportation", "file_id": "dr_SR0511(part2)", "chunk_id": 12 }, { "code": "Social Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "I feel - my mom. Or even my sisters.", "context": "Patient has family members to rely on for help", "file_id": "dr_SR0511(part2)", "chunk_id": 13 }, { "code": "Healthcare Advice", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I could talk to my doctor, Dr. Nair.", "context": "Patient has a doctor they can consult for advice", "file_id": "dr_SR0511(part2)", "chunk_id": 13 }, { "code": "Professional Network", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I have students who are doctors now that, that I feel if I needed to, I could talk to them.", "context": "Patient has a network of medical professionals for guidance", "file_id": "dr_SR0511(part2)", "chunk_id": 13 }, { "code": "Family Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "I would probably call my sisters. They're both pharmacists.", "context": "Patient has family members with medical expertise to consult", "file_id": "dr_SR0511(part2)", "chunk_id": 13 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "I don't, don't driving at night anymore", "context": "Patient has difficulty driving due to eyesight", "file_id": "dr_SR0511(part2)", "chunk_id": 14 }, { "code": "Lack of enjoyment", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "2. Patient Beliefs & Perceptions", "quote": "driving at night is something I would say that I no longer enjoy", "context": "Patient's perception of eyesight affecting daily activities", "file_id": "dr_SR0511(part2)", "chunk_id": 14 }, { "code": "Age related issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "I think part of that is my age", "context": "Patient attributes eyesight issues to age", "file_id": "dr_SR0511(part2)", "chunk_id": 14 }, { "code": "Social support network", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "3. Patient Empowerment", "quote": "Yeah. I feel that there's people out there that I could, yes", "context": "Patient has a supportive network", "file_id": "dr_SR0511(part2)", "chunk_id": 14 }, { "code": "Lack of motivation", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "But I don't feel that my eyesight is what stops me from doing that. Right. Respondent: I think the fact of any, not, just not wanting to is probably why I don't.", "context": "Patient lacks motivation due to perceived lack of vision problems", "file_id": "dr_SR0511(part2)", "chunk_id": 15 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I expected to get in and out. Mm-hmm. Respondent: And I did.", "context": "Patient had a positive experience with the healthcare provider", "file_id": "dr_SR0511(part2)", "chunk_id": 15 }, { "code": "Effective appointment scheduling", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Appointment scheduling difficulties", "quote": "I expected to get in and out. Mm-hmm. Respondent: And I did.", "context": "Patient had a smooth appointment scheduling experience", "file_id": "dr_SR0511(part2)", "chunk_id": 15 }, { "code": "Telehealth options", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Telehealth options", "quote": "if they can give me a shot from my computer, it'd be perfect", "context": "Patient expresses desire for remote healthcare services", "file_id": "dr_SR0511(part2)", "chunk_id": 16 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "", "context": "No direct quote, but implied lack of understanding", "file_id": "dr_SR0511(part2)", "chunk_id": 17 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "", "context": "No direct quote, interview chunk does not provide specific information", "file_id": "dr_SR0511(part2)", "chunk_id": 17 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "", "context": "No direct quote, interview chunk lacks specific details", "file_id": "dr_SR0511(part2)", "chunk_id": 17 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "try to stick to, just seeing what different recipes are out there", "context": "Patient seeks health information for diabetes management", "file_id": "dr_HD1103(part1)", "chunk_id": 0 }, { "code": "Dietary management", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "follow a strict diet, watch your calorie intake", "context": "Patient prioritizes dietary control for diabetes care", "file_id": "dr_HD1103(part1)", "chunk_id": 0 }, { "code": "Health priorities", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "the biggest priority is to stay as healthy as I possibly can", "context": "Patient understands importance of overall health in diabetes management", "file_id": "dr_HD1103(part1)", "chunk_id": 0 }, { "code": "Exercise routine", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I walk, I try to exercise as much as I possibly can", "context": "Patient engages in physical activity for diabetes control", "file_id": "dr_HD1103(part1)", "chunk_id": 0 }, { "code": "Provider advice", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "what are some things that your doctor has discussed with you", "context": "Patient values provider guidance for diabetes care", "file_id": "dr_HD1103(part1)", "chunk_id": 0 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "to follow a strict diet, watch your car-- , calorie intake", "context": "Patient discusses importance of health education for diabetes management", "file_id": "dr_HD1103(part1)", "chunk_id": 1 }, { "code": "Provider discussion", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "what are some things that your doctor has discussed with you", "context": "Patient mentions discussing important topics with their doctor", "file_id": "dr_HD1103(part1)", "chunk_id": 1 }, { "code": "Self management", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I try to keep everything, , at bay", "context": "Patient emphasizes importance of self-managing their condition", "file_id": "dr_HD1103(part1)", "chunk_id": 1 }, { "code": "Health literacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I'm in tune to, , , how high my sugar runs or how low", "context": "Patient demonstrates understanding of their condition and its management", "file_id": "dr_HD1103(part1)", "chunk_id": 1 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't know", "context": "Patient unsure about diabetes effects on eyes", "file_id": "dr_HD1103(part1)", "chunk_id": 2 }, { "code": "Poor provider communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "they really haven't", "context": "Doctors didn't explain diabetes effects on eyes", "file_id": "dr_HD1103(part1)", "chunk_id": 2 }, { "code": "Health literacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "some of it I've read online", "context": "Patient educates self about diabetes and eyes", "file_id": "dr_HD1103(part1)", "chunk_id": 2 }, { "code": "Provider explanation", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "from what I understood from what the doctors explained to me over the years", "context": "Doctors provided some information about diabetes and eyes", "file_id": "dr_HD1103(part1)", "chunk_id": 2 }, { "code": "Lack of education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "I don't know", "context": "Patient lacks understanding about diabetes effects on eyes", "file_id": "dr_HD1103(part1)", "chunk_id": 2 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "from what I understood about how diabetes affects your eyes", "context": "Patient is trying to understand the relationship between diabetes and eye health", "file_id": "dr_HD1103(part1)", "chunk_id": 3 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "so, so they're pretty informative", "context": "Patient finds online resources informative about diabetes and eye health", "file_id": "dr_HD1103(part1)", "chunk_id": 3 }, { "code": "Provider explanation", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "from what I understood from what the doctors explained to me over the years", "context": "Patient values provider's explanation of diabetes and eye health", "file_id": "dr_HD1103(part1)", "chunk_id": 3 }, { "code": "Access to care", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate access to healthcare", "quote": "And where do you typically get your eye exams? Is it here at the Eye Institute or somewhere else where you regularly go?", "context": "Patient has access to multiple providers for eye care", "file_id": "dr_HD1103(part1)", "chunk_id": 3 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "my retinal doctor is at UPMC", "context": "Patient has access to a specialist", "file_id": "dr_HD1103(part1)", "chunk_id": 4 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Dr. H", "context": "Patient mentions doctor by name, implying a relationship", "file_id": "dr_HD1103(part1)", "chunk_id": 4 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "they check for-- , , they check my-- , you know, the, the-- my retina and so on, the nerves of my eye", "context": "Patient seems unsure about the exam procedures", "file_id": "dr_HD1103(part1)", "chunk_id": 5 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "The tech usually makes me read the chart", "context": "Patient mentions a familiar and possibly comfortable procedure with the technician", "file_id": "dr_HD1103(part1)", "chunk_id": 5 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I believe eye exams should be at least every six months", "context": "Patient shows awareness of recommended follow-up frequency", "file_id": "dr_HD1103(part1)", "chunk_id": 5 }, { "code": "Overwhelming experience", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "Sometimes, to me, that's just very overwhelming", "context": "Patient feels overwhelmed by multiple medical students examining them", "file_id": "dr_HD1103(part1)", "chunk_id": 6 }, { "code": "Provider issues", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of continuity of care", "quote": "when you have everybody shining a light in your eye", "context": "Patient is bothered by multiple medical students examining them", "file_id": "dr_HD1103(part1)", "chunk_id": 6 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "when one doctor comes in, does examination and leave", "context": "Patient prefers a single, consistent provider", "file_id": "dr_HD1103(part1)", "chunk_id": 6 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "I scheduled an appointment to see Dr. M. And I can't get an appointment with him till December.", "context": "Patient experiences long wait for doctor's appointment", "file_id": "dr_HD1103(part1)", "chunk_id": 7 }, { "code": "Appointment scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "it's scary because it's-- it seems , , the doctor's appointments are so far out right now.", "context": "Patient finds scheduling process challenging", "file_id": "dr_HD1103(part1)", "chunk_id": 7 }, { "code": "Feeling overwhelmed", "category": "BARRIER - Emotional/Psychological", "subcategory": "Emotional/Psychological", "quote": "Sometimes, to me, that's just very overwhelming.", "context": "Patient feels overwhelmed by their situation", "file_id": "dr_HD1103(part1)", "chunk_id": 7 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I wish they could squeeze you in quicker, .", "context": "Patient desires more accessible healthcare providers", "file_id": "dr_HD1103(part1)", "chunk_id": 7 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "I just wish they could squeeze you in quicker", "context": "Patient experiences long wait times for appointments", "file_id": "dr_HD1103(part1)", "chunk_id": 8 }, { "code": "Appointment scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "I wish there was more open appointments and-- , , and availability", "context": "Patient has difficulty scheduling appointments", "file_id": "dr_HD1103(part1)", "chunk_id": 8 }, { "code": "Lack of continuity of care", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "I know my doctor is up in years. Maybe he's gonna retire. Maybe he's cutting back", "context": "Patient is concerned about potential changes in their healthcare provider", "file_id": "dr_HD1103(part1)", "chunk_id": 8 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Healthcare System Support", "quote": "I just wish they could squeeze you in quicker", "context": "Patient desires more accessible providers for timely care", "file_id": "dr_HD1103(part1)", "chunk_id": 8 }, { "code": "Regular maintenance", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Patient Empowerment", "quote": "you gotta-- you gotta keep everything in tune to make sure everything remains healthy", "context": "Patient understands importance of regular maintenance for health", "file_id": "dr_HD1103(part1)", "chunk_id": 8 }, { "code": "Insurance coverage issues", "category": "BARRIER - SDOH", "subcategory": "Insurance coverage issues", "quote": "I am on, , my insurance.", "context": "Patient is concerned about insurance coverage", "file_id": "dr_HD1103(part1)", "chunk_id": 9 }, { "code": "Health literacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "just regular common sense things", "context": "Patient demonstrates understanding of self-care", "file_id": "dr_HD1103(part1)", "chunk_id": 9 }, { "code": "Insurance coverage issues", "category": "BARRIER - SDOH", "subcategory": "Insurance coverage issues", "quote": "And I don't have-- , as I understand, there's no, no insurance, and it doesn't cover your eyeglasses", "context": "Patient lacks adequate insurance coverage for eye care", "file_id": "dr_HD1103(part1)", "chunk_id": 10 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "And the out-of-pocket expense for supplement insurance is incredible", "context": "Patient faces high costs for supplemental insurance", "file_id": "dr_HD1103(part1)", "chunk_id": 10 }, { "code": "Out-of-pocket costs", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Out-of-pocket costs", "quote": "And the out-of-pocket expense for supplement insurance is incredible", "context": "Patient faces high out-of-pocket expenses", "file_id": "dr_HD1103(part1)", "chunk_id": 10 }, { "code": "Lost wages due to appointments", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Lost wages due to appointments", "quote": "you've really gotta budget yourself, and you-- that's when you find yourself going to a food bank for food", "context": "Patient experiences financial hardship due to appointment-related expenses", "file_id": "dr_HD1103(part1)", "chunk_id": 10 }, { "code": "Adequate insurance coverage", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate insurance coverage", "quote": "And I don't have-- , as I understand, there's no, no insurance, and it doesn't cover your eyeglasses", "context": "Patient lacks adequate insurance coverage, implying its importance", "file_id": "dr_HD1103(part1)", "chunk_id": 10 }, { "code": "Financial assistance programs", "category": "FACILITATOR - Resources & Access", "subcategory": "Financial assistance programs", "quote": "I'm on that threshold too, where I have too much money where I don't qualify for, , , assistance", "context": "Patient is aware of financial assistance programs but does not qualify", "file_id": "dr_HD1103(part1)", "chunk_id": 10 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "what can I cut back on and still be able to afford my eyeglasses?", "context": "Patient struggles with budgeting for healthcare expenses", "file_id": "dr_HD1103(part1)", "chunk_id": 11 }, { "code": "Insurance coverage issues", "category": "BARRIER - SDOH", "subcategory": "Insurance coverage issues", "quote": "if you're in that doughnut hole where, either you make just a little bit over and they, they will deny you", "context": "Patient faces challenges with insurance coverage", "file_id": "dr_HD1103(part1)", "chunk_id": 11 }, { "code": "Cost-related stress", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "it's taxing, and those are my concerns. And, and it gets scary", "context": "Patient experiences emotional distress due to financial worries", "file_id": "dr_HD1103(part1)", "chunk_id": 11 }, { "code": "Lack of access to healthcare", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "being that, you know, Fayette County is a depressed area", "context": "Patient highlights limited healthcare resources in their area", "file_id": "dr_HD1103(part1)", "chunk_id": 11 }, { "code": "Healthcare system support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I wish the system was better, but hopefully, with this research and things that, we can work to, provide you guys more solutions", "context": "Researcher acknowledges need for improved healthcare system support", "file_id": "dr_HD1103(part1)", "chunk_id": 11 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "there has to be something, some type of help for you to get new glasses or get proper eye care", "context": "Patient expresses difficulty accessing necessary eye care", "file_id": "dr_HD1103(part1)", "chunk_id": 12 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "Medicare doesn't cover a lot of that", "context": "Patient faces financial barriers due to limited insurance coverage", "file_id": "dr_HD1103(part1)", "chunk_id": 12 }, { "code": "Insurance coverage issues", "category": "BARRIER - SDOH", "subcategory": "Insurance coverage issues", "quote": "Medicare doesn't cover a lot of that", "context": "Patient experiences limitations in insurance coverage for necessary care", "file_id": "dr_HD1103(part1)", "chunk_id": 12 }, { "code": "Lack of resources", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "it seems the-- I know I'm looking for a handout, but there has to be something, some type of help", "context": "Patient lacks knowledge about available resources for eye care", "file_id": "dr_HD1103(part1)", "chunk_id": 12 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "it's tearful, it's scary", "context": "Patient expresses emotional distress related to potential diagnosis", "file_id": "dr_HD1103(part1)", "chunk_id": 12 }, { "code": "Healthcare system gaps", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of continuity of care", "quote": "there's not enough programs out there available", "context": "Patient perceives shortcomings in the healthcare system", "file_id": "dr_HD1103(part1)", "chunk_id": 12 }, { "code": "Cost-related barriers", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Out-of-pocket costs", "quote": "Medicare doesn't cover a lot of that", "context": "Patient faces financial burden due to out-of-pocket expenses", "file_id": "dr_HD1103(part1)", "chunk_id": 12 }, { "code": "Emotional distress", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "it's tearful, it's scary", "context": "Patient experiences emotional distress related to health concerns", "file_id": "dr_HD1103(part1)", "chunk_id": 12 }, { "code": "Healthcare system support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "you said, when you're on the other side of the desk, you just see the person", "context": "Patient values provider empathy and understanding", "file_id": "dr_HD1103(part1)", "chunk_id": 12 }, { "code": "Resources and access", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate insurance coverage", "quote": "there has to be something, some type of help for you to get new glasses or get proper eye care", "context": "Patient seeks resources to improve access to necessary care", "file_id": "dr_HD1103(part1)", "chunk_id": 12 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "to eat healthy, , vegetables, produce, and everything else is just so expensive", "context": "Patient finds healthy food unaffordable", "file_id": "dr_HD1103(part1)", "chunk_id": 13 }, { "code": "Lack of access to healthcare", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "there's not enough programs out there available", "context": "Patient perceives lack of available health programs", "file_id": "dr_HD1103(part1)", "chunk_id": 13 }, { "code": "Food insecurity", "category": "BARRIER - SDOH", "subcategory": "Social Determinants of Health", "quote": "I had to rely on Food Bank--", "context": "Patient relies on food bank for nutrition", "file_id": "dr_HD1103(part1)", "chunk_id": 13 }, { "code": "Limited resources", "category": "BARRIER - SDOH", "subcategory": "Resources & Access", "quote": "there's not good nourishable food", "context": "Patient lacks access to nutritious food", "file_id": "dr_HD1103(part1)", "chunk_id": 13 }, { "code": "Pride in asking for help", "category": "BARRIER - Emotional/Psychological", "subcategory": "Emotional/Psychological", "quote": "you hate to ask for a handout, but what are you supposed to do, ?", "context": "Patient feels ashamed to ask for assistance", "file_id": "dr_HD1103(part1)", "chunk_id": 13 }, { "code": "Systemic barriers", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "the system shouldn't make you do that", "context": "Patient criticizes healthcare system for inadequate support", "file_id": "dr_HD1103(part1)", "chunk_id": 13 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "you hate to ask for a handout, but what are you supposed to do", "context": "Patient struggles with financial difficulties", "file_id": "dr_HD1103(part1)", "chunk_id": 14 }, { "code": "Expensive treatments", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Expensive treatments/surgery", "quote": "produce should be more affordable", "context": "Patient finds treatments unaffordable", "file_id": "dr_HD1103(part1)", "chunk_id": 14 }, { "code": "Lack of access to healthcare", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "the system shouldn't make you do that", "context": "Patient feels the system hinders access to care", "file_id": "dr_HD1103(part1)", "chunk_id": 14 }, { "code": "Insurance coverage issues", "category": "BARRIER - SDOH", "subcategory": "Insurance coverage issues", "quote": "it's not only people on Medicare", "context": "Patient mentions insurance coverage problems", "file_id": "dr_HD1103(part1)", "chunk_id": 14 }, { "code": "Financial assistance needed", "category": "FACILITATOR - Resources & Access", "subcategory": "Financial assistance programs", "quote": "what are you supposed to do", "context": "Patient implies need for financial help", "file_id": "dr_HD1103(part1)", "chunk_id": 14 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "I just wish the appointments more readily available", "context": "Patient desires more accessible appointment scheduling", "file_id": "dr_HD1103(part1)", "chunk_id": 15 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "cost actually with your copays when you go in to see the doctor", "context": "Patient is concerned about copay costs", "file_id": "dr_HD1103(part1)", "chunk_id": 15 }, { "code": "Insurance coverage issues", "category": "BARRIER - SDOH", "subcategory": "Insurance coverage issues", "quote": "I fall in that doughnut hole to where I-- lot of times I can't afford an appointment because I can't afford the copay", "context": "Patient experiences financial difficulties due to insurance coverage gaps", "file_id": "dr_HD1103(part1)", "chunk_id": 15 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "you have-- you have-- you have a great institution. West Virginia University is fantastic", "context": "Patient praises the healthcare institution", "file_id": "dr_HD1103(part1)", "chunk_id": 15 }, { "code": "Appointment scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "I just wish the appointments more readily available", "context": "Patient experiences difficulty scheduling appointments", "file_id": "dr_HD1103(part1)", "chunk_id": 15 }, { "code": "Out-of-pocket costs", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Out-of-pocket costs", "quote": "cost actually with your copays when you go in to see the doctor", "context": "Patient is concerned about out-of-pocket expenses", "file_id": "dr_HD1103(part1)", "chunk_id": 15 }, { "code": "Cost constraints", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Out-of-pocket costs", "quote": "I fall in that doughnut hole to where I-- lot of times I can't afford an appointment because I can't afford the copay", "context": "Patient cannot afford copays for appointments", "file_id": "dr_HD1103(part1)", "chunk_id": 16 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "I fall in that doughnut hole to where I-- lot of times I can't afford an appointment because I can't afford the copay", "context": "Patient faces financial difficulties due to copays", "file_id": "dr_HD1103(part1)", "chunk_id": 16 }, { "code": "Appointment scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "I just wish that, , the, the appointments could be more, , more generous", "context": "Patient finds appointment scheduling inflexible", "file_id": "dr_HD1103(part1)", "chunk_id": 16 }, { "code": "Lack of provider time", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider issues", "quote": "I don't think doctors are given enough time-- to, to sit there and talk to you", "context": "Patient feels providers are rushed and lack time for discussion", "file_id": "dr_HD1103(part1)", "chunk_id": 16 }, { "code": "Need for patient navigation services", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Patient navigation services", "quote": "I just wish there was some type of, , help at times to help me get through and, , so I could keep the appointment and make it", "context": "Patient desires support for navigating healthcare system", "file_id": "dr_HD1103(part1)", "chunk_id": 16 }, { "code": "Need for financial assistance programs", "category": "FACILITATOR - Resources & Access", "subcategory": "Financial assistance programs", "quote": "there's all-- there's a lot of, -- , if, if there would be more grants or something that you could go after and see if, -- to make it a better way", "context": "Patient suggests need for financial assistance programs", "file_id": "dr_HD1103(part1)", "chunk_id": 16 }, { "code": "Caring providers", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "we need more professionals, , to good professionals, caring professionals, knowledgeable, that are able to listen to what I have to say, absorb it, and then treat it and understand the full person", "context": "Patient values providers who are caring and empathetic", "file_id": "dr_HD1103(part1)", "chunk_id": 16 }, { "code": "Lack of research", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "there's not enough studies for retinal repair, retinal nerve eye, , repair or anything that", "context": "Patient expresses frustration with limited research on retinal repair", "file_id": "dr_HD1103(part1)", "chunk_id": 17 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "Tell me-- be upfront and be honest with me. Tell me, , , , how-- , , rub your crystal ball, , tell me what's going on", "context": "Patient values honesty and openness from their provider", "file_id": "dr_HD1103(part1)", "chunk_id": 17 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I've always had doctors mention about good eye care, good dietary, , ways, and to make sure your eyes-- there's vi-- eye vitamins, there's AREDS", "context": "Patient has received health education from their providers", "file_id": "dr_HD1103(part1)", "chunk_id": 17 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "I'm comfortable. , , , , I'll tell you what's going on with me", "context": "Patient feels comfortable communicating with their provider", "file_id": "dr_HD1103(part1)", "chunk_id": 17 }, { "code": "Lack of research", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "there's not enough studies for retinal repair, retinal nerve eye, repair or anything that", "context": "Patient feels there is insufficient research on retinal repair", "file_id": "dr_HD1103(part1)", "chunk_id": 18 }, { "code": "Insurance coverage issues", "category": "BARRIER - SDOH", "subcategory": "Insurance coverage issues", "quote": "insurance doesn't cover a lot of it because it's experimental", "context": "Patient mentions insurance not covering experimental treatments", "file_id": "dr_HD1103(part1)", "chunk_id": 18 }, { "code": "Regulatory barriers", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of continuity of care", "quote": "the FDA puts the kibosh on a lot of different things, and it just takes too long for something to come about", "context": "Patient feels FDA regulations hinder progress in treatment development", "file_id": "dr_HD1103(part1)", "chunk_id": 18 }, { "code": "Experimental treatment access", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Expensive treatments/surgery", "quote": "insurance doesn't cover a lot of it because it's experimental", "context": "Patient highlights limited access to experimental treatments due to cost", "file_id": "dr_HD1103(part1)", "chunk_id": 18 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "every time I go in, I tell them-- I ask them what's going on, how things are going", "context": "Patient values open communication with their doctor", "file_id": "dr_HD1103(part1)", "chunk_id": 18 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "either they listen or they don't", "context": "Patient questions provider's responsiveness", "file_id": "dr_HD1103(part1)", "chunk_id": 19 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "it just seems it's-- it is absorbed. They just give you the vanilla answer and then move on", "context": "Patient feels provider doesn't fully address concerns", "file_id": "dr_HD1103(part1)", "chunk_id": 19 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I always ask them, , what's new on the horizon? Are we making, , gains forward?", "context": "Patient actively engages with provider", "file_id": "dr_HD1103(part1)", "chunk_id": 19 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "I always ask them, , what's new on the horizon? Are we making, , gains forward?", "context": "Patient and provider have open dialogue", "file_id": "dr_HD1103(part1)", "chunk_id": 19 }, { "code": "Lack of understanding about DR progression", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Patient Beliefs & Perceptions", "quote": "it's not only your eyesight. It, it affects every, , perspective of your body.", "context": "Patient discusses the impact of diabetes on overall health", "file_id": "dr_HD1103(part1)", "chunk_id": 20 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I always ask, , if there's anything new on horizon in care.", "context": "Patient seeks information about new treatments and care options", "file_id": "dr_HD1103(part1)", "chunk_id": 20 }, { "code": "Shared decision-making", "category": "FACILITATOR - Provider Relationship", "subcategory": "Shared decision-making", "quote": "Oh, I do. I do that all the time. , , I've, I've learned-- my-- both of my parents were in nursing homes and I learned one thing, you have to advocate for yourself on everything", "context": "Patient advocates for themselves and engages in shared decision-making", "file_id": "dr_HD1103(part1)", "chunk_id": 20 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "you have to, -- they, they, they don't-- they have a short window. They have 15 minutes to-- you-- and you gotta-- and you gotta share your past six months or a year with them.", "context": "Patient emphasizes the importance of effective communication with healthcare providers", "file_id": "dr_HD1103(part1)", "chunk_id": 20 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Patient empowerment", "quote": "you have to advocate for yourself on everything, no matter who it is, no matter what the doctor, how good or bad the physician-- not bad, but how, -- how good the physician is that day", "context": "Patient takes an active role in their care and advocates for themselves", "file_id": "dr_HD1103(part1)", "chunk_id": 20 }, { "code": "Lack of time", "category": "BARRIER - Provider/System Issues", "subcategory": "Long wait times", "quote": "they have a short window. They have 15 minutes to-- you-- and you gotta-- and you gotta share your past six months or a year with them.", "context": "Patient feels rushed during appointments", "file_id": "dr_HD1103(part1)", "chunk_id": 21 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "they don't-- they have a short window. They have 15 minutes to-- you-- and you gotta-- and you gotta share your past six months or a year with them.", "context": "Patient feels providers do not listen", "file_id": "dr_HD1103(part1)", "chunk_id": 21 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I've learned-- my-- both of my parents were in nursing homes and I learned one thing, you have to advocate for yourself on everything", "context": "Patient takes initiative in healthcare", "file_id": "dr_HD1103(part1)", "chunk_id": 21 }, { "code": "Self advocacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "you have to advocate for yourself on everything, no matter who it is, no matter what the doctor", "context": "Patient understands importance of self-advocacy", "file_id": "dr_HD1103(part1)", "chunk_id": 21 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I'm very fearful of that. You hear about the blue light and so on from computer screens and everything.", "context": "Patient has fear related to eye health", "file_id": "dr_HD1103(part1)", "chunk_id": 21 }, { "code": "Health literacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I'm a firm believer in that. And yes, I do wear sunglasses, and I do watch-- you know, sometimes you get flashed, . , you see a shiny thing, , it'll set your vision off a little bit.", "context": "Patient has knowledge about protective measures", "file_id": "dr_HD1103(part1)", "chunk_id": 21 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't think-- I don't think as a, -- our diets or our food when it's processed has enough, , nutrients in it to keep us healthy", "context": "Patient lacks knowledge about nutrition and eye health", "file_id": "dr_HD1103(part1)", "chunk_id": 22 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I've always believed in, , vitamins and, , fish oil and so on--", "context": "Patient values health knowledge and preventive measures", "file_id": "dr_HD1103(part1)", "chunk_id": 22 }, { "code": "Self care practices", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I do follow protective measures", "context": "Patient takes proactive steps for eye health", "file_id": "dr_HD1103(part1)", "chunk_id": 22 }, { "code": "Positive health beliefs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I believe it's there for a reason", "context": "Patient has positive attitude towards supplements and vitamins", "file_id": "dr_HD1103(part1)", "chunk_id": 22 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "have more time", "context": "Patient desires more time with doctor", "file_id": "dr_HD1103(part1)", "chunk_id": 23 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "maybe spend a little bit more time with me when I come in", "context": "Patient wants more interaction with doctor", "file_id": "dr_HD1103(part1)", "chunk_id": 23 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Healthcare System Support", "quote": "have more time", "context": "Patient values provider availability", "file_id": "dr_HD1103(part1)", "chunk_id": 23 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "maybe spend a little bit more time with me when I come in", "context": "Patient seeks stronger provider bond", "file_id": "dr_HD1103(part1)", "chunk_id": 23 }, { "code": "Lack of time", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider issues", "quote": "have more time", "context": "Patient feels provider does not spend enough time with them", "file_id": "dr_HD1103(part1)", "chunk_id": 24 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "explain it to me, as on layman terms", "context": "Patient wants provider to explain things in a way they can understand", "file_id": "dr_HD1103(part1)", "chunk_id": 24 }, { "code": "Education barriers", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "not all of us are college scholars", "context": "Patient implies that medical explanations can be too complex", "file_id": "dr_HD1103(part1)", "chunk_id": 24 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "explain it to me, as on layman terms", "context": "Patient values clear and simple communication from provider", "file_id": "dr_HD1103(part1)", "chunk_id": 24 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "spend a little bit more time with me when I come in", "context": "Patient wants provider to be more attentive and caring", "file_id": "dr_HD1103(part1)", "chunk_id": 24 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "what's new on the horizon, what's latest and greatest in eye care", "context": "Patient is interested in learning more about their condition and treatment options", "file_id": "dr_HD1103(part1)", "chunk_id": 24 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I think it's-- I, I-- in any, , , adult onset is terrible because you don't know how long you've been a diabetic and how long you're-- it has affected your eyes.", "context": "Patient discusses uncertainty about diabetes impact on vision", "file_id": "dr_HD1103(part1)", "chunk_id": 25 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now' (no perceived urgency)", "quote": "I don't think I'll lose my vision to diabetes.", "context": "Patient believes they won't lose vision due to diabetes", "file_id": "dr_HD1103(part1)", "chunk_id": 25 }, { "code": "Positive outlook", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I think there's a lot to behold with that as well.", "context": "Patient shows awareness of their condition", "file_id": "dr_HD1103(part1)", "chunk_id": 25 }, { "code": "Effective self-management", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I see very well. I, I don't have no issues.", "context": "Patient reports successful management of their condition", "file_id": "dr_HD1103(part1)", "chunk_id": 25 }, { "code": "Lack of urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "I'm able to function. I'm able to get along fine.", "context": "Patient feels no immediate need for follow-up due to current ability to function", "file_id": "dr_HD1103(part1)", "chunk_id": 26 }, { "code": "Lack of mention", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Just--", "context": "Patient seems to lack detailed understanding of their diabetes care", "file_id": "dr_WL1011", "chunk_id": 0 }, { "code": "Health monitoring", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Trying to keep my sugar low", "context": "Patient prioritizes health monitoring", "file_id": "dr_WL1011", "chunk_id": 0 }, { "code": "Access to technology", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate resources", "quote": "They gave me a Dexcom 7", "context": "Patient has access to technology for health monitoring", "file_id": "dr_WL1011", "chunk_id": 0 }, { "code": "Self management", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I take four shots a day", "context": "Patient engages in self-management activities", "file_id": "dr_WL1011", "chunk_id": 0 }, { "code": "Equipment issues", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor device functionality", "quote": "once in a while it will not read", "context": "Patient experiences technical problems with Dexcom 7", "file_id": "dr_WL1011", "chunk_id": 1 }, { "code": "Device malfunction", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of continuity of care", "quote": "wouldn't recognize", "context": "Dexcom 7 sensor fails to function properly", "file_id": "dr_WL1011", "chunk_id": 1 }, { "code": "Frustration with devices", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "So that's the biggest problem with the Dexcom is-- the monitors", "context": "Patient expresses frustration with Dexcom 7", "file_id": "dr_WL1011", "chunk_id": 1 }, { "code": "Lack of awareness", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I didn't know it was gone", "context": "Patient unaware of vision loss in right eye", "file_id": "dr_WL1011", "chunk_id": 2 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "because, I can see with my left eye", "context": "Patient feels no need to address right eye issue due to adequate vision in left eye", "file_id": "dr_WL1011", "chunk_id": 2 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I didn't know it was gone-- because, , I can see with my left eye", "context": "Patient unaware of vision loss in one eye", "file_id": "dr_WL1011", "chunk_id": 3 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "She didn't say a thing. Just -- gone", "context": "Healthcare provider did not communicate effectively", "file_id": "dr_WL1011", "chunk_id": 3 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "He says, 'Well, she said she had a high reading, so let me check to see if she was right.'", "context": "Patient feels doctor did not clearly explain their condition", "file_id": "dr_WL1011", "chunk_id": 4 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "He says, 'Yep. She was right.'", "context": "Patient seems to be questioning doctor's expertise", "file_id": "dr_WL1011", "chunk_id": 4 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Healthcare System Support", "quote": "Went back the next morning at 8:30.", "context": "Patient had easy access to provider for follow-up appointment", "file_id": "dr_WL1011", "chunk_id": 4 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "He says, 'Go home. Get back here 8:30 tomorrow morning, and we'll see if the pressure went down.'", "context": "Doctor clearly explained instructions to patient", "file_id": "dr_WL1011", "chunk_id": 4 }, { "code": "Provider explained risks", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "They told me that I needed to keep my sugar down.", "context": "Patient reports doctor discussed diabetes impact on eyes", "file_id": "dr_WL1011", "chunk_id": 5 }, { "code": "Provider prescribed treatment", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "They put me on eye drops.", "context": "Patient received medical treatment for eye issue", "file_id": "dr_WL1011", "chunk_id": 5 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "They come and get me, and I check in out front", "context": "Patient describes ease of access to care", "file_id": "dr_WL1011", "chunk_id": 6 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "put a-- t-talk to me and ask me how-- if I'm-- have any problems", "context": "Patient reports provider initiates conversation about concerns", "file_id": "dr_WL1011", "chunk_id": 6 }, { "code": "Reminder systems not mentioned", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "None", "context": "Patient does not mention receiving reminders for appointments", "file_id": "dr_WL1011", "chunk_id": 6 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "And he says, 'Everything's fine. It looks good.'", "context": "Patient receives reassuring communication from doctor", "file_id": "dr_WL1011", "chunk_id": 7 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "And he says, 'Everything's fine. It looks good.'", "context": "Patient receives clear information from doctor", "file_id": "dr_WL1011", "chunk_id": 7 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "And then they come and get me and put me in a room, and the doctor comes in and talks to me.", "context": "Patient has access to healthcare provider", "file_id": "dr_WL1011", "chunk_id": 7 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now' (no perceived urgency)", "quote": "And he says, 'Everything's fine. It looks good.'", "context": "Patient may not feel urgent need for follow-up due to positive diagnosis", "file_id": "dr_WL1011", "chunk_id": 7 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "there's a lady here that takes care of all the VAs", "context": "Patient has access to a dedicated VA staff member for scheduling", "file_id": "dr_WL1011", "chunk_id": 8 }, { "code": "Reminder systems", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "she'll call me and say, in a month or so and say, 'Your next appointment is at such and such a date, such and such a time'", "context": "Patient receives reminders for upcoming appointments", "file_id": "dr_WL1011", "chunk_id": 8 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "He's been here every time I've been here", "context": "Patient has a consistent and reliable provider", "file_id": "dr_WL1011", "chunk_id": 8 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "a couple times I've come from my appointment, and I've had to wait and wait and wait", "context": "Patient experiences long wait times at appointments", "file_id": "dr_WL1011", "chunk_id": 9 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "And he says, 'I can't do anything about it.'", "context": "Patient feels doctor is unhelpful in addressing wait time concerns", "file_id": "dr_WL1011", "chunk_id": 9 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Healthcare System Support", "quote": "He's been here every time I've been here", "context": "Patient appreciates consistent provider availability", "file_id": "dr_WL1011", "chunk_id": 9 }, { "code": "Reminder systems", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Healthcare System Support", "quote": "she'll call me and say, in a month or so and say, 'Your next appointment is at such and such a date, such and such a time'", "context": "Patient benefits from reminder calls for appointments", "file_id": "dr_WL1011", "chunk_id": 9 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "back-to-back", "context": "Patient experiences long wait times due to back-to-back appointments", "file_id": "dr_WL1011", "chunk_id": 10 }, { "code": "Lack of provider empathy", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "I talked to the doctor about it, and he says, 'I can't do anything about it'", "context": "Patient feels dismissed by provider", "file_id": "dr_WL1011", "chunk_id": 10 }, { "code": "Transportation issues", "category": "BARRIER - SDOH", "subcategory": "Transportation issues", "quote": "I'm 20-- 22 miles", "context": "Patient travels a distance for appointments", "file_id": "dr_WL1011", "chunk_id": 10 }, { "code": "Time constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "taking up your day", "context": "Patient's daily schedule is affected by appointments", "file_id": "dr_WL1011", "chunk_id": 10 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "we don't have ca-cable where we live", "context": "Patient mentions lack of services in their area", "file_id": "dr_WL1011", "chunk_id": 11 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "If you don't take care of your eyes, you're not go-- you're gonna go blind.", "context": "Patient is fearful of going blind due to diabetes", "file_id": "dr_WL1011", "chunk_id": 12 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "All I know is it, it gets worse.", "context": "Patient lacks knowledge about diabetic retinopathy", "file_id": "dr_WL1011", "chunk_id": 13 }, { "code": "Poor explanation", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "No. S1: 09:29 No? You're not s-- do you-- do anything about it?", "context": "Provider did not explain diabetic retinopathy", "file_id": "dr_WL1011", "chunk_id": 13 }, { "code": "Comfortable communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Fine. S1: 09:43 Very comfortable? S2: 09:44 I Dr. G.", "context": "Patient feels comfortable talking to doctor", "file_id": "dr_WL1011", "chunk_id": 13 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "Oh, yeah", "context": "Patient feels doctor was receptive to concerns", "file_id": "dr_WL1011", "chunk_id": 14 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "he said, 'You got floaters.' I says, 'No. I don't have anything floating.'", "context": "Patient and doctor discussed symptoms", "file_id": "dr_WL1011", "chunk_id": 14 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I, I don't have any problem with, with him", "context": "Patient has a good relationship with doctor", "file_id": "dr_WL1011", "chunk_id": 14 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I'm content with the way he does things", "context": "Patient expresses satisfaction with doctor", "file_id": "dr_WL1011", "chunk_id": 15 }, { "code": "Perceived severity of diabetes", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "It's very serious", "context": "Patient understands the seriousness of diabetes", "file_id": "dr_WL1011", "chunk_id": 15 }, { "code": "Trust in provider recommendations", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "if I need-- he says if I need the shots, they'll go back to giving me the shots", "context": "Patient trusts doctor's treatment plan", "file_id": "dr_WL1011", "chunk_id": 15 }, { "code": "Family history awareness", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "out of the 12, so far that I know of, six of us have diabetes", "context": "Patient is aware of family history of diabetes", "file_id": "dr_WL1011", "chunk_id": 15 }, { "code": "Adherence motivation", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "If I don't pay attention to the doctor, it's probably very s-- very possible", "context": "Patient is motivated to follow doctor's advice", "file_id": "dr_WL1011", "chunk_id": 15 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "If I don't pay attention to the doctor, it's probably very possible", "context": "Patient lacks understanding of diabetes impact on vision", "file_id": "dr_WL1011", "chunk_id": 16 }, { "code": "Provider reassurance", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "But he says, 'Today everything's fine'", "context": "Patient feels reassured by provider's words", "file_id": "dr_WL1011", "chunk_id": 16 }, { "code": "Trust in provider", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "if I need-- he says if I need the shots, they'll go back to giving me the shots", "context": "Patient trusts provider's treatment decisions", "file_id": "dr_WL1011", "chunk_id": 16 }, { "code": "Fear of vision loss", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "If I don't pay attention to the doctor, it's probably very possible", "context": "Patient fears losing vision due to diabetes", "file_id": "dr_WL1011", "chunk_id": 16 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I just can't tell how close I am", "context": "Patient unsure about their condition", "file_id": "dr_WL1011", "chunk_id": 17 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I lost my right eye", "context": "Patient experienced a negative outcome", "file_id": "dr_WL1011", "chunk_id": 17 }, { "code": "Access to healthcare", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate access to care", "quote": "They took those out", "context": "Patient received necessary treatment", "file_id": "dr_WL1011", "chunk_id": 17 }, { "code": "Effective treatment", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "They took the other-- right one out, and then I got the left one done two years ago", "context": "Patient received timely and effective care", "file_id": "dr_WL1011", "chunk_id": 17 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "I don't wanna have to pay for it", "context": "Patient prefers VA care to avoid paying", "file_id": "dr_WL1011", "chunk_id": 18 }, { "code": "Adequate insurance coverage", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate insurance coverage", "quote": "since I'm a veteran, I go to the VA for-- everything that I can go to the VA for", "context": "Patient utilizes VA services due to coverage", "file_id": "dr_WL1011", "chunk_id": 18 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "I don't wanna have to pay for it", "context": "Patient avoids paying for healthcare services", "file_id": "dr_WL1011", "chunk_id": 19 }, { "code": "Cost issues", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Out-of-pocket costs", "quote": "The cost", "context": "Patient is discouraged by high costs of healthcare", "file_id": "dr_WL1011", "chunk_id": 19 }, { "code": "Expensive treatments", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Expensive treatments/surgery", "quote": "it just seems to keep going up and up and up and up", "context": "Patient is concerned about rising healthcare costs", "file_id": "dr_WL1011", "chunk_id": 19 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I go to the VA for everything that I can", "context": "Patient has access to preferred healthcare provider", "file_id": "dr_WL1011", "chunk_id": 19 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "if I-- if I had one that wasn't-- I wasn't happy with, I'd be saying, 'I need another doctor.'", "context": "Patient values a good relationship with their provider", "file_id": "dr_WL1011", "chunk_id": 20 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Just pay attention to what the doctor tells you.", "context": "Patient emphasizes importance of clear communication from providers", "file_id": "dr_WL1011", "chunk_id": 20 }, { "code": "Lack of health literacy", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "I says, 'I'm 35 years old. Ain't nobody telling me what I can eat and what I can't eat.'", "context": "Patient resists dietary advice due to lack of understanding", "file_id": "dr_WL1011", "chunk_id": 21 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "we had to scrimp and pinch", "context": "Patient experienced financial difficulties in the past", "file_id": "dr_WL1011", "chunk_id": 21 }, { "code": "Lack of understanding about DR progression", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "If I'd have listened in '94, I'd have still had my left foot. I'd have had my right eye.", "context": "Patient realizes too late the consequences of not managing diabetes", "file_id": "dr_WL1011", "chunk_id": 21 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "If I'd have listened in '94", "context": "Patient acknowledges the importance of health education and advice", "file_id": "dr_WL1011", "chunk_id": 21 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "If I'd have listened in '94, I'd have still had my left foot. I'd have had my right eye.", "context": "Patient expresses regret over not taking care of diabetes earlier", "file_id": "dr_WL1011", "chunk_id": 22 }, { "code": "Social support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "She tries the best she can.", "context": "Patient's wife helps with diabetes care", "file_id": "dr_WL1011", "chunk_id": 22 }, { "code": "Patient stubbornness", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "I'm still stubborn. She'll fix me something to eat, and if I don't like it, I'll eat a little bit of it, but I won't--", "context": "Patient admits to being stubborn about food choices", "file_id": "dr_WL1011", "chunk_id": 22 }, { "code": "Emotional support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "Oh, yeah. Yeah.", "context": "Patient feels comfortable sharing worries and fears with wife", "file_id": "dr_WL1011", "chunk_id": 22 }, { "code": "Social Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "She'll fix me something to eat", "context": "Patient receives help from a family member", "file_id": "dr_WL1011", "chunk_id": 23 }, { "code": "Health Education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "she got on the computer and started looking up--", "context": "Patient's family member helps them learn about diabetes", "file_id": "dr_WL1011", "chunk_id": 23 }, { "code": "Positive Provider Relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "She, she knows more about diabetes than I do", "context": "Patient trusts and values their provider's knowledge", "file_id": "dr_WL1011", "chunk_id": 23 }, { "code": "Lack Of Understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "sometimes I listened, and sometimes I didn't", "context": "Patient may not fully understand their condition", "file_id": "dr_WL1011", "chunk_id": 23 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "No specific quote, but context implies potential issue", "context": "Patient has a prosthetic and mentions sweating and rubbing, potentially implying mobility or transportation challenges", "file_id": "dr_WL1011", "chunk_id": 24 }, { "code": "Lack of urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "biggest expectation was whether I was gonna have to get another shot or not", "context": "Patient's expectation for care implies a lack of perceived urgency for follow-up", "file_id": "dr_WL1011", "chunk_id": 25 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Doc come in, and he says, No. You don't need one.", "context": "Patient reports clear communication from provider", "file_id": "dr_WL1011", "chunk_id": 25 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Doc come in, and he says, No. You don't need one.", "context": "Patient has access to a provider for follow-up care", "file_id": "dr_WL1011", "chunk_id": 25 }, { "code": "Clear expectations", "category": "FACILITATOR - Provider Relationship", "subcategory": "Shared decision-making", "quote": "he says, I'll see you in two months, and we'll see how it's doing then", "context": "Provider sets clear expectations for follow-up care", "file_id": "dr_WL1011", "chunk_id": 25 }, { "code": "Fear of treatment", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "'cause they are not comfortable", "context": "Patient expresses discomfort with shots", "file_id": "dr_WL1011", "chunk_id": 26 }, { "code": "Provider communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "And he says, 'I'll see you in two months, and we'll see how it's doing then.'", "context": "Patient reports provider's communication about follow-up", "file_id": "dr_WL1011", "chunk_id": 26 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "And I said, 'I'd rather not--'", "context": "Patient reports provider's response to their concerns", "file_id": "dr_WL1011", "chunk_id": 26 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I went to diabetes education classes at Mon General with April Lombardi", "context": "Patient participated in diabetes education classes", "file_id": "dr_DA1010_Part2", "chunk_id": 0 }, { "code": "Provider expertise", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "for somebody to teach diabetes and to tell you what to eat and they don't have diabetes", "context": "Patient questions provider's credibility due to lack of personal experience with diabetes", "file_id": "dr_DA1010_Part2", "chunk_id": 0 }, { "code": "Access to dieticians", "category": "FACILITATOR - Resources & Access", "subcategory": "Community health programs", "quote": "And I've talked to numerous dieticians", "context": "Patient has access to multiple dieticians for support", "file_id": "dr_DA1010_Part2", "chunk_id": 0 }, { "code": "Perceived helpfulness", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "Well, you're gonna learn a little bit from all of 'em", "context": "Patient finds education classes somewhat helpful", "file_id": "dr_DA1010_Part2", "chunk_id": 0 }, { "code": "Lack of trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "for somebody to teach diabetes and to tell you what to eat and they don't have diabetes", "context": "Patient questions provider's credibility due to lack of personal experience with diabetes", "file_id": "dr_DA1010_Part2", "chunk_id": 1 }, { "code": "Health education barriers", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "it's just book learning. I can do that, I can do that from the internet", "context": "Patient feels health education is insufficient or not personalized", "file_id": "dr_DA1010_Part2", "chunk_id": 1 }, { "code": "Social support networks", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "I've got a very, very special friend. And she's the head dietician down here in campus", "context": "Patient has a supportive friend who is a healthcare professional", "file_id": "dr_DA1010_Part2", "chunk_id": 1 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "And she's helped me with a lot of stuff", "context": "Patient has access to a helpful and supportive healthcare provider", "file_id": "dr_DA1010_Part2", "chunk_id": 1 }, { "code": "Personal relationship", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I didn't want that to be a factor", "context": "Patient stopped attending appointments due to personal relationship with dietician", "file_id": "dr_DA1010_Part2", "chunk_id": 2 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "And she's very good", "context": "Patient praises the dietician, indicating a positive relationship", "file_id": "dr_DA1010_Part2", "chunk_id": 2 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I met her through an appointment", "context": "Patient had access to the dietician through an appointment", "file_id": "dr_DA1010_Part2", "chunk_id": 2 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't, I don't know", "context": "Patient expresses uncertainty about treatment", "file_id": "dr_DA1010_Part2", "chunk_id": 3 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "Well, how in the hell can it?", "context": "Patient expresses frustration and uncertainty about treatment outcome", "file_id": "dr_DA1010_Part2", "chunk_id": 3 }, { "code": "Fear of treatment", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "No more. No more.", "context": "Patient expresses fear of needle procedure for eye treatment", "file_id": "dr_DA1010_Part2", "chunk_id": 4 }, { "code": "Painful experience", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "It wasn't no picnic.", "context": "Patient describes previous treatment experience as painful", "file_id": "dr_DA1010_Part2", "chunk_id": 4 }, { "code": "Painful experience", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "It wasn't no road, it wasn't no, , picnic. It was, it was, it was painful.", "context": "Patient had a painful experience during treatment", "file_id": "dr_DA1010_Part2", "chunk_id": 5 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "So what they put in this eye was different than what they put in that eye.", "context": "Patient seems unsure about treatment differences", "file_id": "dr_DA1010_Part2", "chunk_id": 5 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "Whenever I feel jumping up and running.", "context": "Patient feels anxious during treatment", "file_id": "dr_DA1010_Part2", "chunk_id": 5 }, { "code": "Lack of trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "It seems you come in to get one problem fixed and they create two others", "context": "Patient expresses distrust in healthcare providers", "file_id": "dr_DA1010_Part2", "chunk_id": 6 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "It seems you come in to get one problem fixed and they create two others", "context": "Patient implies poor communication from healthcare providers", "file_id": "dr_DA1010_Part2", "chunk_id": 6 }, { "code": "Negative expectations", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "It seems you come in to get one problem fixed and they create two others", "context": "Patient has negative expectations about healthcare visits", "file_id": "dr_DA1010_Part2", "chunk_id": 6 }, { "code": "Routine exam", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Well, today was just a routine exam", "context": "Patient attends regular check-ups", "file_id": "dr_DA1010_Part2", "chunk_id": 6 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "he's happy", "context": "Patient seems satisfied with provider's attitude", "file_id": "dr_DA1010_Part2", "chunk_id": 7 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "he checked the retinas to make sure it was still staying attached", "context": "Patient understands what provider did during exam", "file_id": "dr_DA1010_Part2", "chunk_id": 7 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "today was just a routine exam", "context": "Patient had easy access to scheduled appointment", "file_id": "dr_DA1010_Part2", "chunk_id": 7 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I just do regular things. I don't do things about my diabetes.", "context": "Patient lacks awareness about diabetes self-care", "file_id": "dr_RJ0619", "chunk_id": 0 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now' (no perceived urgency)", "quote": "I just do regular things. I don't do things about my diabetes.", "context": "Patient does not prioritize diabetes care", "file_id": "dr_RJ0619", "chunk_id": 0 }, { "code": "Health education needed", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I just do regular things. I don't do things about my diabetes.", "context": "Patient requires health education to manage diabetes", "file_id": "dr_RJ0619", "chunk_id": 0 }, { "code": "Medication adherence", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I take my medication.", "context": "Patient is adherent to medication regimen", "file_id": "dr_RJ0619", "chunk_id": 0 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "My, , lips beginning to get stuck", "context": "Patient describes vague symptoms indicating potential lack of understanding about diabetes progression", "file_id": "dr_RJ0619", "chunk_id": 1 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Stop eating sweets and, , start curbing down on my sugar intake", "context": "Patient describes self-management strategies indicating some level of health education", "file_id": "dr_RJ0619", "chunk_id": 1 }, { "code": "Health literacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "Stop eating sweets and, , start curbing down on my sugar intake", "context": "Patient demonstrates understanding of diabetes management through diet", "file_id": "dr_RJ0619", "chunk_id": 1 }, { "code": "Self management support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "Stop eating sweets and, , start curbing down on my sugar intake", "context": "Patient describes actions taken to manage diabetes", "file_id": "dr_RJ0619", "chunk_id": 1 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "My, , lips beginning to get stuck", "context": "Patient describes vague symptoms", "file_id": "dr_RJ0619", "chunk_id": 2 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "Especially when my mouth and get dry and stuff", "context": "Patient expresses anxiety about symptoms", "file_id": "dr_RJ0619", "chunk_id": 2 }, { "code": "Health literacy barriers", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "I just can feel", "context": "Patient lacks clear understanding of condition", "file_id": "dr_RJ0619", "chunk_id": 2 }, { "code": "Emotional distress", "category": "BARRIER - Emotional/Psychological", "subcategory": "Diabetes distress", "quote": "Hard for me to say things because- my mouth all glued up", "context": "Patient expresses frustration with symptoms", "file_id": "dr_RJ0619", "chunk_id": 2 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "So the dry mouth", "context": "Patient learns about diabetes symptoms", "file_id": "dr_RJ0619", "chunk_id": 2 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "they were not gonna be 100%, ? 'Cause the damage has been so bad because of the blood sugar", "context": "Patient lacks clear understanding of their condition", "file_id": "dr_RJ0619", "chunk_id": 3 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "they gave, they, at one point they was working on it and they're getting better", "context": "Patient feels supported by their doctor", "file_id": "dr_RJ0619", "chunk_id": 3 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "what has your doctor told you about how diabetes, , that has affected or might have affected your eyes?", "context": "Patient receives guidance from their doctor", "file_id": "dr_RJ0619", "chunk_id": 3 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "the damage has been so bad because of the blood sugar", "context": "Patient is concerned about their condition", "file_id": "dr_RJ0619", "chunk_id": 3 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "what has your doctor told you about how diabetes, , that has affected or might have affected your eyes?", "context": "Patient and doctor communicate effectively", "file_id": "dr_RJ0619", "chunk_id": 3 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "But it is not getting any worse", "context": "Patient seems unaware of potential diabetes complications", "file_id": "dr_RJ0619", "chunk_id": 4 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Here at the Eye Institute", "context": "Patient has easy access to eye care services", "file_id": "dr_RJ0619", "chunk_id": 4 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "They'll go in and they'll do, , the pressure and then, , every so often, maybe about two or three times, they'll do the... where they take the pictures", "context": "Patient understands procedures and feels informed", "file_id": "dr_RJ0619", "chunk_id": 4 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "because I drive,", "context": "Patient mentions driving themselves to appointments", "file_id": "dr_RJ0619", "chunk_id": 5 }, { "code": "Lack of access", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "At least once a year", "context": "Patient implies potential lack of access to more frequent care", "file_id": "dr_RJ0619", "chunk_id": 5 }, { "code": "No perceived urgency", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "2. Patient Beliefs & Perceptions", "quote": "At least once a year", "context": "Patient may not see the need for more frequent follow-ups", "file_id": "dr_RJ0619", "chunk_id": 5 }, { "code": "Accessible providers", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "1. Healthcare System Support", "quote": "I go in, I check in", "context": "Patient has easy access to care", "file_id": "dr_RJ0619", "chunk_id": 5 }, { "code": "Positive experience", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "2. Provider Relationship", "quote": "Other than that, it's, it's not a problem", "context": "Patient has a positive experience with their care", "file_id": "dr_RJ0619", "chunk_id": 5 }, { "code": "Lack of scheduling issues", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "It's pretty, pretty, pretty easy", "context": "Patient finds scheduling process to be easy", "file_id": "dr_RJ0619", "chunk_id": 6 }, { "code": "Occasional scheduling difficulty", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "Every, every so often I can't get the day or the time I want", "context": "Patient occasionally has trouble getting desired schedule", "file_id": "dr_RJ0619", "chunk_id": 6 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "people here... Pretty, , well about what they do, so it's not a, not difficult at all", "context": "Patient finds providers to be accessible and knowledgeable", "file_id": "dr_RJ0619", "chunk_id": 6 }, { "code": "Flexible scheduling", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Appointment scheduling difficulties", "quote": "But they normally get it around where I can work with", "context": "Patient appreciates flexibility in scheduling", "file_id": "dr_RJ0619", "chunk_id": 6 }, { "code": "Appointment scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "Every, every so often I can't get the day or the time I want", "context": "Patient experiences difficulty scheduling appointments at preferred times", "file_id": "dr_RJ0619", "chunk_id": 7 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Long wait times", "quote": "Yeah. No", "context": "Patient denies experiencing long wait times, but question implies it could be a concern", "file_id": "dr_RJ0619", "chunk_id": 7 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "Other than the shots that they tell me, ... They don't tell me do this, do that", "context": "Patient feels providers do not communicate effectively about eye care recommendations", "file_id": "dr_RJ0619", "chunk_id": 7 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Yeah, they get me in pretty quick", "context": "Patient appreciates prompt access to providers", "file_id": "dr_RJ0619", "chunk_id": 7 }, { "code": "Lack of challenges", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "No perceived urgency", "quote": "I don't quite know", "context": "Patient doesn't perceive any challenges", "file_id": "dr_RJ0619", "chunk_id": 8 }, { "code": "Top quality care", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I believe I'm getting top quality care", "context": "Patient is satisfied with their care", "file_id": "dr_RJ0619", "chunk_id": 8 }, { "code": "No suggested changes", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "Nothing that I would change", "context": "Patient has a positive experience with provider", "file_id": "dr_RJ0619", "chunk_id": 8 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "I'm an over-the-road truck driver", "context": "Patient's job as a truck driver may impact ability to attend follow-up appointments", "file_id": "dr_RJ0619", "chunk_id": 9 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Before the shots, he told me that I'm looked I was goin', goin' progression blind", "context": "Patient's initial lack of understanding about disease progression", "file_id": "dr_RJ0619", "chunk_id": 10 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "Very close. Very comfortable", "context": "Patient feels comfortable with their doctor", "file_id": "dr_RJ0619", "chunk_id": 10 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Very comfortable", "context": "Patient can express concerns to their doctor", "file_id": "dr_RJ0619", "chunk_id": 10 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "you have to wait to get exam here", "context": "Patient mentions waiting time for exams", "file_id": "dr_RJ0619", "chunk_id": 11 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Very comfortable", "context": "Patient feels comfortable talking to doctor", "file_id": "dr_RJ0619", "chunk_id": 11 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "They just gave me a new prescription", "context": "Patient receives timely care from provider", "file_id": "dr_RJ0619", "chunk_id": 11 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "I asked, bout my glasses", "context": "Patient openly discusses concerns with doctor", "file_id": "dr_RJ0619", "chunk_id": 11 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I didn't know it was a serious, , serious, but now with the eye care I'm getting, I know now that it is very serious", "context": "Patient initially lacked understanding of diabetes severity", "file_id": "dr_RJ0619", "chunk_id": 12 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "I follow what they say", "context": "Patient trusts and follows provider recommendations", "file_id": "dr_RJ0619", "chunk_id": 12 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "now with the eye care I'm getting, I know now that it is very serious", "context": "Patient received health education through eye care", "file_id": "dr_RJ0619", "chunk_id": 12 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I follow what they say", "context": "Patient has a positive and trusting relationship with provider", "file_id": "dr_RJ0619", "chunk_id": 12 }, { "code": "Lack of perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "I don't think I'm gonna lose my vision", "context": "Patient feels current treatment is effective, reducing concern about vision loss", "file_id": "dr_RJ0619", "chunk_id": 13 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Now that I'm doing what I'm doing with, with all these doctors...", "context": "Patient implies trust in healthcare providers due to collaborative care", "file_id": "dr_RJ0619", "chunk_id": 13 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Now that I'm doing what I'm doing with, with all these doctors...", "context": "Patient suggests awareness and engagement in health management through doctor interactions", "file_id": "dr_RJ0619", "chunk_id": 13 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Whatever. He said that will probably stopped the need for shots.", "context": "Patient seems unclear about treatment options", "file_id": "dr_RJ0619", "chunk_id": 14 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "Whatever. He said that will probably stopped the need for shots.", "context": "Patient's nonchalant attitude may indicate fear or avoidance", "file_id": "dr_RJ0619", "chunk_id": 14 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "He said that will probably stopped the need for shots.", "context": "Provider is explaining treatment in a reassuring manner", "file_id": "dr_RJ0619", "chunk_id": 14 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "they're doing a marvelous job at what they do", "context": "Patient expresses satisfaction with healthcare providers", "file_id": "dr_RJ0619", "chunk_id": 15 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I'm very informed about my eye care", "context": "Patient feels informed about their eye care", "file_id": "dr_RJ0619", "chunk_id": 15 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "they're doing a marvelous job at what they do", "context": "Patient has positive experience with healthcare system", "file_id": "dr_RJ0619", "chunk_id": 15 }, { "code": "Lack of health education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "They tried, but I didn't go", "context": "Patient did not attend diabetes education classes", "file_id": "dr_RJ0619", "chunk_id": 16 }, { "code": "Food preference barriers", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Cultural beliefs about healthcare", "quote": "'cause I'm not going to eat that food", "context": "Patient's food preferences hindered attendance at diabetes education classes", "file_id": "dr_RJ0619", "chunk_id": 16 }, { "code": "No social support", "category": "BARRIER - SDOH", "subcategory": "Social support networks", "quote": "No. Nobody? No family members that", "context": "Patient lacks social support for daily diabetes care", "file_id": "dr_RJ0619", "chunk_id": 16 }, { "code": "Lack of motivation", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "I'm gonna eat what I wanna eat", "context": "Patient shows lack of motivation to follow dietary advice", "file_id": "dr_RJ0619", "chunk_id": 17 }, { "code": "Social support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "I have people to talk to, yeah", "context": "Patient has friends to share worries and fears with", "file_id": "dr_RJ0619", "chunk_id": 17 }, { "code": "Resistance to advice", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't want them giving me no advice 'cause... hey", "context": "Patient resists advice from others, potentially due to lack of understanding", "file_id": "dr_RJ0619", "chunk_id": 17 }, { "code": "Lack of social support", "category": "BARRIER - SDOH", "subcategory": "Social Determinants of Health", "quote": "No. When you get sick, do you have someone to help you with your daily chores, food, transportation, and taking medications? Speaker 2: No.", "context": "Patient lacks support for daily tasks", "file_id": "dr_RJ0619", "chunk_id": 18 }, { "code": "Desire for independence", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Patient beliefs", "quote": "I'm sick, get out. Speaker 1: So you'd rather just take care of it? Speaker 2: Yeah, yeah. Be by myself.", "context": "Patient prefers self-care over seeking help", "file_id": "dr_RJ0619", "chunk_id": 18 }, { "code": "Limited health guidance", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "They, they might try to tell me something and I, I don't know.", "context": "Patient unsure about provider's advice", "file_id": "dr_RJ0619", "chunk_id": 18 }, { "code": "Available support system", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "Yeah, but I, I don't", "context": "Patient has someone to call for advice", "file_id": "dr_RJ0619", "chunk_id": 18 }, { "code": "Healthcare access barriers", "category": "BARRIER - SDOH", "subcategory": "Access to healthcare", "quote": "No. Have you ever needed somebody in those times? Speaker 2: No.", "context": "Patient lacks access to necessary care", "file_id": "dr_RJ0619", "chunk_id": 18 }, { "code": "Lack of social support", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Cultural beliefs about healthcare", "quote": "I'm sick, get out. Yeah, yeah. Be by myself.", "context": "Patient prefers to be alone when dealing with health issues", "file_id": "dr_RJ0619", "chunk_id": 19 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "None. At all. None.", "context": "Patient does not feel their eyesight is currently limiting", "file_id": "dr_RJ0619", "chunk_id": 19 }, { "code": "Positive expectations", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "To get my shots and to get, , my prescription.", "context": "Patient has clear expectations for their eye visit", "file_id": "dr_RJ0619", "chunk_id": 19 }, { "code": "Accessible care", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Everything went well", "context": "Patient had a positive experience with their eye visit", "file_id": "dr_RJ0619", "chunk_id": 19 }, { "code": "Fear of pain", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "my expectation for them not to hurt me", "context": "Patient fears pain from shots", "file_id": "dr_RJ0619", "chunk_id": 20 }, { "code": "Positive experience", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Everything went well. They gave me my shots. It was awesome.", "context": "Patient had a positive experience with healthcare provider", "file_id": "dr_RJ0619", "chunk_id": 20 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "They gave me my shots. It was awesome.", "context": "Patient felt informed and communicated with by provider", "file_id": "dr_RJ0619", "chunk_id": 20 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "maybe your diabetes is getting worse or maybe your sugar's messed up a little bit", "context": "Patient unsure about diabetes progression", "file_id": "dr_KD0321", "chunk_id": 1 }, { "code": "Symptom awareness", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "of course the blurry vision", "context": "Patient aware of symptoms indicating poor diabetes control", "file_id": "dr_KD0321", "chunk_id": 1 }, { "code": "Self monitoring", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "Anything... Any specific signs", "context": "Patient actively monitors diabetes symptoms", "file_id": "dr_KD0321", "chunk_id": 1 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't know if it had anything to do with this retinal tear or not", "context": "Patient unsure about diabetes impact on eyes", "file_id": "dr_KD0321", "chunk_id": 2 }, { "code": "Uncertainty about diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't know if it had anything to do with this retinal tear or not", "context": "Patient unsure about diabetes impact on eyes", "file_id": "dr_KD0321", "chunk_id": 2 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't know if it had anything to do with this retinal tear or not", "context": "Patient unsure about diabetes impact on eyes", "file_id": "dr_KD0321", "chunk_id": 3 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "It hasn't affected my acuity, my visual acuity", "context": "Patient feels no immediate need for follow-up", "file_id": "dr_KD0321", "chunk_id": 3 }, { "code": "Provider communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "They, they have? What have they told you- ... about that? Anything specific?", "context": "Patient receives information from doctor", "file_id": "dr_KD0321", "chunk_id": 3 }, { "code": "Access to healthcare", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate insurance coverage", "quote": "Ophthalmologist. Local. Bridgeport. Local", "context": "Patient has local access to eye care", "file_id": "dr_KD0321", "chunk_id": 3 }, { "code": "Local access", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate resources", "quote": "Local. Bridgeport.", "context": "Patient has local access to eye exams", "file_id": "dr_KD0321", "chunk_id": 4 }, { "code": "Accessible provider", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Ophthalmologist. Local. Bridgeport.", "context": "Patient has accessible provider for eye exams", "file_id": "dr_KD0321", "chunk_id": 4 }, { "code": "Good doctor", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I had a very good doctor", "context": "Patient appreciates their doctor", "file_id": "dr_KD0321", "chunk_id": 5 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "saw something, saw a red flag", "context": "Doctor effectively communicates concerns to patient", "file_id": "dr_KD0321", "chunk_id": 5 }, { "code": "Accessible provider", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "sent me here immediately, the same day", "context": "Patient received prompt referral to specialist", "file_id": "dr_KD0321", "chunk_id": 6 }, { "code": "Positive experience", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Uneventful. Just- Uneventful?", "context": "Patient had a smooth and uneventful experience with dilation", "file_id": "dr_KD0321", "chunk_id": 6 }, { "code": "Transportation assistance", "category": "FACILITATOR - Resources & Access", "subcategory": "Transportation assistance", "quote": "And I had a driver", "context": "Patient has access to transportation", "file_id": "dr_KD0321", "chunk_id": 6 }, { "code": "Having a driver", "category": "FACILITATOR - Resources & Access", "subcategory": "Transportation assistance", "quote": "And I had a driver", "context": "Patient has access to transportation", "file_id": "dr_KD0321", "chunk_id": 7 }, { "code": "Provider explanation", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Yeah. Which, , light. , bright light- Mm-hmm. ... and, , she provided the, , , darkening, , shield.", "context": "Provider explained process to patient", "file_id": "dr_KD0321", "chunk_id": 7 }, { "code": "Positive provider interaction", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "They were very good about that. , yeah.", "context": "Patient has positive experience with provider", "file_id": "dr_KD0321", "chunk_id": 7 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "They're very backed up", "context": "Patient experiences long wait times for appointments", "file_id": "dr_KD0321", "chunk_id": 8 }, { "code": "Appointment scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "They're very backed up", "context": "Patient has difficulty scheduling appointments due to provider's busy schedule", "file_id": "dr_KD0321", "chunk_id": 8 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "They're very backed up", "context": "Patient experiences long wait times due to high patient volume", "file_id": "dr_KD0321", "chunk_id": 9 }, { "code": "Appointment scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "They're very backed up now, even with- Yeah", "context": "Patient has trouble scheduling appointments due to clinic's busy schedule", "file_id": "dr_KD0321", "chunk_id": 9 }, { "code": "Provider availability", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "I think number of patients are- Mm.", "context": "Patient mentions issue with doctor's availability", "file_id": "dr_KD0321", "chunk_id": 10 }, { "code": "Lack of providers", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "No, dozens. There aren't?", "context": "Patient notes scarcity of optometrists in the area", "file_id": "dr_KD0321", "chunk_id": 10 }, { "code": "Continuity of care", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of continuity of care", "quote": "when you've had a family doctor for years and an- Mm-hmm.", "context": "Patient values long-term relationships with healthcare providers", "file_id": "dr_KD0321", "chunk_id": 10 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Do you have any recommendations about, , regarding your eye care? , any suggestions to improve the experience?", "context": "Patient seeks improvement in provider accessibility", "file_id": "dr_KD0321", "chunk_id": 10 }, { "code": "Accessible facility", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate access to care", "quote": "access to the facility is fine", "context": "Patient finds the clinic easily accessible", "file_id": "dr_KD0321", "chunk_id": 11 }, { "code": "Helpful staff", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Patient navigation services", "quote": "helpful people", "context": "Patient receives support from clinic staff", "file_id": "dr_KD0321", "chunk_id": 11 }, { "code": "Lack of challenges", "category": "BARRIER - Social Determinants of Health", "subcategory": "None", "quote": "No. ... care? No?", "context": "Patient reports no challenges with receiving care", "file_id": "dr_KD0321", "chunk_id": 12 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "So for example, do you wear sunglasses to r-", "context": "Patient is asked about self-care practices", "file_id": "dr_KD0321", "chunk_id": 12 }, { "code": "Self care practices", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "So what are some ways that you specifically take care of your eyes?", "context": "Patient is asked about eye care habits", "file_id": "dr_KD0321", "chunk_id": 12 }, { "code": "Access to care", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate access", "quote": "None. That's good to hear.", "context": "Patient reports no issues with accessing care", "file_id": "dr_KD0321", "chunk_id": 12 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "No", "context": "Patient does not express concern for vision loss with diabetes", "file_id": "dr_KD0321", "chunk_id": 13 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "So a multivitamin?", "context": "Patient is taking supplements, indicating some health awareness", "file_id": "dr_KD0321", "chunk_id": 13 }, { "code": "Accessible care", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Do you take any supplements for your eyes?", "context": "Interviewer is inquiring about patient's eye health, indicating accessible care", "file_id": "dr_KD0321", "chunk_id": 13 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "my PCP is very good about giving me a global", "context": "Patient has a positive relationship with their primary care physician", "file_id": "dr_KD0321", "chunk_id": 14 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "we discuss it every time", "context": "Patient and provider have open and regular discussions about diabetes management", "file_id": "dr_KD0321", "chunk_id": 14 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "my PCP is very good about giving me a global", "context": "Patient feels their provider is understanding and supportive", "file_id": "dr_KD0321", "chunk_id": 14 }, { "code": "Shared decision-making", "category": "FACILITATOR - Provider Relationship", "subcategory": "Shared decision-making", "quote": "we talk about all complications", "context": "Patient and provider work together to make informed decisions about diabetes management", "file_id": "dr_KD0321", "chunk_id": 14 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "availability of herself", "context": "Patient has easy access to their provider", "file_id": "dr_KD0321", "chunk_id": 14 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "Bringing him- Yeah. ... to Morgantown for laser-", "context": "Patient mentions bringing a family member to another location for treatment, implying potential transportation challenges", "file_id": "dr_KD0321", "chunk_id": 15 }, { "code": "Honest communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "To be honest with me", "context": "Patient values honesty from doctor", "file_id": "dr_KD0321", "chunk_id": 16 }, { "code": "Trust in provider", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "give me the basic, honest truth", "context": "Patient wants trustworthy care from doctor", "file_id": "dr_KD0321", "chunk_id": 16 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "It would terrify me", "context": "Patient expresses fear of losing eyesight due to diabetes", "file_id": "dr_KD0321", "chunk_id": 17 }, { "code": "Health literacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "give me the basic, honest truth", "context": "Patient desires clear and accurate information about their condition", "file_id": "dr_KD0321", "chunk_id": 17 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "never fear telling me the truth", "context": "Patient values honest communication with their provider", "file_id": "dr_KD0321", "chunk_id": 17 }, { "code": "Lack of perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "I don't see it as threatening", "context": "Patient does not feel threatened by potential complications", "file_id": "dr_KD0321", "chunk_id": 18 }, { "code": "Health awareness", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I am aware of what complications can occur", "context": "Patient has knowledge about potential complications", "file_id": "dr_KD0321", "chunk_id": 18 }, { "code": "Self management", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "Watching my diet", "context": "Patient takes control of their diet to manage condition", "file_id": "dr_KD0321", "chunk_id": 18 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I didn't even know I had this tear. I had no clue.", "context": "Patient was unaware of their condition", "file_id": "dr_KD0321", "chunk_id": 19 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "I don't see it as threatening.", "context": "Patient does not feel their condition is a threat", "file_id": "dr_KD0321", "chunk_id": 19 }, { "code": "Accessible provider", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "So she was right on it. , right on- In- ... top of it", "context": "Provider was responsive and proactive", "file_id": "dr_KD0321", "chunk_id": 19 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "She says, 'Wait a minute.' , 'I need you to go to Morgantown to, , have a more extensive exam.'", "context": "Provider clearly communicated the need for further examination", "file_id": "dr_KD0321", "chunk_id": 19 }, { "code": "Accessible provider", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "So she was right on it.", "context": "Patient appreciates prompt provider action", "file_id": "dr_KD0321", "chunk_id": 20 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "She says, 'Wait a minute.'", "context": "Provider clearly communicates need for further exam", "file_id": "dr_KD0321", "chunk_id": 20 }, { "code": "Desire longevity", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I want to have longevity and a quality of life to enjoy that longevity", "context": "Patient motivated by desire for long and healthy life", "file_id": "dr_KD0321", "chunk_id": 21 }, { "code": "Receptive doctor", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "Very much so", "context": "Patient feels doctor is supportive of their goals", "file_id": "dr_KD0321", "chunk_id": 21 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "She's quite an advocate for that", "context": "Patient feels supported by their doctor", "file_id": "dr_KD0321", "chunk_id": 22 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "She's quite an advocate for that", "context": "Patient feels heard and understood by their doctor", "file_id": "dr_KD0321", "chunk_id": 22 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "She's quite an advocate for that", "context": "Patient feels their doctor cares about their well-being", "file_id": "dr_KD0321", "chunk_id": 22 }, { "code": "Positive experience", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "you've had such a good experience", "context": "Patient had a positive experience with their provider", "file_id": "dr_KD0321", "chunk_id": 24 }, { "code": "Allergy season", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "It's allergy season", "context": "Patient mentions allergy season as a potential challenge", "file_id": "dr_KD0321", "chunk_id": 24 }, { "code": "Health Education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "More education", "context": "Patient appreciates educational content in waiting room", "file_id": "dr_KD0321", "chunk_id": 25 }, { "code": "Provider Education", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "they're reaching out, in that way", "context": "Patient values provider's effort to educate", "file_id": "dr_KD0321", "chunk_id": 25 }, { "code": "Lack of education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "Who's ever had enough education?", "context": "Patient expresses need for more education", "file_id": "dr_KD0321", "chunk_id": 26 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Provide education", "context": "Patient suggests providing education as a facilitator", "file_id": "dr_KD0321", "chunk_id": 26 }, { "code": "Diabetes self-management support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "self-advocated", "context": "Patient mentions self-advocacy as a facilitator", "file_id": "dr_KD0321", "chunk_id": 26 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Reading more about diabetes", "context": "Patient takes initiative to learn about diabetes", "file_id": "dr_KD0321", "chunk_id": 27 }, { "code": "Community resources", "category": "FACILITATOR - Resources & Access", "subcategory": "Community health programs", "quote": "they do offer them in the community", "context": "Patient aware of community-based diabetes programs", "file_id": "dr_KD0321", "chunk_id": 27 }, { "code": "Positive staff", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "staff are very, patient-oriented", "context": "Patient praises clinic staff", "file_id": "dr_KD0321", "chunk_id": 28 }, { "code": "Smooth process", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "Bangsolutely. Start to finish", "context": "Patient describes efficient clinic experience", "file_id": "dr_KD0321", "chunk_id": 28 }, { "code": "Patient-oriented staff", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "staff are very, patient-oriented", "context": "Patient appreciates the clinic's patient-centered approach", "file_id": "dr_KD0321", "chunk_id": 29 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "staff are very, patient-oriented", "context": "Patient values the positive interaction with clinic staff", "file_id": "dr_KD0321", "chunk_id": 29 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "nothing in particular. , I just take the medication that I'm supposed to.", "context": "Patient seems unaware of comprehensive diabetes management", "file_id": "dr_SS0921", "chunk_id": 0 }, { "code": "Disciplined patient", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I, I'm kind of disciplined. So I keep a very regular diet.", "context": "Patient takes initiative in managing diabetes through diet", "file_id": "dr_SS0921", "chunk_id": 0 }, { "code": "Regular diet", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "So I keep a very regular diet.", "context": "Patient prioritizes healthy eating for diabetes management", "file_id": "dr_SS0921", "chunk_id": 0 }, { "code": "Health priorities", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "to keep it under control. That's number one.", "context": "Patient recognizes importance of controlling diabetes", "file_id": "dr_SS0921", "chunk_id": 0 }, { "code": "Flexible schedule", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate resources", "quote": "I'm lucky to have a very, lot of free time", "context": "Patient has ample free time for self-care", "file_id": "dr_SS0921", "chunk_id": 1 }, { "code": "Regular schedule", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I can keep a very regular schedule", "context": "Patient prioritizes routine for diet management", "file_id": "dr_SS0921", "chunk_id": 1 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "So that was very important. So I do that. I'm very particular in terms of what I eat.", "context": "Patient prioritizes diet due to health knowledge", "file_id": "dr_SS0921", "chunk_id": 2 }, { "code": "Self management", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I'm very particular about my weight. I maintain my weight.", "context": "Patient actively manages weight for health", "file_id": "dr_SS0921", "chunk_id": 2 }, { "code": "Lack of symptoms", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "No perceived urgency", "quote": "Not really. Nothing that makes you- No, nothing that, ...", "context": "Patient does not experience symptoms to prompt follow-up", "file_id": "dr_SS0921", "chunk_id": 3 }, { "code": "Family history awareness", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "this is based on my family history, so it is-", "context": "Patient is aware of family history and its implications", "file_id": "dr_SS0921", "chunk_id": 3 }, { "code": "Self management support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I keep it under control, so..", "context": "Patient takes active role in managing diabetes", "file_id": "dr_SS0921", "chunk_id": 3 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Not really. Nothing that makes you- No, nothing that, ... , , , I, I've been, , pre-diabetic for last 15, 20 years.", "context": "Patient seems unaware of diabetes progression", "file_id": "dr_SS0921", "chunk_id": 4 }, { "code": "Family history awareness", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "my father had the same issues", "context": "Patient aware of hereditary component", "file_id": "dr_SS0921", "chunk_id": 4 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now' (no perceived urgency)", "quote": "Not really. , I think one of my eyes, the right side, , is the one that is gonna create problems, I know that.", "context": "Patient lacks sense of urgency for follow-up", "file_id": "dr_SS0921", "chunk_id": 4 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't know if this is, maybe this is of interest to you", "context": "Patient unsure about their condition", "file_id": "dr_SS0921", "chunk_id": 5 }, { "code": "Hereditary beliefs", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Cultural beliefs about healthcare", "quote": "my father had the same issues", "context": "Patient attributes condition to heredity", "file_id": "dr_SS0921", "chunk_id": 5 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I developed, , eye problems", "context": "Patient lacks knowledge about eye problems related to DR", "file_id": "dr_SS0921", "chunk_id": 6 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "my eyesight's improved a lot", "context": "Patient feels no need for follow-up due to improved eyesight", "file_id": "dr_SS0921", "chunk_id": 6 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "my eyesight's improved a lot", "context": "Patient feels their eyesight has improved, potentially reducing motivation for follow-up", "file_id": "dr_SS0921", "chunk_id": 7 }, { "code": "Lack of perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "it improved, dramatically. And I had, I did not have to use glasses anymore.", "context": "Patient feels they can see well and may not prioritize follow-up", "file_id": "dr_SS0921", "chunk_id": 8 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "because of age, because I know that that is gonna happen again", "context": "Patient is aware of potential vision decline with age and may fear diagnosis", "file_id": "dr_SS0921", "chunk_id": 8 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I think it is-", "context": "Patient is aware of their condition, implying some level of health education", "file_id": "dr_SS0921", "chunk_id": 8 }, { "code": "Positive outlook", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "But, it is, I've been okay", "context": "Patient has a positive outlook on their condition, possibly due to health literacy", "file_id": "dr_SS0921", "chunk_id": 8 }, { "code": "Lack of perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "But, , it is, , I, I've been okay. ... In terms of eyesight.", "context": "Patient feels no urgent need for follow-up due to current stable eyesight", "file_id": "dr_SS0921", "chunk_id": 9 }, { "code": "Understanding of DR progression", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "But then, , diabetes, , pre, pre-diabetic, , that is going to create problems.", "context": "Patient has some awareness of potential diabetes-related eye issues but lacks detailed understanding", "file_id": "dr_SS0921", "chunk_id": 9 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "eventually, , , , glaucoma is a problem, potential problem", "context": "Patient has limited knowledge about diabetes effects on eyes", "file_id": "dr_SS0921", "chunk_id": 10 }, { "code": "Family history awareness", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "my parents have, both my father and mother have the, , what do you call that thing? ... Cataracts?", "context": "Patient is aware of family medical history", "file_id": "dr_SS0921", "chunk_id": 10 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now' (no perceived urgency)", "quote": "So I don't have any issues at all. In terms of eyesight.", "context": "Patient does not feel urgent need for follow-up", "file_id": "dr_SS0921", "chunk_id": 10 }, { "code": "Regular check-ups", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I have regular check-ups, so I came for my check-up today", "context": "Patient attends regular follow-up appointments", "file_id": "dr_SS0921", "chunk_id": 11 }, { "code": "Lack of awareness", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Nothing in particular, no", "context": "Patient seems unaware of potential diabetes-related complications", "file_id": "dr_SS0921", "chunk_id": 11 }, { "code": "Family history awareness", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "my parents have, both my father and mother have the, what do you call that thing? ... Cataracts", "context": "Patient is aware of family medical history", "file_id": "dr_SS0921", "chunk_id": 11 }, { "code": "Regular eye checks", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "we, I check my, eyes every four months", "context": "Patient prioritizes regular eye exams", "file_id": "dr_SS0921", "chunk_id": 11 }, { "code": "Regular check-ups", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I have regular check-ups, so I came for my check-up today", "context": "Patient attends regular follow-up appointments", "file_id": "dr_SS0921", "chunk_id": 12 }, { "code": "Provider navigation", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Patient navigation services", "quote": "they take pictures- ... of my insides, retina and all that stuff", "context": "Patient receives guided care from providers", "file_id": "dr_SS0921", "chunk_id": 12 }, { "code": "Accessible location", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate insurance coverage", "quote": "where do you typically get your routine eye exams? Is it here at the institute? ... This, this building", "context": "Patient has easy access to care location", "file_id": "dr_SS0921", "chunk_id": 12 }, { "code": "Routine screenings", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "typical visit is, , , we have the, , , nurse or, , what do you call, nursing aide, they do the check-up first", "context": "Patient receives regular screenings as part of follow-up care", "file_id": "dr_SS0921", "chunk_id": 12 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "And then the physician", "context": "Patient interacts with multiple providers, suggesting a team-based approach to care", "file_id": "dr_SS0921", "chunk_id": 12 }, { "code": "Lack of difficulties", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "The, nothing really", "context": "Patient experiences no issues with eye dilation", "file_id": "dr_SS0921", "chunk_id": 13 }, { "code": "Regular schedule", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "my recommendation, , recommended schedule is six months, every six months", "context": "Patient is aware of and follows recommended follow-up schedule", "file_id": "dr_SS0921", "chunk_id": 13 }, { "code": "Positive experience", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "no. , okay. The, nothing really", "context": "Patient has a positive interaction with healthcare provider", "file_id": "dr_SS0921", "chunk_id": 13 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "because I have to drive after it is done", "context": "Patient mentions driving as an issue after eye dilation", "file_id": "dr_SS0921", "chunk_id": 14 }, { "code": "Accessible providers", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "1. Healthcare System Support", "quote": "Your doctor's availability has been good", "context": "Patient finds it easy to schedule with their doctor", "file_id": "dr_SS0921", "chunk_id": 14 }, { "code": "Easy scheduling", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "1. Healthcare System Support", "quote": "We do it online. Or on the phone", "context": "Patient finds scheduling process convenient", "file_id": "dr_SS0921", "chunk_id": 14 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "your doctor's availability has been good. It hasn't been hard to find them", "context": "Patient finds it easy to access their doctor", "file_id": "dr_SS0921", "chunk_id": 15 }, { "code": "No transportation issues", "category": "BARRIER - SDOH", "subcategory": "Transportation issues", "quote": "No. Nothing that", "context": "Patient does not experience transportation barriers", "file_id": "dr_SS0921", "chunk_id": 15 }, { "code": "No long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Long wait times", "quote": "No long wait times", "context": "Patient does not experience long wait times", "file_id": "dr_SS0921", "chunk_id": 15 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "No long wait times, it's hard to get here", "context": "Patient mentions difficulty getting to appointments", "file_id": "dr_SS0921", "chunk_id": 16 }, { "code": "Transportation issues", "category": "BARRIER - SDOH", "subcategory": "Transportation issues", "quote": "it's hard to get here", "context": "Patient has trouble accessing the clinic due to transportation", "file_id": "dr_SS0921", "chunk_id": 16 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Do what they, is it artificial tears or is it-", "context": "Patient shows confusion about treatment", "file_id": "dr_SS0921", "chunk_id": 17 }, { "code": "Health literacy barriers", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "Do what they, is it artificial tears or is it-", "context": "Patient lacks understanding of medical terms", "file_id": "dr_SS0921", "chunk_id": 17 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I can pull it up and tell you", "context": "Provider is willing to help patient find information", "file_id": "dr_SS0921", "chunk_id": 17 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I should be able to find it", "context": "Patient takes initiative to find medical information", "file_id": "dr_SS0921", "chunk_id": 17 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't know", "context": "Patient unsure about eye care habits", "file_id": "dr_SS0921", "chunk_id": 18 }, { "code": "Cultural beliefs", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Cultural beliefs about healthcare", "quote": "because of our skin color", "context": "Patient mentions skin color as a factor", "file_id": "dr_SS0921", "chunk_id": 18 }, { "code": "Regular eye checkup", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Again, we have a regular eye checkup", "context": "Patient has regular eye exams", "file_id": "dr_SS0921", "chunk_id": 18 }, { "code": "Provider communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "what does your eye doctor or your diabetes doctor told you", "context": "Patient receives information from providers", "file_id": "dr_SS0921", "chunk_id": 18 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Just the potential risk", "context": "Patient seems unsure about diabetes-related vision loss", "file_id": "dr_SS0921", "chunk_id": 19 }, { "code": "Provider communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "They've told you?", "context": "Patient indicates provider has informed them about risks", "file_id": "dr_SS0921", "chunk_id": 19 }, { "code": "Patient concern expression", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "can you talk about a time when you were able to express a concern", "context": "Patient is encouraged to ask questions and express concerns", "file_id": "dr_SS0921", "chunk_id": 19 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "the only thing is about glaucoma", "context": "Patient mentions a specific concern, potentially indicating fear", "file_id": "dr_SS0921", "chunk_id": 19 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't know. I mean, , maybe eventually.", "context": "Patient unsure about diabetes causing vision loss", "file_id": "dr_SS0921", "chunk_id": 20 }, { "code": "Poor patient-provider communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "No. It's okay. I, I, yeah, we, we, , anything I'm, I'm okay with any -", "context": "Patient struggles to express themselves to doctor", "file_id": "dr_SS0921", "chunk_id": 20 }, { "code": "Regular exams", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Well, , I think, , continue with the regular, , exam.", "context": "Patient values regular check-ups", "file_id": "dr_SS0921", "chunk_id": 20 }, { "code": "Lack of patient empowerment", "category": "BARRIER - Patient Empowerment", "subcategory": "Health education programs", "quote": "I don't know. I mean, , maybe eventually.", "context": "Patient lacks knowledge about diabetes and vision loss", "file_id": "dr_SS0921", "chunk_id": 20 }, { "code": "Limited self-advocacy", "category": "BARRIER - Patient Empowerment", "subcategory": "Health literacy", "quote": "No, I don't have any issues. No problems, no.", "context": "Patient does not express needs or concerns to doctor", "file_id": "dr_SS0921", "chunk_id": 20 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't know. I mean, , maybe eventually.", "context": "Patient unsure about diabetes impact on vision", "file_id": "dr_SS0921", "chunk_id": 21 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "I have no problems. I don't have any issues.", "context": "Patient feels no current vision problems", "file_id": "dr_SS0921", "chunk_id": 21 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "continue with the regular, , exam.", "context": "Patient values regular exams from provider", "file_id": "dr_SS0921", "chunk_id": 21 }, { "code": "Family History", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "he did not have a glaucoma. He was primarily, diabetic.", "context": "Patient discusses family history of diabetes", "file_id": "dr_SS0921", "chunk_id": 22 }, { "code": "Lack of Understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "age-related? Yeah, absolutely, because, I would say getting glasses, that is age-related.", "context": "Patient shows limited understanding of eye conditions", "file_id": "dr_SS0921", "chunk_id": 22 }, { "code": "Healthcare System Support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "have you ever been diagnosed with the following eye conditions?", "context": "Provider inquires about patient's eye health", "file_id": "dr_SS0921", "chunk_id": 22 }, { "code": "Patient Empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Any changes recently that you've noticed? Even mild changes?", "context": "Provider educates patient on importance of monitoring eye health", "file_id": "dr_SS0921", "chunk_id": 22 }, { "code": "Regular follow up", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "when I check out, my next, visit is decided then", "context": "Patient appreciates scheduled follow-ups", "file_id": "dr_SS0921", "chunk_id": 24 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "treatment is all fine", "context": "Patient has positive experience with healthcare providers", "file_id": "dr_SS0921", "chunk_id": 24 }, { "code": "Regular follow up", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "when I check out, my next, visit is decided then", "context": "Patient appreciates scheduled follow-ups", "file_id": "dr_SS0921", "chunk_id": 25 }, { "code": "High premiums", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Out-of-pocket costs", "quote": "the amount of premiums that we pay. It is becoming ridiculous", "context": "Patient finds insurance premiums too expensive", "file_id": "dr_SS0921", "chunk_id": 25 }, { "code": "Financial investment", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate insurance coverage", "quote": "I'm paying a lot of money anyway, so-", "context": "Patient feels motivated to use services due to financial investment", "file_id": "dr_SS0921", "chunk_id": 25 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "$60. Now it is over $400.", "context": "Patient discusses significant increase in cost", "file_id": "dr_SS0921", "chunk_id": 26 }, { "code": "Cost discouragement", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Out-of-pocket costs", "quote": "Sometimes you're , maybe, , the cost isn't worth it.", "context": "Patient considers cost as a potential deterrent", "file_id": "dr_SS0921", "chunk_id": 26 }, { "code": "Healthcare value perception", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "No, I think it is, it is worth it.", "context": "Patient believes healthcare services are valuable despite costs", "file_id": "dr_SS0921", "chunk_id": 26 }, { "code": "Family medical background", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I have a family background in medicine, so I think that is part of the mix", "context": "Patient's family medical history influences their healthcare attitudes", "file_id": "dr_SS0921", "chunk_id": 26 }, { "code": "Family Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "I have a family background in medicine", "context": "Patient's family has a medical background, potentially influencing their positive attitude towards healthcare", "file_id": "dr_SS0921", "chunk_id": 27 }, { "code": "Regular Appointments", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "regular appointments, regular screenings and checkups", "context": "Patient believes regular appointments are important for their care", "file_id": "dr_SS0921", "chunk_id": 27 }, { "code": "Lack Of Daily Care Support", "category": "BARRIER - Social Determinants of Health", "subcategory": "Education/health literacy barriers", "quote": "not really", "context": "Patient lacks support for daily diabetes care", "file_id": "dr_SS0921", "chunk_id": 27 }, { "code": "Lack of education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "No, I think, , what I said earlier, , regular appointments, regular screenings and checkups, I think that is what is important.", "context": "Patient seems to lack understanding of diabetes care beyond regular appointments", "file_id": "dr_SS0921", "chunk_id": 28 }, { "code": "No health education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "Speaker 2: No. Speaker 1: , do you have people that you feel you can share about your worries and fears about your diabetes in your eyesight?", "context": "Patient has not participated in diabetes education classes", "file_id": "dr_SS0921", "chunk_id": 28 }, { "code": "Family support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "Speaker 2: , , I have family.", "context": "Patient has family support for emotional needs", "file_id": "dr_SS0921", "chunk_id": 28 }, { "code": "Lack of daily care support", "category": "BARRIER - SDOH", "subcategory": "Social determinants", "quote": "Actually, right now I'm living on my own. Speaker 1: Okay. Speaker 2: So not, not...", "context": "Patient lacks support for daily care", "file_id": "dr_SS0921", "chunk_id": 28 }, { "code": "No navigation assistance", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "Speaker 2: No. Speaker 1: , do you have someone to help you with your daily diabetes care? Speaker 2: , not really. Right now, no.", "context": "Patient does not have navigation assistance for care", "file_id": "dr_SS0921", "chunk_id": 28 }, { "code": "Lack of social support", "category": "BARRIER - Social Determinants of Health (SDOH)", "subcategory": "Education/health literacy barriers", "quote": "Actually, right now I'm living on my own", "context": "Patient lacks daily support", "file_id": "dr_SS0921", "chunk_id": 29 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "first phone call is my primary care. Physician", "context": "Patient has a primary care physician for advice", "file_id": "dr_SS0921", "chunk_id": 29 }, { "code": "Social support networks", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "Yeah, sure. , family, friends, , , , I have family here", "context": "Patient has family and friends for healthcare advice", "file_id": "dr_SS0921", "chunk_id": 29 }, { "code": "Social Support Networks", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "I can call them", "context": "Patient has family and friends to seek advice from", "file_id": "dr_SS0921", "chunk_id": 30 }, { "code": "Access To Healthcare", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "they are in New Jersey, so...", "context": "Patient's support system is geographically distant", "file_id": "dr_SS0921", "chunk_id": 30 }, { "code": "Healthcare Advice", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I can even talk to them", "context": "Patient seeks healthcare advice from family physicians abroad", "file_id": "dr_SS0921", "chunk_id": 30 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "No limitations, yeah.", "context": "Patient feels no current limitation in eyesight", "file_id": "dr_SS0921", "chunk_id": 31 }, { "code": "Lack of understanding about DR progression", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Nothing new. Nothing. No difference.", "context": "Patient expects no change or progression in condition", "file_id": "dr_SS0921", "chunk_id": 31 }, { "code": "Physical limitations", "category": "BARRIER - Social Determinants of Health (SDOH)", "subcategory": "Transportation issues", "quote": "I got bad knees", "context": "Patient has physical limitation due to knee issue", "file_id": "dr_HD0225", "chunk_id": 0 }, { "code": "Exercise barriers", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I can't do a lot because I got bad knees", "context": "Patient's physical limitation affects exercise routine", "file_id": "dr_HD0225", "chunk_id": 0 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Proper food", "context": "Patient prioritizes healthy eating", "file_id": "dr_HD0225", "chunk_id": 0 }, { "code": "Self management", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "Try to exercise every day", "context": "Patient attempts regular physical activity", "file_id": "dr_HD0225", "chunk_id": 0 }, { "code": "Dietary control", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "Eating right. Not eating-- control the amount", "context": "Patient understands importance of diet control", "file_id": "dr_HD0225", "chunk_id": 0 }, { "code": "Lack of discussion", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "", "context": "No mention of doctor discussing follow-up appointments", "file_id": "dr_HD0225", "chunk_id": 1 }, { "code": "Medication adherence", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Take your medications on a regular basis?", "context": "Patient understands importance of medication adherence", "file_id": "dr_HD0225", "chunk_id": 1 }, { "code": "Social support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "And my wife prepares them every day", "context": "Patient has supportive family member helping with medication management", "file_id": "dr_HD0225", "chunk_id": 1 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "we have grandkids", "context": "Patient mentions family obligations", "file_id": "dr_HD0225", "chunk_id": 2 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "my wife tries to keep stuff that out of the house", "context": "Patient implies budgeting for snacks", "file_id": "dr_HD0225", "chunk_id": 2 }, { "code": "Education barriers", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "I had to-- my wife tries to keep stuff that out of the house", "context": "Patient lacks knowledge about healthy snacks", "file_id": "dr_HD0225", "chunk_id": 2 }, { "code": "Family support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "my wife tries to keep stuff that out of the house", "context": "Patient has supportive family member", "file_id": "dr_HD0225", "chunk_id": 2 }, { "code": "Health literacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I watch out for snacks", "context": "Patient is aware of healthy eating habits", "file_id": "dr_HD0225", "chunk_id": 2 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "No. No, the strawberries don't.", "context": "Patient seems unaware of how certain foods affect blood sugar", "file_id": "dr_HD0225", "chunk_id": 5 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I'm always trying to find stuff out.", "context": "Patient is proactive in learning about their condition", "file_id": "dr_HD0225", "chunk_id": 5 }, { "code": "Self management support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I'm try-- , I'm always trying to find stuff out.", "context": "Patient is taking initiative to manage their diabetes", "file_id": "dr_HD0225", "chunk_id": 5 }, { "code": "Expensive food", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "It's expensive too. Yeah. I-it's fi-- 4 or 5 dollars a piece.", "context": "Patient finds healthy food options to be costly", "file_id": "dr_HD0225", "chunk_id": 6 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't know why, but they are", "context": "Patient shows lack of understanding about certain foods", "file_id": "dr_HD0225", "chunk_id": 9 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "The diet is a big part of it", "context": "Patient recognizes importance of diet in managing condition", "file_id": "dr_HD0225", "chunk_id": 9 }, { "code": "Provider guidance", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "both the doctors", "context": "Patient mentions receiving guidance from doctors", "file_id": "dr_HD0225", "chunk_id": 9 }, { "code": "Social Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "they'll do stuff for me", "context": "Patient receives help from family members", "file_id": "dr_HD0225", "chunk_id": 10 }, { "code": "Family Influence", "category": "BARRIER - Social Determinants of Health", "subcategory": "Education/health literacy barriers", "quote": "I'm trying to get my wife on board with", "context": "Patient's family member may not understand health importance", "file_id": "dr_HD0225", "chunk_id": 10 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "it's hard to keep enough food in the house", "context": "Patient struggles with financial stability", "file_id": "dr_HD0225", "chunk_id": 11 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "But it's tough. You got somebody in the house with diabetes.", "context": "Patient expresses difficulty managing diabetes", "file_id": "dr_HD0225", "chunk_id": 12 }, { "code": "Diabetes distress", "category": "BARRIER - Emotional/Psychological", "subcategory": "Diabetes distress", "quote": "I've been struggling with it now for 10 years or more.", "context": "Patient expresses long-term struggle with diabetes", "file_id": "dr_HD0225", "chunk_id": 12 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "They told me to take it in the evening or before I go to bed because your cholesterol-- on a normal person, cholesterol goes up when you're asleep, so.", "context": "Patient receives health education about medication timing", "file_id": "dr_HD0225", "chunk_id": 12 }, { "code": "Lack of perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "So I'm not worried about much of", "context": "Patient does not feel urgent need for follow-up", "file_id": "dr_HD0225", "chunk_id": 13 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "they don't even come back for four months", "context": "Patient may be avoiding follow-up due to fear", "file_id": "dr_HD0225", "chunk_id": 13 }, { "code": "Provider communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Dr. C told me that", "context": "Patient receives clear information from provider", "file_id": "dr_HD0225", "chunk_id": 13 }, { "code": "Lack of perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "But my vision isn't that bad. But right now, it is because", "context": "Patient does not feel urgent need for follow-up due to current vision", "file_id": "dr_HD0225", "chunk_id": 14 }, { "code": "Fear of diagnosis/treatment", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "And if she does the cataract surgery, it'll disturb that and make it worse", "context": "Patient is concerned about potential negative outcomes of treatment", "file_id": "dr_HD0225", "chunk_id": 14 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "Dr. C told me that", "context": "Patient mentions provider by name, implying a positive relationship", "file_id": "dr_HD0225", "chunk_id": 14 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I didn't know anything about that", "context": "Patient lacked knowledge about diabetes effects on eyes", "file_id": "dr_HD0225", "chunk_id": 15 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "And, , I can still see-- my left eye is never gonna be any better", "context": "Patient feels no urgent need for follow-up", "file_id": "dr_HD0225", "chunk_id": 15 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I didn't know anything about that", "context": "Patient lacked knowledge about their condition", "file_id": "dr_HD0225", "chunk_id": 16 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now' (no perceived urgency)", "quote": "my vision wasn't quite as good", "context": "Patient didn't feel urgent need for follow-up", "file_id": "dr_HD0225", "chunk_id": 16 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Dr. C said, 'Yeah, they're not real bad yet, but it is there'", "context": "Provider clearly communicated diagnosis to patient", "file_id": "dr_HD0225", "chunk_id": 16 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "They told me that", "context": "Patient had access to provider for diagnosis and discussion", "file_id": "dr_HD0225", "chunk_id": 16 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "it's not getting any worse", "context": "Patient seems to lack understanding of diabetes impact on retinas", "file_id": "dr_HD0225", "chunk_id": 17 }, { "code": "Positive provider communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "He says it's about the same", "context": "Provider effectively communicates diagnosis to patient", "file_id": "dr_HD0225", "chunk_id": 17 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Getting it down-- helps all that", "context": "Patient understands the importance of managing diabetes for overall health", "file_id": "dr_HD0225", "chunk_id": 17 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "He says it's about the same, so it's not getting any worse", "context": "Provider shows empathy by reassuring patient about their condition", "file_id": "dr_HD0225", "chunk_id": 17 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "it just blurred vision", "context": "Patient lacks detailed understanding of diabetes effects on eyes", "file_id": "dr_HD0225", "chunk_id": 18 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "my family doctor told me that years ago", "context": "Patient received health education from family doctor", "file_id": "dr_HD0225", "chunk_id": 18 }, { "code": "Provider communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "they said it-- , I knew from right from the beginning", "context": "Patient received clear information from healthcare provider", "file_id": "dr_HD0225", "chunk_id": 18 }, { "code": "Lack of urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "I can still see real well", "context": "Patient perceives no immediate need for follow-up", "file_id": "dr_HD0225", "chunk_id": 19 }, { "code": "Limited understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "it just blurred vision", "context": "Patient lacks comprehensive knowledge of DR effects", "file_id": "dr_HD0225", "chunk_id": 19 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't know a whole lot", "context": "Patient lacks knowledge about diabetic retinopathy", "file_id": "dr_HD0225", "chunk_id": 20 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "that's why I got to keep my numbers down", "context": "Patient has some understanding of diabetes management", "file_id": "dr_HD0225", "chunk_id": 20 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "he told me a while ago, two doctors did", "context": "Patient has trust in their healthcare providers", "file_id": "dr_HD0225", "chunk_id": 20 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "if, if I hadn't taken care of the diabetes, they would be worse", "context": "Patient shows some understanding of disease progression", "file_id": "dr_HD0225", "chunk_id": 21 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "She's the one referred me to come over here", "context": "Patient has a referral from another provider", "file_id": "dr_HD0225", "chunk_id": 21 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I take care of the diabetes", "context": "Patient is taking care of their diabetes, implying some level of health knowledge", "file_id": "dr_HD0225", "chunk_id": 21 }, { "code": "Accessible provider", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "She's the one referred me to come over here", "context": "Patient has a referral from a trusted provider", "file_id": "dr_HD0225", "chunk_id": 22 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "She's the one that told me I had beginnings of glaucoma and cataracts", "context": "Patient has a positive interaction with their provider", "file_id": "dr_HD0225", "chunk_id": 22 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "She's the one that told me I had beginnings of glaucoma and cataracts", "context": "Patient receives clear information from their provider", "file_id": "dr_HD0225", "chunk_id": 22 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "what I'm saying? I mean, you still got to see", "context": "Patient implies difficulty accessing care", "file_id": "dr_HD0225", "chunk_id": 23 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "and then she got me hooked up with come over here", "context": "Patient has access to a provider", "file_id": "dr_HD0225", "chunk_id": 23 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "and then she got me hooked up with come over here", "context": "Patient has a positive interaction with provider", "file_id": "dr_HD0225", "chunk_id": 23 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "what I'm saying? I mean, you still got to see", "context": "Patient is educated about importance of eye exams", "file_id": "dr_HD0225", "chunk_id": 23 }, { "code": "Easy scheduling", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I-it's good. Easy.", "context": "Patient finds scheduling process easy", "file_id": "dr_HD0225", "chunk_id": 24 }, { "code": "Provider availability", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Always-- he's always available.", "context": "Patient's doctor is always available", "file_id": "dr_HD0225", "chunk_id": 24 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "he's always available", "context": "Patient finds doctor's availability convenient", "file_id": "dr_HD0225", "chunk_id": 25 }, { "code": "Flexible scheduling", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Appointment scheduling difficulties", "quote": "It fits my schedule", "context": "Patient appreciates flexible appointment scheduling", "file_id": "dr_HD0225", "chunk_id": 25 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "he's always available", "context": "Patient has a positive experience with their doctor", "file_id": "dr_HD0225", "chunk_id": 25 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "what do they tell you that you should be doing?", "context": "Patient receives clear guidance from their doctor", "file_id": "dr_HD0225", "chunk_id": 25 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Just take care of my diabetes", "context": "Patient receives health advice from their doctor", "file_id": "dr_HD0225", "chunk_id": 25 }, { "code": "Lack of specific advice", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "Just take care of my diabetes. That's the most important.", "context": "Patient receives general advice from doctors", "file_id": "dr_HD0225", "chunk_id": 26 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "'Yep,' pat me on the shoulders, says, 'Keep it up. Keep going.'", "context": "Patient feels encouraged by doctors", "file_id": "dr_HD0225", "chunk_id": 26 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "You got to eat the right stuff. That's the main thing is my eating.", "context": "Patient receives dietary advice from doctors", "file_id": "dr_HD0225", "chunk_id": 26 }, { "code": "Patient motivation", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I love to eat. I mean, I, I love buffets", "context": "Patient is aware of their eating habits", "file_id": "dr_HD0225", "chunk_id": 26 }, { "code": "Food preferences", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I love to eat. I mean, I, I love buffets.", "context": "Patient prioritizes food enjoyment over health", "file_id": "dr_HD0225", "chunk_id": 27 }, { "code": "Family obligations", "category": "BARRIER - Social Determinants of Health", "subcategory": "Social support networks", "quote": "we-well, when I go-- we, we do go to buffets because look at those grandkids.", "context": "Patient's family responsibilities influence food choices", "file_id": "dr_HD0225", "chunk_id": 27 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "It cost you fortune", "context": "Patient mentions high costs of food or potentially other expenses", "file_id": "dr_HD0225", "chunk_id": 29 }, { "code": "Expensive treatments", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Expensive treatments/surgery", "quote": "It cost you fortune", "context": "Patient mentions high costs of treatment", "file_id": "dr_HD0225", "chunk_id": 30 }, { "code": "Out-of-pocket costs", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Out-of-pocket costs", "quote": "I come outta there 60 bucks for all four of us", "context": "Patient mentions high out-of-pocket expenses", "file_id": "dr_HD0225", "chunk_id": 30 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "It cost you fortune", "context": "Patient implies financial burden of treatment", "file_id": "dr_HD0225", "chunk_id": 30 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't know exactly--what to do", "context": "Patient unsure about diet soda's impact on health", "file_id": "dr_HD0225", "chunk_id": 31 }, { "code": "Education barriers", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "I've heard it's good. I've heard it's bad", "context": "Patient lacks clear information about diet soda", "file_id": "dr_HD0225", "chunk_id": 31 }, { "code": "No Transportation Issues", "category": "FACILITATOR - Resources & Access", "subcategory": "Transportation assistance", "quote": "No, my wife drives. I don't even drive over here. She does.", "context": "Patient has reliable transportation to clinic", "file_id": "dr_HD0225", "chunk_id": 32 }, { "code": "No Wait Times Issues", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "No", "context": "Patient does not experience long wait times", "file_id": "dr_HD0225", "chunk_id": 32 }, { "code": "Positive Provider Relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "my doctor, I need to talk to him, I guess.", "context": "Patient has a positive and trusting relationship with their provider", "file_id": "dr_HD0225", "chunk_id": 32 }, { "code": "Transportation assistance", "category": "FACILITATOR - Resources & Access", "subcategory": "Transportation assistance", "quote": "my wife drives", "context": "Patient has reliable transportation to clinic", "file_id": "dr_HD0225", "chunk_id": 33 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Long wait times", "quote": "I expect-- when I come here, they, believe it, look they're having a convention or something", "context": "Patient expects long wait times at clinic", "file_id": "dr_HD0225", "chunk_id": 33 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "They cover all the basics and--", "context": "Patient perceives clinic as having accessible providers", "file_id": "dr_HD0225", "chunk_id": 33 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "They cover all the basics", "context": "Patient feels informed about eye care", "file_id": "dr_HD0225", "chunk_id": 34 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "They cover all the basics and--", "context": "Patient has positive experience with providers", "file_id": "dr_HD0225", "chunk_id": 34 }, { "code": "Health literacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "Wanna protect my eyes in the sun because the sun's harder in your eyes", "context": "Patient demonstrates understanding of eye protection", "file_id": "dr_HD0225", "chunk_id": 34 }, { "code": "Lack of mention", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "because it shades your eyes", "context": "Patient discusses coping mechanism without mentioning follow-up", "file_id": "dr_HD0225", "chunk_id": 35 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "So that's, that's one thing I do", "context": "Patient shares self-care strategy, implying some health knowledge", "file_id": "dr_HD0225", "chunk_id": 35 }, { "code": "Supplement use", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I take vitamin C every day", "context": "Patient takes supplements, indicating proactive approach to health", "file_id": "dr_HD0225", "chunk_id": 35 }, { "code": "Lack of education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "I take that every day. That and C, and that's it.", "context": "Patient seems unsure about medications", "file_id": "dr_HD0225", "chunk_id": 36 }, { "code": "Health literacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I take that every day. That and C, and that's it.", "context": "Patient is aware of daily supplements", "file_id": "dr_HD0225", "chunk_id": 36 }, { "code": "Accessible care", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I'm on it maybe an hour or so a day.", "context": "Patient has access to TV and possibly other resources", "file_id": "dr_HD0225", "chunk_id": 36 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "No, no, no, no.", "context": "Patient does not express concern for eye health", "file_id": "dr_HD0225", "chunk_id": 36 }, { "code": "Self care", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I give my eyes a rest when I'm working on the computer for a long time or watching TV", "context": "Patient takes breaks to rest eyes", "file_id": "dr_HD0225", "chunk_id": 36 }, { "code": "Resource access", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate resources", "quote": "I use, -- what's it called? Artificial Tears, or?", "context": "Patient has access to eye drops", "file_id": "dr_HD0225", "chunk_id": 36 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "You got to keep the sugar down", "context": "Patient's limited understanding of diabetes management", "file_id": "dr_HD0225", "chunk_id": 37 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Everybody that I've talked to has told me, 'Hey, you got to keep-- you got to keep an eye on this stuff'", "context": "Patient receives clear guidance from healthcare providers", "file_id": "dr_HD0225", "chunk_id": 37 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "You got to keep the sugar down", "context": "Patient receives health education on diabetes management", "file_id": "dr_HD0225", "chunk_id": 37 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "Everybody that I've talked to has told me, 'Hey, you got to keep-- you got to keep an eye on this stuff'", "context": "Patient feels supported by healthcare providers", "file_id": "dr_HD0225", "chunk_id": 37 }, { "code": "Lack of cure", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "there's no money in the cures. There's money in treatment.", "context": "Patient believes there is no financial incentive for a cure", "file_id": "dr_HD0225", "chunk_id": 38 }, { "code": "Resignation", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "it's just something I live with.", "context": "Patient feels resigned to their condition", "file_id": "dr_HD0225", "chunk_id": 38 }, { "code": "Acceptance", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I'm not mad about it. Not angry about it.", "context": "Patient has accepted their condition and is empowered to manage it", "file_id": "dr_HD0225", "chunk_id": 38 }, { "code": "Provider advice", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Everybody that I've talked to has told me, 'Hey, you got to keep-- you got to keep an eye on this stuff.'", "context": "Patient receives guidance from healthcare providers", "file_id": "dr_HD0225", "chunk_id": 38 }, { "code": "Family History Awareness", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "my grandfather had it", "context": "Patient is aware of family history of diabetes", "file_id": "dr_HD0225", "chunk_id": 39 }, { "code": "Personal Experience", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "it's just something I do", "context": "Patient has personal experience with diabetes management", "file_id": "dr_HD0225", "chunk_id": 39 }, { "code": "Health Awareness", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "you have to-- it's, it's on your mind", "context": "Patient is aware of the importance of diabetes management", "file_id": "dr_HD0225", "chunk_id": 39 }, { "code": "Positive attitude", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "You have to be", "context": "Patient has a positive outlook on managing their condition", "file_id": "dr_HD0225", "chunk_id": 40 }, { "code": "No issues with provider", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "It's fine. It don't bother me that", "context": "Patient feels comfortable discussing their concerns with their doctor", "file_id": "dr_HD0225", "chunk_id": 40 }, { "code": "Limited treatment options", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of continuity of care", "quote": "when they tell you, there's only certain things they can do", "context": "Patient feels limited by the treatments available for their condition", "file_id": "dr_HD0225", "chunk_id": 40 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "It's fine. It don't bother me that--", "context": "Patient feels comfortable talking to their doctor", "file_id": "dr_HD0225", "chunk_id": 41 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "They know that I'm working with it.", "context": "Patient feels heard and understood by their doctor", "file_id": "dr_HD0225", "chunk_id": 41 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "what you eat and all this other stuff. It's still up to me, most of it.", "context": "Patient takes responsibility for their health", "file_id": "dr_HD0225", "chunk_id": 41 }, { "code": "Shared decision-making", "category": "FACILITATOR - Provider Relationship", "subcategory": "Shared decision-making", "quote": "But it's a two way street.", "context": "Patient feels involved in their care decisions", "file_id": "dr_HD0225", "chunk_id": 41 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "I never tell", "context": "Patient does not express concerns to doctor", "file_id": "dr_HD0225", "chunk_id": 42 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "I never tell", "context": "Patient does not communicate effectively with doctor", "file_id": "dr_HD0225", "chunk_id": 42 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Just give me lists of stuff to do", "context": "Patient seeks guidance on self-management", "file_id": "dr_HD0225", "chunk_id": 42 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "you wanna know if it's progressing-- getting better, staying the same", "context": "Patient asks questions and seeks information from doctor", "file_id": "dr_HD0225", "chunk_id": 42 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "They were happy with it", "context": "Doctor shows positive attitude towards patient's progress", "file_id": "dr_HD0225", "chunk_id": 42 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "I don't-- never-- I never tell.", "context": "Patient hesitant to share information with doctor", "file_id": "dr_HD0225", "chunk_id": 43 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "Just give me lists of stuff to do. Give me lists of stuff to eat.", "context": "Patient desires clear instructions from doctor", "file_id": "dr_HD0225", "chunk_id": 43 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Patient Empowerment", "quote": "She gave me this whole big, long thing of food on it.", "context": "Patient finds health education from counselor helpful", "file_id": "dr_HD0225", "chunk_id": 43 }, { "code": "Patient-provider trust", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "My other doctor, the woman in there, she's a counselor.", "context": "Patient has positive relationship with counselor", "file_id": "dr_HD0225", "chunk_id": 43 }, { "code": "Understanding of DR progression", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Patient Beliefs & Perceptions", "quote": "It's very serious. Because I only have the one eye--", "context": "Patient understands severity of diabetes on vision", "file_id": "dr_HD0225", "chunk_id": 43 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "You don't realize it until you don't have it anymore", "context": "Patient lacks full understanding of vision loss impact", "file_id": "dr_HD0225", "chunk_id": 44 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "my main doctor and everybody over here, they've told me that, . You got to stay on top of it", "context": "Patient feels supported by healthcare providers", "file_id": "dr_HD0225", "chunk_id": 44 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "They've told me that, . You got to stay on top of it", "context": "Patient receives health education from providers", "file_id": "dr_HD0225", "chunk_id": 44 }, { "code": "Perceived importance", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "To me, vision is the most precious thing in the world", "context": "Patient understands importance of vision preservation", "file_id": "dr_HD0225", "chunk_id": 44 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I've noticed a difference", "context": "Patient is starting to see changes in vision but lacks full understanding", "file_id": "dr_HD0225", "chunk_id": 45 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "if it can change that much-- it can get worse", "context": "Patient is worried about vision getting worse", "file_id": "dr_HD0225", "chunk_id": 45 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "my main doctor and everybody over here, they've told me that, . You got to stay on top of it", "context": "Patient feels supported by provider", "file_id": "dr_HD0225", "chunk_id": 45 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "They-- , my main doctor and everybody over here, they've told me that, . You got to stay on top of it", "context": "Patient is receiving health education from provider", "file_id": "dr_HD0225", "chunk_id": 45 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "it's steady. Not getting any worse.", "context": "Patient feels their vision is stable", "file_id": "dr_HD0225", "chunk_id": 46 }, { "code": "Lack of understanding about DR progression", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Not getting mu-much any better", "context": "Patient lacks awareness of potential vision decline", "file_id": "dr_HD0225", "chunk_id": 46 }, { "code": "Education/health literacy barriers", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "a lot of fine print or whatever", "context": "Patient struggles with reading small text", "file_id": "dr_HD0225", "chunk_id": 47 }, { "code": "Lack of understanding about DR progression", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I can watch it without glasses", "context": "Patient may not fully understand vision limitations", "file_id": "dr_HD0225", "chunk_id": 47 }, { "code": "Health literacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "read everything on it and everything else", "context": "Patient is able to read and understand information", "file_id": "dr_HD0225", "chunk_id": 47 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "Now I can't do that much anymore", "context": "Patient's limited ability to perform tasks due to vision", "file_id": "dr_HD0225", "chunk_id": 48 }, { "code": "Education barriers", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "Because everything anymore is so tiny", "context": "Patient's difficulty understanding their condition", "file_id": "dr_HD0225", "chunk_id": 48 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "I used to work on cars, car work, all that stuff. Now I can't do that much anymore", "context": "Patient's reduced income due to vision limitations", "file_id": "dr_HD0225", "chunk_id": 48 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "It looks to me it is", "context": "Patient's uncertain understanding of their condition", "file_id": "dr_HD0225", "chunk_id": 48 }, { "code": "Feeling overwhelmed", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "So it's, I mean, it's restricted a little bit", "context": "Patient's emotional response to vision limitations", "file_id": "dr_HD0225", "chunk_id": 48 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I have to get magnifying glass out", "context": "Patient's use of assistive devices, implying accessible care", "file_id": "dr_HD0225", "chunk_id": 48 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Because everything anymore is so tiny", "context": "Patient's awareness of their vision limitations, implying some level of health education", "file_id": "dr_HD0225", "chunk_id": 48 }, { "code": "Lack of perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "I actually thought I could see better", "context": "Patient believes their vision has improved", "file_id": "dr_HD0225", "chunk_id": 49 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't know about that, but--", "context": "Patient shows uncertainty about age-related eyesight decline", "file_id": "dr_HD0225", "chunk_id": 50 }, { "code": "Positive attitude", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I'm not ready to give up", "context": "Patient shows determination and motivation", "file_id": "dr_HD0225", "chunk_id": 50 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "That attitude makes all the difference", "context": "Provider shows understanding and support", "file_id": "dr_HD0225", "chunk_id": 50 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't know about that", "context": "Patient shows lack of knowledge about age-related eyesight decline", "file_id": "dr_HD0225", "chunk_id": 51 }, { "code": "Family history awareness", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "My grandfather had, and I guess my dad had it", "context": "Patient is aware of family history of diabetes", "file_id": "dr_HD0225", "chunk_id": 51 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "it's scary", "context": "Patient expresses fear after being diagnosed with eye issues", "file_id": "dr_HD0225", "chunk_id": 52 }, { "code": "Positive attitude", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "If I can do something to make something better--that's what you do", "context": "Patient shows proactive approach to managing health", "file_id": "dr_HD0225", "chunk_id": 52 }, { "code": "Lack of concern", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "It's fine", "context": "Patient seems unconcerned about follow-ups and treatment plans", "file_id": "dr_HD0225", "chunk_id": 52 }, { "code": "Accessible Transportation", "category": "FACILITATOR - Resources & Access", "subcategory": "Transportation assistance", "quote": "I always got transportation. I can either-- she can bring me or I can bring myself", "context": "Patient has reliable transportation to clinic", "file_id": "dr_HD0225", "chunk_id": 53 }, { "code": "Positive Attitude", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "It's just-- it's just something I have to do", "context": "Patient is motivated to attend follow-ups", "file_id": "dr_HD0225", "chunk_id": 53 }, { "code": "Effective Healthcare System", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "It's fine. No issues at all?", "context": "Patient has positive experience with healthcare system", "file_id": "dr_HD0225", "chunk_id": 53 }, { "code": "Reminder Systems", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "MyChart helpful", "context": "Patient uses digital tools to stay on track with appointments", "file_id": "dr_HD0225", "chunk_id": 53 }, { "code": "Transportation access", "category": "FACILITATOR - Resources & Access", "subcategory": "Transportation assistance", "quote": "I always got transportation. I can either-- she can bring me or I can bring myself.", "context": "Patient has reliable transportation to clinic", "file_id": "dr_HD0225", "chunk_id": 54 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "Under $10,000", "context": "Patient is price-sensitive when making a purchase", "file_id": "dr_HD0225", "chunk_id": 55 }, { "code": "Transportation issues", "category": "BARRIER - SDOH", "subcategory": "Transportation issues", "quote": "Four-wheel drive", "context": "Patient is discussing vehicle features, potentially related to transportation needs", "file_id": "dr_HD0225", "chunk_id": 55 }, { "code": "Financial assistance", "category": "FACILITATOR - Resources & Access", "subcategory": "Financial assistance programs", "quote": "they got money in the bank", "context": "Patient has access to financial resources", "file_id": "dr_HD0225", "chunk_id": 55 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "Anyway, she's got a car sitting in the yard", "context": "Patient mentions having a car, implying potential resolution to transportation issues", "file_id": "dr_HD0225", "chunk_id": 57 }, { "code": "Insurance coverage", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "they're getting insurance on it for me and my wife", "context": "Patient mentions insurance, which could be a barrier or facilitator to healthcare access", "file_id": "dr_HD0225", "chunk_id": 57 }, { "code": "Accessible transportation", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "4. Resources & Access", "quote": "Anyway, she's got a car sitting in the yard", "context": "Patient has access to a vehicle, facilitating transportation to appointments", "file_id": "dr_HD0225", "chunk_id": 57 }, { "code": "Lack of barriers", "category": "BARRIER - Social Determinants of Health", "subcategory": "None", "quote": "No, not really.", "context": "Patient reports no discouragement from using healthcare services", "file_id": "dr_HD0225", "chunk_id": 58 }, { "code": "Positive experience", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Because I love healthcare services.", "context": "Patient has a positive perception of healthcare services", "file_id": "dr_HD0225", "chunk_id": 58 }, { "code": "Emotional benefit", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Because it makes me feel better.", "context": "Patient feels healthcare services have a positive impact on their well-being", "file_id": "dr_HD0225", "chunk_id": 58 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "They try to help me, and I try to cooperate", "context": "Patient feels supported by healthcare providers", "file_id": "dr_HD0225", "chunk_id": 59 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "If I come over here, it's always-- I always come out of here with a, a good attitude", "context": "Patient has easy access to healthcare services", "file_id": "dr_HD0225", "chunk_id": 59 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "They try to help me, and I try to cooperate", "context": "Patient feels heard and understood by providers", "file_id": "dr_HD0225", "chunk_id": 59 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "it looked it had a convention out here in the hallway", "context": "Patient observes busy clinic environment", "file_id": "dr_HD0225", "chunk_id": 60 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "They try to help me, and I try to cooperate", "context": "Patient expresses cooperation with providers", "file_id": "dr_HD0225", "chunk_id": 60 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Healthcare System Support", "quote": "I'm impressed with the whole deal", "context": "Patient praises clinic experience", "file_id": "dr_HD0225", "chunk_id": 60 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "I'm impressed-- with the whole deal. S2: 29:32 Thank you. S1: 29:33 --with the doctors, you, everybody.", "context": "Patient expresses satisfaction with healthcare providers", "file_id": "dr_HD0225", "chunk_id": 61 }, { "code": "Social support networks", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "Yeah. We-well, the kids, just they did this morning, she goes, 'They'll get checked of sugar.'", "context": "Patient receives help from family members with diabetes care", "file_id": "dr_HD0225", "chunk_id": 61 }, { "code": "Reminders and assistance", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Oh, they, they, they had-- they're on top of it, the grandkids, .", "context": "Patient's family members provide reminders and assistance with diabetes care", "file_id": "dr_HD0225", "chunk_id": 61 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I'm impressed-- with the whole deal. S2: 29:32 Thank you. S1: 29:33 --with the doctors, you, everybody.", "context": "Patient expresses satisfaction with accessibility of healthcare providers", "file_id": "dr_HD0225", "chunk_id": 61 }, { "code": "Social Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "she takes care of me in that regard", "context": "Patient receives help from family member", "file_id": "dr_HD0225", "chunk_id": 62 }, { "code": "Family Assistance", "category": "FACILITATOR - Resources & Access", "subcategory": "Community health programs", "quote": "Sometimes it's already on the-- on the island ready", "context": "Patient receives practical help from family", "file_id": "dr_HD0225", "chunk_id": 62 }, { "code": "Lack of education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "No, I doubt if I would, because it's just something else.", "context": "Patient shows lack of interest in diabetes education", "file_id": "dr_HD0225", "chunk_id": 63 }, { "code": "No health education offered", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "No. S2: 30:53 No, it's never offered?", "context": "Patient reports not being offered diabetes education", "file_id": "dr_HD0225", "chunk_id": 63 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "If somebody cares enough.", "context": "Patient values caring providers", "file_id": "dr_HD0225", "chunk_id": 63 }, { "code": "Social support networks", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "She's a counselor. S1: 31:09 She had-- , I used to look to her when I first got on diabetes stuff.", "context": "Patient has a supportive counselor", "file_id": "dr_HD0225", "chunk_id": 63 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "you got to read the stuff", "context": "Patient emphasizes importance of reading health information", "file_id": "dr_HD0225", "chunk_id": 64 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "She really helped me a lot", "context": "Patient appreciates counselor's support", "file_id": "dr_HD0225", "chunk_id": 64 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "But you got to listen to her", "context": "Patient values listening to counselor's advice", "file_id": "dr_HD0225", "chunk_id": 64 }, { "code": "Lack of social support", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Cultural beliefs about healthcare", "quote": "Because she got enough on her plate-- with the grandkids and everything else", "context": "Patient feels unable to share worries with wife due to her responsibilities", "file_id": "dr_HD0225", "chunk_id": 65 }, { "code": "Emotional support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "My wife", "context": "Patient has someone to share worries with, but limited due to her plate", "file_id": "dr_HD0225", "chunk_id": 65 }, { "code": "Family responsibilities", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "Because she got enough on her plate-- with the grandkids and everything else", "context": "Patient's wife has family responsibilities limiting support", "file_id": "dr_HD0225", "chunk_id": 65 }, { "code": "Age-related concerns", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "She's 68", "context": "Patient's wife is older and may have limited ability to handle stress", "file_id": "dr_HD0225", "chunk_id": 65 }, { "code": "Limited emotional support", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "She no spring-- she's 68", "context": "Patient's wife has limited ability to handle patient's worries", "file_id": "dr_HD0225", "chunk_id": 65 }, { "code": "Social Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "everybody has chores to do", "context": "Patient has family help with daily tasks", "file_id": "dr_HD0225", "chunk_id": 66 }, { "code": "Family Assistance", "category": "FACILITATOR - Resources & Access", "subcategory": "Community health programs", "quote": "Kids help her with that", "context": "Patient's children assist with household responsibilities", "file_id": "dr_HD0225", "chunk_id": 66 }, { "code": "Emotional Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I think so. I really do. I think so", "context": "Patient feels supported by family members", "file_id": "dr_HD0225", "chunk_id": 66 }, { "code": "Lack of social support", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Cultural beliefs about healthcare", "quote": "No, not really", "context": "Patient lacks family or friends to ask for advice on health and eye problems", "file_id": "dr_HD0225", "chunk_id": 67 }, { "code": "Accessible provider", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Yeah, i-if I have a problem, I call the doctor", "context": "Patient has easy access to their doctor for advice", "file_id": "dr_HD0225", "chunk_id": 67 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "my mind is just as good probably as it ever was", "context": "Patient seems to downplay potential health issues", "file_id": "dr_HD0225", "chunk_id": 68 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "my mind is just as good probably as it ever was", "context": "Patient does not see the need for follow-up", "file_id": "dr_HD0225", "chunk_id": 68 }, { "code": "Social support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "my wife questions this", "context": "Patient has a supportive family member", "file_id": "dr_HD0225", "chunk_id": 68 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "people gets, , dementia and all that other stuff, they don't know", "context": "Patient lacks knowledge about disease progression", "file_id": "dr_HD0225", "chunk_id": 69 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "No, you're nuts", "context": "Patient expresses fear of being told they have a problem", "file_id": "dr_HD0225", "chunk_id": 69 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I'm trying to keep an eye on that", "context": "Patient takes initiative to monitor their health", "file_id": "dr_HD0225", "chunk_id": 69 }, { "code": "Positive attitude", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I'm aware of things", "context": "Patient shows awareness and willingness to take control", "file_id": "dr_HD0225", "chunk_id": 69 }, { "code": "Positive attitude", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "keep a good attitude", "context": "Patient believes having a positive attitude helps", "file_id": "dr_HD0225", "chunk_id": 70 }, { "code": "Good attitude", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "keep an att-- a good attitude, a positive attitude", "context": "Patient emphasizes the importance of attitude in management", "file_id": "dr_HD0225", "chunk_id": 70 }, { "code": "Health awareness", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I'm aware of things", "context": "Patient is knowledgeable about their condition", "file_id": "dr_HD0225", "chunk_id": 70 }, { "code": "Positive attitude", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "positive attitude. Positive influence. Everything.", "context": "Patient mentions importance of positive attitude", "file_id": "dr_HD0225", "chunk_id": 71 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I didn't know what was going on", "context": "Patient unsure about their condition", "file_id": "dr_HD0225", "chunk_id": 72 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I was in the fog--because I didn't know what was going on", "context": "Patient anxious about unknown diagnosis", "file_id": "dr_HD0225", "chunk_id": 72 }, { "code": "Positive attitude", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "You have to be positive", "context": "Patient emphasizes importance of positivity", "file_id": "dr_HD0225", "chunk_id": 72 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "because I didn't know what was going on", "context": "Patient initially lacked knowledge about their condition", "file_id": "dr_HD0225", "chunk_id": 73 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "they do-- , I ask them questions, they answer them", "context": "Patient experiences open communication with providers", "file_id": "dr_HD0225", "chunk_id": 73 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I feel great when I come here", "context": "Patient has a positive experience with their healthcare providers", "file_id": "dr_HD0225", "chunk_id": 73 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "the woman over at Walmart, , ch-checks my eyes", "context": "Patient has access to convenient eye care services", "file_id": "dr_HD0225", "chunk_id": 73 }, { "code": "Expensive treatments", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Expensive treatments/surgery", "quote": "Blood work alone can cost you $1,000", "context": "Patient mentions high cost of medical tests", "file_id": "dr_HD0225", "chunk_id": 74 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "I know it's expensive to go to a doctor for blood tests, blood work", "context": "Patient highlights expense of healthcare", "file_id": "dr_HD0225", "chunk_id": 74 }, { "code": "Healthcare costs", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Out-of-pocket costs", "quote": "Healthcare is expensive", "context": "Patient and interviewer discuss high cost of healthcare", "file_id": "dr_HD0225", "chunk_id": 74 }, { "code": "Expensive treatments", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Expensive treatments/surgery", "quote": "Healthcare is expensive. Yeah. Blood work alone can cost you $1,000.", "context": "Patient discusses high costs of healthcare", "file_id": "dr_HD0225", "chunk_id": 75 }, { "code": "Lack of awareness", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "But there aren't enough people that know about it--that have it.", "context": "Patient mentions lack of awareness about diabetes", "file_id": "dr_HD0225", "chunk_id": 75 }, { "code": "Adequate insurance coverage", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate insurance coverage", "quote": "Of course, luckily, now I've got insurance--that pays for it.", "context": "Patient has insurance that covers healthcare costs", "file_id": "dr_HD0225", "chunk_id": 75 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "that's $100", "context": "Patient mentions cost as a concern for doctor visits", "file_id": "dr_HD0225", "chunk_id": 76 }, { "code": "Lack of access to healthcare", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "They ain't going to a damn doctor", "context": "Patient implies that some people do not visit the doctor", "file_id": "dr_HD0225", "chunk_id": 76 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "But you got to take care of yourself", "context": "Patient emphasizes self-care and personal responsibility", "file_id": "dr_HD0225", "chunk_id": 76 }, { "code": "Lack of awareness", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "But I don't see a lot of stuff on TV about it. Not enough. Awareness.", "context": "Patient mentions lack of public awareness about diabetic retinopathy", "file_id": "dr_HD0225", "chunk_id": 77 }, { "code": "Self care importance", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "You got to take care of yourself. Nobody else is gonna do it for you.", "context": "Patient emphasizes personal responsibility for health", "file_id": "dr_HD0225", "chunk_id": 77 }, { "code": "Personal motivation", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "Number one comes first. And you got to take care of yourself.", "context": "Patient prioritizes self-care and health", "file_id": "dr_HD0225", "chunk_id": 77 }, { "code": "Lack of awareness", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "there's not enough of it. People don't know about it.", "context": "Patient believes lack of awareness is a major issue", "file_id": "dr_HD0225", "chunk_id": 78 }, { "code": "Education barriers", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "Awareness. That's the key word right there.", "context": "Patient emphasizes importance of awareness and education", "file_id": "dr_HD0225", "chunk_id": 78 }, { "code": "Lack of self care", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "He's not taking care of it", "context": "Patient describes someone who doesn't take care of their health", "file_id": "dr_HD0225", "chunk_id": 79 }, { "code": "Fatalistic beliefs", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Cultural beliefs about healthcare", "quote": "He thinks he's just making a fatal stab at it", "context": "Patient describes someone with fatalistic views on health", "file_id": "dr_HD0225", "chunk_id": 79 }, { "code": "Lack of health motivation", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "No perceived urgency", "quote": "Don't want it. I'll take care of himself", "context": "Patient describes someone who lacks motivation to manage their health", "file_id": "dr_HD0225", "chunk_id": 79 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "I spent $500", "context": "Patient mentions high initial cost of insulin", "file_id": "dr_HD0225", "chunk_id": 80 }, { "code": "Insurance coverage issues", "category": "BARRIER - SDOH", "subcategory": "Insurance coverage issues", "quote": "the one plan I had there a while back, it was free", "context": "Patient discusses variability in insurance coverage", "file_id": "dr_HD0225", "chunk_id": 80 }, { "code": "Adequate insurance coverage", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate insurance coverage", "quote": "it was free", "context": "Patient has access to free medication through insurance", "file_id": "dr_HD0225", "chunk_id": 80 }, { "code": "Financial assistance programs", "category": "FACILITATOR - Resources & Access", "subcategory": "Financial assistance programs", "quote": "I just go to the drug store, and then they-- whatever", "context": "Patient implies access to financial assistance for medication", "file_id": "dr_HD0225", "chunk_id": 80 }, { "code": "Insurance coverage issues", "category": "BARRIER - SDOH", "subcategory": "Insurance coverage issues", "quote": "I didn't have part B. Medicare-- for a long time.", "context": "Patient lacked necessary insurance coverage", "file_id": "dr_HD0225", "chunk_id": 81 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "It's almost everything I get free-- 12, 13 prescriptions.", "context": "Patient implies reliance on free or low-cost services due to financial limitations", "file_id": "dr_HD0225", "chunk_id": 81 }, { "code": "Adequate insurance coverage", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate insurance coverage", "quote": "I didn't have part B. Medicare-- for a long time. Didn't have it. Had Part A.", "context": "Patient eventually obtained necessary insurance coverage, facilitating access to care", "file_id": "dr_HD0225", "chunk_id": 81 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "Cost me 300 something dollars a month", "context": "Patient mentions expensive insurance costs", "file_id": "dr_HD0225", "chunk_id": 82 }, { "code": "Insurance coverage issues", "category": "BARRIER - SDOH", "subcategory": "Insurance coverage issues", "quote": "Had Part A", "context": "Patient had limited insurance coverage initially", "file_id": "dr_HD0225", "chunk_id": 82 }, { "code": "Cost-related barriers", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Out-of-pocket costs", "quote": "Cost me 300 something dollars a month", "context": "Patient mentions expensive monthly insurance costs", "file_id": "dr_HD0225", "chunk_id": 82 }, { "code": "Financial assistance", "category": "FACILITATOR - Resources & Access", "subcategory": "Financial assistance programs", "quote": "It's worth it", "context": "Patient considers insurance cost worthwhile, implying financial assistance is helpful", "file_id": "dr_HD0225", "chunk_id": 82 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "she don't wanna spend that money", "context": "Patient hesitant to spend money on healthcare", "file_id": "dr_HD0225", "chunk_id": 83 }, { "code": "Cost concerns", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Out-of-pocket costs", "quote": "But we're not rich", "context": "Patient considers financial situation when deciding on healthcare spending", "file_id": "dr_HD0225", "chunk_id": 83 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "She can't hear half the time", "context": "Patient experiences poor communication due to provider's hearing issues", "file_id": "dr_HD0225", "chunk_id": 84 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "That makes her nervous", "context": "Patient feels nervous, indicating potential lack of trust in provider", "file_id": "dr_HD0225", "chunk_id": 84 }, { "code": "Lack of recall", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I wouldn't remember anyway", "context": "Patient has difficulty recalling previous eye exams", "file_id": "dr_MA1103(Part2)", "chunk_id": 0 }, { "code": "Emergency visit", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "I started coming here because of an emergency", "context": "Patient's initial visit was due to an emergency, potentially indicating difficulty with scheduled appointments", "file_id": "dr_MA1103(Part2)", "chunk_id": 0 }, { "code": "Lack of recent exams", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "it's been a couple years", "context": "Patient has not had regular eye exams, indicating potential lack of understanding about importance of follow-up", "file_id": "dr_MA1103(Part2)", "chunk_id": 0 }, { "code": "Follow-up care", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "So coming here today was just a follow-up to make sure that's-", "context": "Patient is receiving follow-up care, indicating access to healthcare services", "file_id": "dr_MA1103(Part2)", "chunk_id": 0 }, { "code": "Provider monitoring", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "just made sure everything was healing properly and, , that they didn't see any complications", "context": "Patient's provider is actively monitoring their condition, facilitating follow-up care", "file_id": "dr_MA1103(Part2)", "chunk_id": 0 }, { "code": "Lack of urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "I just ... I slacked", "context": "Patient doesn't feel urgent need for regular check-ups", "file_id": "dr_MA1103(Part2)", "chunk_id": 1 }, { "code": "Busy schedule", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Life gets busy", "context": "Patient's busy life interferes with regular check-ups", "file_id": "dr_MA1103(Part2)", "chunk_id": 1 }, { "code": "Annual check-ups", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "It should probably be an annual thing, I would think", "context": "Patient has some understanding of recommended check-up frequency", "file_id": "dr_MA1103(Part2)", "chunk_id": 1 }, { "code": "Importance of regular checks", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "then it needs to be done more often", "context": "Patient recognizes need for more frequent check-ups with age", "file_id": "dr_MA1103(Part2)", "chunk_id": 1 }, { "code": "Reminder systems", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "I got the reminders", "context": "Patient received reminders for follow-up appointment", "file_id": "dr_MA1103(Part2)", "chunk_id": 2 }, { "code": "Accessible scheduling", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Appointment scheduling difficulties", "quote": "Any difficulties with trying to schedule at that time? Speaker 1: No", "context": "Patient did not experience difficulty scheduling appointment", "file_id": "dr_MA1103(Part2)", "chunk_id": 2 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I've been thrilled here with ... I thought I was going lose vision in that eye.", "context": "Patient finds provider accessible and helpful", "file_id": "dr_MA1103(Part2)", "chunk_id": 3 }, { "code": "Reminder systems", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "So it just, yeah, I got the reminders.", "context": "Patient receives reminders for follow-up appointments", "file_id": "dr_MA1103(Part2)", "chunk_id": 3 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I've been thrilled here with ... I thought I was going lose vision in that eye.", "context": "Patient has a positive relationship with their provider", "file_id": "dr_MA1103(Part2)", "chunk_id": 3 }, { "code": "Positive experience", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "This really has been a really good experience", "context": "Patient reports positive interaction with healthcare system", "file_id": "dr_MA1103(Part2)", "chunk_id": 4 }, { "code": "No challenges", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate access to care", "quote": "No, not really", "context": "Patient does not face challenges in receiving eye care", "file_id": "dr_MA1103(Part2)", "chunk_id": 4 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "because of the- Mm-hmm. ... the diabetes and the veins", "context": "Patient seems unclear about relationship between diabetes and vision loss", "file_id": "dr_MA1103(Part2)", "chunk_id": 5 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "The doctor's amazing", "context": "Patient feels comfortable with their eye doctor", "file_id": "dr_MA1103(Part2)", "chunk_id": 6 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "I guess just through this whole process. ... being able to ...", "context": "Patient feels able to express concerns to their doctor", "file_id": "dr_MA1103(Part2)", "chunk_id": 6 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "They both mentioned that because of the-", "context": "Patient is informed about their risk of vision loss", "file_id": "dr_MA1103(Part2)", "chunk_id": 6 }, { "code": "No hesitation to discuss concerns", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I don't feel any hesitation-", "context": "Patient feels comfortable discussing their diabetes and eye problems", "file_id": "dr_MA1103(Part2)", "chunk_id": 6 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "The doctor's amazing", "context": "Patient expresses admiration for their doctor", "file_id": "dr_MA1103(Part2)", "chunk_id": 7 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Anything you felt you weren't able to express? Speaker 1: No. Not at all.", "context": "Patient feels heard and able to express themselves", "file_id": "dr_MA1103(Part2)", "chunk_id": 7 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "do you ever tell your doctors what you feel is good for you? So , advocating for yourself?", "context": "Patient takes an active role in their care", "file_id": "dr_MA1103(Part2)", "chunk_id": 7 }, { "code": "Self advocacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "yeah. Speaker 2: What kinds of things do you make sure to point out to them? Speaker 1: , any changes or anything.", "context": "Patient is proactive in discussing their health with their doctor", "file_id": "dr_MA1103(Part2)", "chunk_id": 7 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I'm not sure what they should do", "context": "Patient unsure of expectations from healthcare providers", "file_id": "dr_MA1103(Part2)", "chunk_id": 8 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Just the, the communication", "context": "Patient values clear communication with providers", "file_id": "dr_MA1103(Part2)", "chunk_id": 8 }, { "code": "Efficient system", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "It's really efficient", "context": "Patient appreciates efficient healthcare system", "file_id": "dr_MA1103(Part2)", "chunk_id": 8 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "Just being here, the way things operate", "context": "Patient feels comfortable with providers and system", "file_id": "dr_MA1103(Part2)", "chunk_id": 8 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I was gonna pass out all the time", "context": "Patient experienced adverse reaction to medication", "file_id": "dr_MA1103(Part2)", "chunk_id": 8 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I have no idea what the-", "context": "Patient unsure about diabetes-related vision loss odds", "file_id": "dr_MA1103(Part2)", "chunk_id": 9 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "Nobody's gotten to that point", "context": "Patient feels providers haven't discussed vision loss likelihood", "file_id": "dr_MA1103(Part2)", "chunk_id": 9 }, { "code": "Lack of perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "Yeah, it's fine.", "context": "Patient does not feel urgent need for follow-up", "file_id": "dr_MA1103(Part2)", "chunk_id": 10 }, { "code": "No vision problems", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "No. No. None of the, weird images or, stuff floating around.", "context": "Patient is unaware of potential vision problems", "file_id": "dr_MA1103(Part2)", "chunk_id": 10 }, { "code": "Aging concerns", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I think aging ... Actually now that you mentioned that though, I have been ... I don't know if it's an aging thing or-", "context": "Patient attributes vision issues to aging", "file_id": "dr_MA1103(Part2)", "chunk_id": 10 }, { "code": "Night vision difficulties", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I've been having a harder and harder time seeing at night", "context": "Patient recognizes need for follow-up due to vision difficulties", "file_id": "dr_MA1103(Part2)", "chunk_id": 10 }, { "code": "Lack of urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "Yeah, I can say well enough to get through life basically", "context": "Patient does not perceive their vision as a significant issue", "file_id": "dr_MA1103(Part2)", "chunk_id": 11 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "I forgot today", "context": "Patient did not discuss their night vision issues with their provider", "file_id": "dr_MA1103(Part2)", "chunk_id": 11 }, { "code": "Positive experience", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "It's been, it's actually been awesome", "context": "Patient describes overall positive experience with eye care", "file_id": "dr_MA1103(Part2)", "chunk_id": 12 }, { "code": "Easy follow-ups", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "Yeah. Yeah", "context": "Patient implies follow-up appointments are easy to manage", "file_id": "dr_MA1103(Part2)", "chunk_id": 12 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "It's all been- ... a good experience", "context": "Patient has positive experience with healthcare system", "file_id": "dr_MA1103(Part2)", "chunk_id": 13 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "And the way that you guys can shift information around to each other", "context": "Patient appreciates provider communication and coordination", "file_id": "dr_MA1103(Part2)", "chunk_id": 13 }, { "code": "Patient navigation services", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Patient navigation services", "quote": "And the way that you guys can shift information around to each other", "context": "Patient benefits from healthcare system's navigation and coordination", "file_id": "dr_MA1103(Part2)", "chunk_id": 13 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "You got to take this on a piece of paper and get file", "context": "Patient mentions difficulty with paperwork and accessibility", "file_id": "dr_MA1103(Part2)", "chunk_id": 14 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "It's very hard to read on the screen", "context": "Patient implies that communication methods are outdated and ineffective", "file_id": "dr_MA1103(Part2)", "chunk_id": 14 }, { "code": "Accessibility issues", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "We still do fax stuff to people", "context": "Patient highlights outdated communication methods as a barrier", "file_id": "dr_MA1103(Part2)", "chunk_id": 14 }, { "code": "Healthcare system support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Working here in West Virginia, it was, we were in early '90s", "context": "Patient mentions past experience with healthcare system, implying some level of support", "file_id": "dr_MA1103(Part2)", "chunk_id": 14 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "because there were quite a ways away", "context": "Patient mentions distance as an issue, implying transportation concerns", "file_id": "dr_MA1103(Part2)", "chunk_id": 15 }, { "code": "Lack of motivation", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "No perceived urgency", "quote": "Getting older", "context": "Patient's motivation for keeping up with healthcare services", "file_id": "dr_MA1103(Part2)", "chunk_id": 16 }, { "code": "Past negative experiences", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "never saw a doctor", "context": "Patient's history of not seeking medical care", "file_id": "dr_MA1103(Part2)", "chunk_id": 16 }, { "code": "No discouraging factors", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Oh, not really", "context": "Patient does not experience anything that discourages them from using healthcare services", "file_id": "dr_MA1103(Part2)", "chunk_id": 16 }, { "code": "Aging as motivator", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Getting older", "context": "Patient's motivation for keeping up with healthcare services", "file_id": "dr_MA1103(Part2)", "chunk_id": 16 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "never saw a doctor", "context": "Patient has limited experience with healthcare services", "file_id": "dr_MA1103(Part2)", "chunk_id": 17 }, { "code": "No transportation issues", "category": "BARRIER - SDOH", "subcategory": "Transportation issues", "quote": "No, nothing that", "context": "Patient does not experience transportation barriers", "file_id": "dr_MA1103(Part2)", "chunk_id": 17 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "Has been awesome", "context": "Patient has a positive experience with primary care doctor", "file_id": "dr_MA1103(Part2)", "chunk_id": 17 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Has been awesome", "context": "Patient values effective communication with healthcare provider", "file_id": "dr_MA1103(Part2)", "chunk_id": 17 }, { "code": "Hopeful attitude", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Little more hopeful", "context": "Patient feels more positive about managing diabetes and eye care", "file_id": "dr_MA1103(Part2)", "chunk_id": 17 }, { "code": "Positive attitude", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Little more hopeful. Less doubt.", "context": "Patient feels hopeful about managing diabetes", "file_id": "dr_MA1103(Part2)", "chunk_id": 18 }, { "code": "Social support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "me and my brother", "context": "Patient has family support for daily diabetes care", "file_id": "dr_MA1103(Part2)", "chunk_id": 18 }, { "code": "Satisfactory care", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I wouldn't change anything here.", "context": "Patient is satisfied with current healthcare services", "file_id": "dr_MA1103(Part2)", "chunk_id": 18 }, { "code": "Social Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "me and my brother", "context": "Patient has a supportive family member", "file_id": "dr_MA1103(Part2)", "chunk_id": 19 }, { "code": "Lack of Education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "No", "context": "Patient has not participated in diabetes education classes", "file_id": "dr_MA1103(Part2)", "chunk_id": 19 }, { "code": "Emotional Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "have people that you feel you can share if you have worries and fears about your diabetes and eye care", "context": "Patient has people to talk to about concerns", "file_id": "dr_MA1103(Part2)", "chunk_id": 19 }, { "code": "Healthcare Access", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate insurance coverage", "quote": "actually have a friend who's a doctor", "context": "Patient has access to medical expertise through a friend", "file_id": "dr_MA1103(Part2)", "chunk_id": 19 }, { "code": "Social Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "Oh, yeah. , actually have a friend who's a doctor.", "context": "Patient has a supportive friend who is a doctor", "file_id": "dr_MA1103(Part2)", "chunk_id": 20 }, { "code": "Provider Support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "They're my regular doctor and ... For some reason a bunch of nurses.", "context": "Patient has access to regular doctor and nurses", "file_id": "dr_MA1103(Part2)", "chunk_id": 20 }, { "code": "Emotional Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "When you share your worries with them, do you feel that they understand you and support you, , in the things that you do to get better? Speaker 1: Oh, yeah.", "context": "Patient feels supported by healthcare providers", "file_id": "dr_MA1103(Part2)", "chunk_id": 20 }, { "code": "Lack Of Daily Support", "category": "BARRIER - SDOH", "subcategory": "Social Determinants of Health", "quote": "I live alone, so. Speaker 2: So sure. Sure. Speaker 1: So there's nobody there.", "context": "Patient lacks daily support due to living alone", "file_id": "dr_MA1103(Part2)", "chunk_id": 20 }, { "code": "Family Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "But yeah, I can call my brother. Speaker 2: Okay. Speaker 1: One of my brothers", "context": "Patient has supportive family members", "file_id": "dr_MA1103(Part2)", "chunk_id": 20 }, { "code": "Social Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "I can call my brother", "context": "Patient mentions calling family for advice on health issues", "file_id": "dr_MA1103(Part2)", "chunk_id": 21 }, { "code": "Health Literacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "friends who are RNs", "context": "Patient has friends who are medical professionals, potentially providing health advice", "file_id": "dr_MA1103(Part2)", "chunk_id": 21 }, { "code": "Access to Advice", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "friends a doctor", "context": "Patient has access to medical professional friends for advice", "file_id": "dr_MA1103(Part2)", "chunk_id": 21 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Just my blood pressure maybe", "context": "Patient shows uncertainty about medical condition", "file_id": "dr_MA1103(Part2)", "chunk_id": 22 }, { "code": "Health literacy barriers", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "the whatever diastolic", "context": "Patient demonstrates limited medical knowledge", "file_id": "dr_MA1103(Part2)", "chunk_id": 22 }, { "code": "Social support networks", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "friends a doctor, a bunch of friends who are RNs", "context": "Patient has access to informal medical advice", "file_id": "dr_MA1103(Part2)", "chunk_id": 22 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "None", "context": "No direct quote, but implied by discussion of eye care visit", "file_id": "dr_MA1103(Part2)", "chunk_id": 23 }, { "code": "Vision limitations", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "because I don't see as well as I should", "context": "Patient experiences vision problems", "file_id": "dr_MA1103(Part2)", "chunk_id": 23 }, { "code": "Driving difficulties", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "driving at night's becoming more of a problem", "context": "Patient experiences vision problems affecting daily activities", "file_id": "dr_MA1103(Part2)", "chunk_id": 23 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "So you have people to call", "context": "Patient has access to healthcare providers", "file_id": "dr_MA1103(Part2)", "chunk_id": 23 }, { "code": "Lack of expectations", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I didn't really have any set expectations", "context": "Patient lacks understanding of eye care visit purpose", "file_id": "dr_MA1103(Part2)", "chunk_id": 23 }, { "code": "Lack of expectations", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Patient Beliefs & Perceptions", "quote": "I didn't really have any set expectations", "context": "Patient had no clear goals for the eye care visit", "file_id": "dr_MA1103(Part2)", "chunk_id": 24 }, { "code": "Hope for no worsening", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Hoping that, nothing was worse than before", "context": "Patient is informed about potential progression of DR", "file_id": "dr_MA1103(Part2)", "chunk_id": 24 }, { "code": "Met expectations", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "Yeah. Those were answered and things that", "context": "Patient felt heard and understood by the provider", "file_id": "dr_MA1103(Part2)", "chunk_id": 24 }, { "code": "Self-monitoring awareness", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I could tell that there was something wrong with my blood sugar because- ... of my vision was changing", "context": "Patient is aware of the link between blood sugar and vision changes", "file_id": "dr_MA1103(Part2)", "chunk_id": 24 }, { "code": "Lack of urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "of my vision was changing", "context": "Patient experienced vision changes but didn't prioritize follow-up", "file_id": "dr_MA1103(Part2)", "chunk_id": 25 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "my regular doctor, yeah", "context": "Patient has open communication with their doctor", "file_id": "dr_MA1103(Part2)", "chunk_id": 25 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "", "context": "No direct quote, insufficient data", "file_id": "dr_MA1103(Part2)", "chunk_id": 26 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "", "context": "No direct quote, insufficient data", "file_id": "dr_MA1103(Part2)", "chunk_id": 26 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "", "context": "No direct quote, insufficient data", "file_id": "dr_MA1103(Part2)", "chunk_id": 26 }, { "code": "Lack of questions", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "No", "context": "Patient does not have questions about their care", "file_id": "dr_DL0111", "chunk_id": 0 }, { "code": "Effective medication management", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "just take my-- take my medications. I count carbs--", "context": "Patient is managing their diabetes through medication and carb counting", "file_id": "dr_DL0111", "chunk_id": 0 }, { "code": "Accessible treatment options", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I started Ozempic", "context": "Patient has access to effective treatment options like Ozempic", "file_id": "dr_DL0111", "chunk_id": 0 }, { "code": "Positive health outcomes", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "My A1C in January of last year was 15.8... now I'm , I think, 7.7 or 7.8", "context": "Patient has experienced improved health outcomes through effective management", "file_id": "dr_DL0111", "chunk_id": 0 }, { "code": "Easy treatment adjustment", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "The Ozempic made it really easy", "context": "Patient found it easy to adjust to new treatment with provider support", "file_id": "dr_DL0111", "chunk_id": 0 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "I wish I had it five years ago", "context": "Patient expresses regret over delayed access to effective treatment", "file_id": "dr_DL0111", "chunk_id": 1 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "The Ozempic made it really easy", "context": "Patient appreciates provider's prescription of effective medication", "file_id": "dr_DL0111", "chunk_id": 1 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Just making sure this is working, the-- Dexcom", "context": "Patient uses technology to manage condition, indicating some level of health education", "file_id": "dr_DL0111", "chunk_id": 1 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "The Ozempic made it really easy", "context": "Patient has access to effective treatment, implying accessible providers", "file_id": "dr_DL0111", "chunk_id": 1 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "I ran out", "context": "Patient experienced issues with sensor supply", "file_id": "dr_DL0111", "chunk_id": 2 }, { "code": "Device issues", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "he kept saying I was low reading, low reading, and I was pricking my fingers", "context": "Patient experienced faulty readings from device", "file_id": "dr_DL0111", "chunk_id": 2 }, { "code": "Health literacy", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "I just don't prick my finger every day", "context": "Patient uses backup method for blood glucose monitoring", "file_id": "dr_DL0111", "chunk_id": 2 }, { "code": "Provider communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "we just-- actually, this is, the second month I've been using this", "context": "Patient discussed device issues with doctor", "file_id": "dr_DL0111", "chunk_id": 2 }, { "code": "Device support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I always have the backup for the one touch barrier that I, I check against it", "context": "Patient has access to alternative monitoring method", "file_id": "dr_DL0111", "chunk_id": 2 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "they didn't have any Libre 3s", "context": "Patient faced issues with availability of medical devices", "file_id": "dr_DL0111", "chunk_id": 3 }, { "code": "Equipment issues", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of continuity of care", "quote": "the sensors were supposed to last 15 days, and they were only lasting sometimes between 6 and 11", "context": "Patient experienced problems with medical equipment", "file_id": "dr_DL0111", "chunk_id": 3 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "they put-- they-- gave me the Dexcom 7", "context": "Patient received alternative solution from healthcare provider", "file_id": "dr_DL0111", "chunk_id": 3 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "And they said, 'Do you wanna try it?'", "context": "Patient felt supported by healthcare provider's offer to try alternative device", "file_id": "dr_DL0111", "chunk_id": 3 }, { "code": "Lack of assistance", "category": "BARRIER - Social Determinants of Health (SDOH)", "subcategory": "Education/health literacy barriers", "quote": "I have to have somebody else do it", "context": "Patient needs help with medical device", "file_id": "dr_DL0111", "chunk_id": 4 }, { "code": "Fear of hypoglycemia", "category": "BARRIER - Emotional/Psychological", "subcategory": "Diabetes distress", "quote": "my main concern, is that it drops too low", "context": "Patient worries about low blood sugar", "file_id": "dr_DL0111", "chunk_id": 4 }, { "code": "Self monitoring skills", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I'll finger stick for two or three days, and then I'll put it back on", "context": "Patient demonstrates ability to manage diabetes", "file_id": "dr_DL0111", "chunk_id": 4 }, { "code": "Social support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "I have to have somebody else do it", "context": "Patient has someone to help with medical tasks", "file_id": "dr_DL0111", "chunk_id": 4 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "my sight was really, really bad", "context": "Patient mentions vision problems but doesn't elaborate on understanding of DR", "file_id": "dr_DL0111", "chunk_id": 5 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I thought I wet the bed", "context": "Patient expresses fear and anxiety related to diabetes symptoms", "file_id": "dr_DL0111", "chunk_id": 5 }, { "code": "Emotional distress", "category": "BARRIER - Emotional/Psychological", "subcategory": "Diabetes distress", "quote": "I get very tired", "context": "Patient experiences emotional and physical distress due to diabetes", "file_id": "dr_DL0111", "chunk_id": 5 }, { "code": "Self management support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I always keep little candies beside my bed", "context": "Patient has developed strategies to manage diabetes", "file_id": "dr_DL0111", "chunk_id": 5 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I'm very-- I get very tired when it goes too low", "context": "Patient has some understanding of diabetes symptoms and management", "file_id": "dr_DL0111", "chunk_id": 5 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "when the numbers are high-- even now, -- I-- there's a little slight difference in my, my-- with my sugar being 300. I don't know why it's 300 right now", "context": "Patient seems unsure about relationship between blood sugar and vision", "file_id": "dr_DL0111", "chunk_id": 6 }, { "code": "Effective treatment", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "The cataract removal and, I think, because of the, the Ozempic and-- numbers coming down", "context": "Patient attributes improved vision to successful treatment", "file_id": "dr_DL0111", "chunk_id": 6 }, { "code": "Positive outcome", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I haven't seen this well since, -- I was probably 11, 12 years old--", "context": "Patient experiences improved vision, possibly due to better disease management", "file_id": "dr_DL0111", "chunk_id": 6 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't know why it's 300 right now", "context": "Patient unsure about blood sugar levels", "file_id": "dr_DL0111", "chunk_id": 7 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "when the numbers are high-- even now", "context": "Patient anxious about high blood sugar levels", "file_id": "dr_DL0111", "chunk_id": 7 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "since the vision's changed?", "context": "Patient aware of vision changes due to diabetes", "file_id": "dr_DL0111", "chunk_id": 7 }, { "code": "Self management", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "if it's below 140, I-I'm fine", "context": "Patient managing blood sugar levels", "file_id": "dr_DL0111", "chunk_id": 7 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "not really anything", "context": "Patient reports doctor hasn't discussed vision changes", "file_id": "dr_DL0111", "chunk_id": 8 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "not really anything", "context": "Patient lacks information from doctor about vision changes", "file_id": "dr_DL0111", "chunk_id": 9 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "you can go blind from it", "context": "Patient aware of potential severe consequences of diabetes", "file_id": "dr_DL0111", "chunk_id": 9 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "watch your sugar levels", "context": "Patient understands importance of managing blood sugar", "file_id": "dr_DL0111", "chunk_id": 9 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "they're impressed that", "context": "Patient feels valued by healthcare provider", "file_id": "dr_DL0111", "chunk_id": 9 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "the chances are that you-- that I- - that I could lose my sight altogether", "context": "Patient fears losing sight due to DR", "file_id": "dr_DL0111", "chunk_id": 10 }, { "code": "Provider Referral", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "And that's when, , Dr. L sent me to Dr. P,", "context": "Patient was referred to another provider by their current doctor", "file_id": "dr_DL0111", "chunk_id": 10 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "they don't do the contact exams here", "context": "Patient has to go elsewhere for special eye care needs", "file_id": "dr_DL0111", "chunk_id": 11 }, { "code": "Healthcare System Support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I get them here, all of the--", "context": "Patient has access to eye care at the current location", "file_id": "dr_DL0111", "chunk_id": 11 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "your dilated eye exam is important? Yes, because-- she shows me the pictures of what's-- she's looking for", "context": "Patient seems to understand importance after provider explanation", "file_id": "dr_DL0111", "chunk_id": 12 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "--she shows me the pictures of what's-- she's looking for", "context": "Patient feels informed by provider", "file_id": "dr_DL0111", "chunk_id": 12 }, { "code": "Regular check-ups", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "for the last year, I've been going every four weeks", "context": "Patient is aware of regular check-up schedule", "file_id": "dr_DL0111", "chunk_id": 12 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "--she shows me the pictures of what's-- she's looking for", "context": "Patient trusts provider's explanations", "file_id": "dr_DL0111", "chunk_id": 12 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "they said there's something with capillaries", "context": "Patient lacks clear understanding of diabetes-related eye conditions", "file_id": "dr_DL0111", "chunk_id": 13 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "zapping-- that's what I call it, zapping, --", "context": "Patient uses informal language to describe treatment, possibly indicating fear or apprehension", "file_id": "dr_DL0111", "chunk_id": 13 }, { "code": "Provider communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "no, she, --", "context": "Patient struggles to recall specific information from doctor, possibly due to poor communication", "file_id": "dr_DL0111", "chunk_id": 13 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "they said there's something with capillaries", "context": "Doctor explained condition in terms patient could understand, facilitating follow-up", "file_id": "dr_DL0111", "chunk_id": 13 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "they said there's something with capillaries", "context": "Patient received some level of health education, empowering them to manage condition", "file_id": "dr_DL0111", "chunk_id": 13 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "What do you mean they're not bad? I'm looking through a prism sometimes--", "context": "Patient expresses confusion about diagnosis", "file_id": "dr_DL0111", "chunk_id": 14 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "Oh, you got the cataracts, but they're not bad. They're not bad.", "context": "Patient receives unclear information from provider", "file_id": "dr_DL0111", "chunk_id": 14 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "As soon as Dr. L saw them, she sent me to Dr. P.", "context": "Patient receives attentive care from providers", "file_id": "dr_DL0111", "chunk_id": 14 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "And P-P was, 'Yep, they're coming off.'", "context": "Patient receives clear information from provider", "file_id": "dr_DL0111", "chunk_id": 14 }, { "code": "Second opinion", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "And as soon as Dr. L saw them, she sent me to Dr. P.", "context": "Patient receives additional care from specialist", "file_id": "dr_DL0111", "chunk_id": 14 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "If something's wrong, I tell them", "context": "Patient feels comfortable discussing issues with doctor", "file_id": "dr_DL0111", "chunk_id": 15 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "If something's wrong, I tell them", "context": "Patient communicates openly with doctor", "file_id": "dr_DL0111", "chunk_id": 15 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I had a tear in the retina--", "context": "Patient has knowledge of diabetes-related eye problems", "file_id": "dr_DL0111", "chunk_id": 15 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "If something's wrong, I tell them", "context": "Patient takes initiative in discussing health issues", "file_id": "dr_DL0111", "chunk_id": 15 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I trust him 100%", "context": "Patient expresses high level of trust in doctor", "file_id": "dr_DL0111", "chunk_id": 16 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Dr. P, this is what's going on", "context": "Patient uses messaging system to communicate with doctor", "file_id": "dr_DL0111", "chunk_id": 16 }, { "code": "Healthcare System Support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "MyChart's my best friend", "context": "Patient finds online portal helpful for communication and access", "file_id": "dr_DL0111", "chunk_id": 16 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I trust him 100%.", "context": "Patient expresses high level of trust in their doctor", "file_id": "dr_DL0111", "chunk_id": 17 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "speaking with the diabetic educators and, , my family doctor and the pharmacy team has opened my eyes a lot more.", "context": "Patient values open communication with healthcare team", "file_id": "dr_DL0111", "chunk_id": 17 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "I didn't feel I was getting anywhere with, , endocrinology--", "context": "Patient felt unheard by previous healthcare provider", "file_id": "dr_DL0111", "chunk_id": 17 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "speaking with the diabetic educators... has opened my eyes a lot more.", "context": "Patient benefits from health education", "file_id": "dr_DL0111", "chunk_id": 17 }, { "code": "Diabetes self-management support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "they got me to counting carbs", "context": "Patient receives support for managing diabetes", "file_id": "dr_DL0111", "chunk_id": 17 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "they got me to counting carbs", "context": "Patient received health education on carb counting", "file_id": "dr_DL0111", "chunk_id": 18 }, { "code": "Effective medication", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible treatments", "quote": "I'm not hungry all the time", "context": "Patient experiences positive effects from Ozempic medication", "file_id": "dr_DL0111", "chunk_id": 18 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "If you were to ask me that a year ago, I would've said, '100%, I think I'll lose it.'", "context": "Patient previously had poor understanding of diabetes impact on vision", "file_id": "dr_DL0111", "chunk_id": 19 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I wish I would've known about it six years ago, and maybe I would still have my leg.", "context": "Patient expresses regret over not knowing about treatment options sooner, implying fear of diagnosis", "file_id": "dr_DL0111", "chunk_id": 19 }, { "code": "Positive outlook", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "now I'm, I'm fairly comfortable with it, and I think it's-- if I can keep maintaining what I'm doing--", "context": "Patient feels empowered to manage condition after learning more", "file_id": "dr_DL0111", "chunk_id": 19 }, { "code": "Lack of urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "Okay. I'm coming up on a year next month--", "context": "Patient mentions timing of next appointment, implying they don't feel urgent need", "file_id": "dr_DL0111", "chunk_id": 20 }, { "code": "Family influence", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "my stepmom, she had the cataracts, but she's not diabetic, so", "context": "Patient mentions family member's experience with eye health", "file_id": "dr_DL0111", "chunk_id": 20 }, { "code": "Personal experience", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "she just now had to go get an eye exam and get glasses again", "context": "Patient learns from family member's experience with eye exams", "file_id": "dr_DL0111", "chunk_id": 20 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "Very scary at first", "context": "Patient describes initial reaction to diagnosis", "file_id": "dr_DL0111", "chunk_id": 21 }, { "code": "Lack of worry", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "No perceived urgency", "quote": "I haven't-- had any problems", "context": "Patient doesn't perceive follow-ups as urgent", "file_id": "dr_DL0111", "chunk_id": 22 }, { "code": "Trust in provider", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I don't have to worry about what's gonna happen", "context": "Patient trusts their provider", "file_id": "dr_DL0111", "chunk_id": 22 }, { "code": "Accessible care", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "everybody's , 'Y-you live an hour and a half away. Why do you keep coming here?'", "context": "Patient finds the healthcare system accessible despite distance", "file_id": "dr_DL0111", "chunk_id": 22 }, { "code": "Continuity of care", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Lack of continuity of care", "quote": "Everybody knows, so they can see it", "context": "Patient appreciates the continuity of care in the healthcare system", "file_id": "dr_DL0111", "chunk_id": 22 }, { "code": "Transportation issues", "category": "BARRIER - SDOH", "subcategory": "Transportation issues", "quote": "Y-you live an hour and a half away", "context": "Patient faces transportation challenges due to distance", "file_id": "dr_DL0111", "chunk_id": 22 }, { "code": "Lack of trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "But I don't trust them", "context": "Patient expresses distrust in local healthcare providers", "file_id": "dr_DL0111", "chunk_id": 23 }, { "code": "Perceived better care", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "The care is better here", "context": "Patient believes care is better at the current facility", "file_id": "dr_DL0111", "chunk_id": 23 }, { "code": "Negative provider experience", "category": "BARRIER - Provider/System Issues", "subcategory": "Rude or dismissive providers", "quote": "All you guys did was put lipstick on a pig", "context": "Patient had a negative experience with local healthcare staff", "file_id": "dr_DL0111", "chunk_id": 23 }, { "code": "Rude providers", "category": "BARRIER - Provider/System Issues", "subcategory": "Rude or dismissive providers", "quote": "All you guys did was put lipstick on a pig. You're making those buildings look beautiful, but you need to change the staff.", "context": "Patient expresses dissatisfaction with provider behavior", "file_id": "dr_DL0111", "chunk_id": 24 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "All you guys did was put lipstick on a pig. You're making those buildings look beautiful, but you need to change the staff.", "context": "Patient implies poor communication from providers", "file_id": "dr_DL0111", "chunk_id": 24 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "I'm talking about the doctors because--", "context": "Patient expresses concern about doctor's behavior", "file_id": "dr_DL0111", "chunk_id": 24 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "The care is better here.", "context": "Patient perceives better care at current facility", "file_id": "dr_DL0111", "chunk_id": 24 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "they were gonna give me fluids. I begged them for water and never got it", "context": "Patient experienced lack of access to basic care during emergency visit", "file_id": "dr_DL0111", "chunk_id": 25 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "they kept saying they were gonna give me fluids. I begged them for water and never got it", "context": "Patient experienced poor communication from healthcare providers", "file_id": "dr_DL0111", "chunk_id": 25 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Long wait times", "quote": "we were there for 14 hours", "context": "Patient experienced long wait time during emergency visit", "file_id": "dr_DL0111", "chunk_id": 25 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "they did all this within the first three hours. And they kept saying they were gonna give me fluids", "context": "Patient experienced distrust due to unfulfilled promises by healthcare providers", "file_id": "dr_DL0111", "chunk_id": 25 }, { "code": "Transportation issues", "category": "BARRIER - SDOH", "subcategory": "Transportation issues", "quote": "I'll drive myself", "context": "Patient considered driving themselves to another hospital due to lack of transportation options", "file_id": "dr_DL0111", "chunk_id": 25 }, { "code": "Rude providers", "category": "BARRIER - Provider/System Issues", "subcategory": "Rude or dismissive providers", "quote": "I begged them for water and never got it", "context": "Patient felt neglected by healthcare staff", "file_id": "dr_DL0111", "chunk_id": 26 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "Well, we don't know what to do with you, so we're going-- we're going to get an ambulance and take you to W-- to Ruby", "context": "Patient experienced unclear communication from providers", "file_id": "dr_DL0111", "chunk_id": 26 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "They didn't give me anything", "context": "Patient distrusts provider's actions and decisions", "file_id": "dr_DL0111", "chunk_id": 26 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "And they started giving me fluids", "context": "Patient received timely care from responsive providers", "file_id": "dr_DL0111", "chunk_id": 26 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Were you-- sorry. Were you able to, , express those concerns when you were here? , did they-- were they responsive of--", "context": "Patient had open dialogue with provider about concerns", "file_id": "dr_DL0111", "chunk_id": 26 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "they said, 'Well, we'd to give you another, , bag of fluids, but we can't because Reynolds has already charted that they did do.'", "context": "Patient experienced poor communication with healthcare providers", "file_id": "dr_DL0111", "chunk_id": 27 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "They didn't do anything, so--", "context": "Patient distrusts provider's actions", "file_id": "dr_DL0111", "chunk_id": 27 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Healthcare System Support", "quote": "they did because they said, 'Well, we'd to give you another, , bag of fluids, but we can't because Reynolds has already charted that they did do.'", "context": "Providers attempted to address patient concerns", "file_id": "dr_DL0111", "chunk_id": 27 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Patient Empowerment", "quote": "And I-- and I know that one of the things for blood pressure low is to drink water to increase it, so.", "context": "Patient takes initiative in managing health", "file_id": "dr_DL0111", "chunk_id": 27 }, { "code": "No Transportation Issues", "category": "FACILITATOR - Resources & Access", "subcategory": "Transportation assistance", "quote": "So it doesn't bother me to drive down here", "context": "Patient has no issues with driving to appointments", "file_id": "dr_DL0111", "chunk_id": 28 }, { "code": "Provider Instruction", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "a doctor said, 'This is when you come back,' so that's when I come back", "context": "Patient follows provider's instructions for follow-up", "file_id": "dr_DL0111", "chunk_id": 28 }, { "code": "Self Awareness", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I'm just always been one that I know when something's wrong with me", "context": "Patient is aware of their health and takes action", "file_id": "dr_DL0111", "chunk_id": 28 }, { "code": "Provider Empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "a doctor said, 'This is when you come back,'", "context": "Patient values provider's instruction and care", "file_id": "dr_DL0111", "chunk_id": 29 }, { "code": "Patient Empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I know when something's wrong with me", "context": "Patient takes initiative in seeking help", "file_id": "dr_DL0111", "chunk_id": 29 }, { "code": "Effective Communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "a doctor said, 'This is when you come back,'", "context": "Clear instruction from provider facilitates follow-up", "file_id": "dr_DL0111", "chunk_id": 29 }, { "code": "Patient Autonomy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I argued with the doctors in the emergency--", "context": "Patient takes active role in healthcare decisions", "file_id": "dr_DL0111", "chunk_id": 29 }, { "code": "Social Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "I had my dad take me", "context": "Family support facilitates access to care", "file_id": "dr_DL0111", "chunk_id": 29 }, { "code": "Lack of trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "Most guys would just let it burst", "context": "Patient questions doctor's decision", "file_id": "dr_DL0111", "chunk_id": 30 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I know my body", "context": "Patient takes initiative in healthcare", "file_id": "dr_DL0111", "chunk_id": 30 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "And the doctor asked me", "context": "Doctor involves patient in decision-making", "file_id": "dr_DL0111", "chunk_id": 30 }, { "code": "Social support networks", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "I have a nurse friend", "context": "Patient has supportive relationships", "file_id": "dr_DL0111", "chunk_id": 30 }, { "code": "Social Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "I have a friend who's a nurse, so we're still good friends", "context": "Patient has a supportive friend who is a nurse", "file_id": "dr_DL0111", "chunk_id": 31 }, { "code": "Healthcare Advice", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "She told me, she said, 'Ask them for HIDA scan'", "context": "Patient received healthcare advice from a nurse friend", "file_id": "dr_DL0111", "chunk_id": 31 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "sometimes I, I will plan it, and I'll say, 'Okay. I, I need somebody to drive me home.'", "context": "Patient needs someone to drive them home after appointments", "file_id": "dr_DL0111", "chunk_id": 32 }, { "code": "Provider empathy", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "2. Provider Relationship", "quote": "We were so in tune to each other that, , we could actually have a conversation and not say a word.", "context": "Patient feels connected with their provider", "file_id": "dr_DL0111", "chunk_id": 32 }, { "code": "Trust in providers", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "2. Provider Relationship", "quote": "if your doctor's suggesting it, follow through with it-- , because it-- they're the professionals, and they know best.", "context": "Patient trusts their provider's expertise", "file_id": "dr_DL0111", "chunk_id": 32 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "because I wasn't paying attention and I wasn't doing anything", "context": "Patient initially lacked awareness of disease progression", "file_id": "dr_DL0111", "chunk_id": 33 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "when Dr. L started doing the, the lasers on my eyes", "context": "Patient's fear of treatment procedures", "file_id": "dr_DL0111", "chunk_id": 33 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "Dr. L started doing the, the lasers on my eyes and, and I was coming back and she goes, 'They're coming back. They're, they're growing faster, and I can zap them away'", "context": "Patient feels comforted by provider's explanation", "file_id": "dr_DL0111", "chunk_id": 33 }, { "code": "Social support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "my mom lives next door. And the first thing she says when she see me, 'Did you take your meds?'", "context": "Patient receives support from family member", "file_id": "dr_DL0111", "chunk_id": 33 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I need to follow through with getting my sugars down and getting--everything down", "context": "Patient learns about importance of managing blood sugar", "file_id": "dr_DL0111", "chunk_id": 33 }, { "code": "Social Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "my mom lives next door. And the first thing she says when she see me, 'Did you take your meds?'", "context": "Patient has family support for daily diabetes care", "file_id": "dr_DL0111", "chunk_id": 34 }, { "code": "Family Involvement", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "And she actually comes over and checks to make sure that I've filled up my weekly pill bottle.", "context": "Patient's family member helps with medication management", "file_id": "dr_DL0111", "chunk_id": 34 }, { "code": "Healthcare Team Support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "'Cause I got the ha-- the, the pharmacy team-- and Dr", "context": "Patient has support from healthcare team", "file_id": "dr_DL0111", "chunk_id": 34 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "they message me and say, 'Hey, how's this going? How's--'", "context": "Patient feels supported by provider", "file_id": "dr_DL0111", "chunk_id": 35 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "they message me and say, 'Hey, how's this going? How's--'", "context": "Patient receives regular updates from provider", "file_id": "dr_DL0111", "chunk_id": 35 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I got the ha-- the, the pharmacy team-- and Dr. P--", "context": "Patient has access to multiple healthcare professionals", "file_id": "dr_DL0111", "chunk_id": 35 }, { "code": "Reminder systems", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "They sent me a message yesterday. 'So we're checking up about the Jardiance.'", "context": "Patient receives reminders from healthcare team", "file_id": "dr_DL0111", "chunk_id": 35 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "That feels more personal, .", "context": "Patient values personal connection with provider", "file_id": "dr_DL0111", "chunk_id": 35 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "That feels more personal", "context": "Patient appreciates personalized care from provider", "file_id": "dr_DL0111", "chunk_id": 36 }, { "code": "Feeling comfortable with provider", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "I feel comfortable with them", "context": "Patient feels at ease with healthcare team", "file_id": "dr_DL0111", "chunk_id": 36 }, { "code": "Positive attitude", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "If you can't laugh about it--", "context": "Patient uses humor to cope with health issues", "file_id": "dr_DL0111", "chunk_id": 37 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I will call here", "context": "Patient has easy access to healthcare providers", "file_id": "dr_DL0111", "chunk_id": 37 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Dr. M came in, the surgeon, saw me in recovery", "context": "Patient receives clear communication from healthcare provider", "file_id": "dr_DL0111", "chunk_id": 37 }, { "code": "Coping mechanisms", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "It is what it is. I'm-- I gotta live with it, so", "context": "Patient uses coping mechanisms to deal with health issues", "file_id": "dr_DL0111", "chunk_id": 37 }, { "code": "Healthcare access", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate insurance coverage", "quote": "I will call here", "context": "Patient has access to healthcare services", "file_id": "dr_DL0111", "chunk_id": 37 }, { "code": "Appointment scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "And i-it's hard to get an appointment-- that quick anyways", "context": "Patient finds it challenging to schedule appointments quickly", "file_id": "dr_DL0111", "chunk_id": 38 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I will call here", "context": "Patient has easy access to healthcare providers via phone or messaging", "file_id": "dr_DL0111", "chunk_id": 38 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Hey, this is going on. What should I do, or any suggestions?", "context": "Patient experiences open and effective communication with healthcare providers", "file_id": "dr_DL0111", "chunk_id": 38 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "You mentioned earlier that you did, , diabetes education classes, right--", "context": "Patient participates in diabetes education classes for empowerment", "file_id": "dr_DL0111", "chunk_id": 38 }, { "code": "Appointment scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "it's hard to get an appointment-- that quick anyways", "context": "Patient finds it challenging to schedule appointments quickly", "file_id": "dr_DL0111", "chunk_id": 39 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "diabetes education classes", "context": "Patient participated in diabetes education classes", "file_id": "dr_DL0111", "chunk_id": 39 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "the diabetic educators. A lot of it was when I was hospitalized. They'd come in and talk to me", "context": "Patient had access to diabetic educators during hospitalization", "file_id": "dr_DL0111", "chunk_id": 39 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "someone from family medicine would come in and talk to me", "context": "Patient received communication from family medicine providers", "file_id": "dr_DL0111", "chunk_id": 39 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "when I started counting carbs and I learned how to count carbs", "context": "Patient received education on carb counting", "file_id": "dr_DL0111", "chunk_id": 40 }, { "code": "Effective self management", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I saw a big difference", "context": "Patient experienced positive outcomes from self-management", "file_id": "dr_DL0111", "chunk_id": 40 }, { "code": "Lack of side effects", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I am not having any side effects on them", "context": "Patient is empowered by lack of side effects from medication", "file_id": "dr_DL0111", "chunk_id": 43 }, { "code": "Social support networks", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "And I tell people all the time", "context": "Patient has social support from friends", "file_id": "dr_DL0111", "chunk_id": 43 }, { "code": "Lack of side effects", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I am not having any side effects on them", "context": "Patient is aware of medication side effects", "file_id": "dr_DL0111", "chunk_id": 44 }, { "code": "Positive treatment experience", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I'm happy with it", "context": "Patient has positive experience with medication", "file_id": "dr_DL0111", "chunk_id": 44 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "I live, an hour a half away up", "context": "Patient mentions living far from the clinic", "file_id": "dr_DL0111", "chunk_id": 45 }, { "code": "Telehealth options", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "1. Healthcare System Support", "quote": "I've done that a couple of times, not with the eye doctor, but", "context": "Patient has experience with telemedicine", "file_id": "dr_DL0111", "chunk_id": 45 }, { "code": "Telemedicine limitations", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of continuity of care", "quote": "if it was for eyes-- them being able to visually see my eyes-- and look into them and-- see what they're looking at when they're-- using that", "context": "Patient concerned about telemedicine limitations for eye exams", "file_id": "dr_DL0111", "chunk_id": 46 }, { "code": "Transportation issues", "category": "BARRIER - SDOH", "subcategory": "Transportation issues", "quote": "couldn't get down here to it", "context": "Patient had difficulty traveling to clinic during COVID", "file_id": "dr_DL0111", "chunk_id": 46 }, { "code": "Healthcare System Support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Telehealth options", "quote": "that's how I got through COVID 'cause I-- couldn't get down here to it", "context": "Patient used telemedicine as an alternative to in-person visits", "file_id": "dr_DL0111", "chunk_id": 46 }, { "code": "Provider Relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "Oh, no, we do that", "context": "Patient has a established relationship with primary care provider", "file_id": "dr_DL0111", "chunk_id": 46 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "--couldn't get down here to it", "context": "Patient had difficulty traveling to the clinic", "file_id": "dr_DL0111", "chunk_id": 47 }, { "code": "Lack of access to healthcare", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "--couldn't get down here to it", "context": "Patient had difficulty accessing healthcare due to location", "file_id": "dr_DL0111", "chunk_id": 47 }, { "code": "Rude or dismissive providers", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "3. Provider/System Issues", "quote": "--We told you there's nothing wrong with you. Why do you keep coming here?", "context": "Patient experienced rude treatment from healthcare providers", "file_id": "dr_DL0111", "chunk_id": 47 }, { "code": "Poor communication", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "3. Provider/System Issues", "quote": "--We told you there's nothing wrong with you. Why do you keep coming here?", "context": "Patient experienced poor communication from healthcare providers", "file_id": "dr_DL0111", "chunk_id": 47 }, { "code": "Lack of patient-provider trust", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "3. Provider/System Issues", "quote": "I actually tried changing my PCP to a local, and that was a disaster", "context": "Patient lacked trust in their healthcare provider", "file_id": "dr_DL0111", "chunk_id": 47 }, { "code": "Rude providers", "category": "BARRIER - Provider/System Issues", "subcategory": "Rude or dismissive providers", "quote": "\"We told you there's nothing wrong with you. Why do you keep coming here?\"", "context": "Patient feels dismissed by provider", "file_id": "dr_DL0111", "chunk_id": 48 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "\"We told you you had Lyme disease.\" But they admitted me every time for one night.", "context": "Patient experiences inconsistent messaging from providers", "file_id": "dr_DL0111", "chunk_id": 48 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "And the person who was supposed-- doctor who's supposed to be my PCP, walk past the room every time I was in the hospital but never stepped in to see me.", "context": "Patient feels neglected by their PCP", "file_id": "dr_DL0111", "chunk_id": 48 }, { "code": "Appointment scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "I'd make a P-- appointment with PCP, and then they tell me I didn't have an appointment, or they cancel it or change it.", "context": "Patient experiences issues with scheduling appointments", "file_id": "dr_DL0111", "chunk_id": 48 }, { "code": "Lack of continuity of care", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of continuity of care", "quote": "And the person who was supposed-- doctor who's supposed to be my PCP, walk past the room every time I was in the hospital but never stepped in to see me.", "context": "Patient lacks consistent care from their PCP", "file_id": "dr_DL0111", "chunk_id": 48 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "She goes, 'Oh, somebody screwed up,' and that's all she said and slid the window u-- down.", "context": "Patient experiences poor communication with healthcare staff", "file_id": "dr_DL0111", "chunk_id": 49 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "And he just look-looked at me, and I just got up and walked away.", "context": "Patient lacks trust in healthcare provider", "file_id": "dr_DL0111", "chunk_id": 49 }, { "code": "Appointment scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "They're -- she's, 'No, you don't. We, we don't have appointments on Friday.'", "context": "Patient experiences difficulty with appointment scheduling", "file_id": "dr_DL0111", "chunk_id": 49 }, { "code": "Rude or dismissive providers", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "She goes, 'Oh, somebody screwed up,' and that's all she said and slid the window u-- down.", "context": "Patient experiences rude behavior from healthcare staff", "file_id": "dr_DL0111", "chunk_id": 49 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Healthcare System Support", "quote": "And I called, -- as I was walking out the door, I called Dr", "context": "Patient seeks care from a trusted provider", "file_id": "dr_DL0111", "chunk_id": 49 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "I don't have an appointment for-- , I don't have anything available until August something.", "context": "Patient faces difficulty in getting an appointment", "file_id": "dr_DL0111", "chunk_id": 50 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "Nobody will listen to me at all.", "context": "Patient feels unheard by healthcare providers", "file_id": "dr_DL0111", "chunk_id": 50 }, { "code": "Accessible provider", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "She has this lovely Thursday night office hours.", "context": "Patient appreciates flexible office hours", "file_id": "dr_DL0111", "chunk_id": 50 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "And she said, 'I'll find it.' And she kept looking and looking", "context": "Patient feels heard and helped by provider", "file_id": "dr_DL0111", "chunk_id": 50 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "And she said, 'I'll find it.' And she kept looking and looking", "context": "Patient experiences effective communication with provider", "file_id": "dr_DL0111", "chunk_id": 50 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "nobody will listen to me in, in Glendale. Nobody--will listen to me at all.", "context": "Patient felt unheard by previous providers", "file_id": "dr_DL0111", "chunk_id": 51 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I trust her", "context": "Patient has a trusting relationship with current provider", "file_id": "dr_DL0111", "chunk_id": 51 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "she likes very thorough, da, da, da.", "context": "Provider is described as thorough and attentive", "file_id": "dr_DL0111", "chunk_id": 51 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "I trust her", "context": "Patient feels comfortable with provider", "file_id": "dr_DL0111", "chunk_id": 52 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I trust her. I trust--", "context": "Patient has established trust with provider", "file_id": "dr_DL0111", "chunk_id": 52 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "they'll ask me, 'Do you mind if--'", "context": "Provider communicates clearly and respectfully with patient", "file_id": "dr_DL0111", "chunk_id": 52 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "So, but, -- so I trust her", "context": "Patient feels comfortable with provider", "file_id": "dr_DL0111", "chunk_id": 53 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "And it's good that you felt comfortable enough to express that to her", "context": "Patient and provider have open communication", "file_id": "dr_DL0111", "chunk_id": 53 }, { "code": "Patient-provider trust", "category": "FACILITATOR - Provider Relationship", "subcategory": "Lack of patient-provider trust", "quote": "So, but, -- so I trust her", "context": "Patient has established trust with provider", "file_id": "dr_DL0111", "chunk_id": 53 }, { "code": "Fear of diagnosis/treatment", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "the first two, , I was in pain, and it felt he was pushing the needle", "context": "Patient experienced pain during treatment", "file_id": "dr_DL0111", "chunk_id": 53 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "I pretty much just go with whatever she suggests", "context": "Patient trusts doctor's suggestions", "file_id": "dr_DL0111", "chunk_id": 54 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "If it's something that I'm not familiar with or something's changing", "context": "Patient feels comfortable asking questions", "file_id": "dr_DL0111", "chunk_id": 54 }, { "code": "Shared decision-making", "category": "FACILITATOR - Provider Relationship", "subcategory": "Shared decision-making", "quote": "how you and your doctor make decisions about your care together", "context": "Patient discusses collaborative decision-making with doctor", "file_id": "dr_DL0111", "chunk_id": 54 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "You're crazy", "context": "Patient expresses distrust in doctor's diagnosis", "file_id": "dr_DL0111", "chunk_id": 54 }, { "code": "Lack of trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "I'm not going back", "context": "Patient lost trust in providers due to poor experience", "file_id": "dr_DL0111", "chunk_id": 55 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "nobody came in", "context": "Patient felt neglected by healthcare staff", "file_id": "dr_DL0111", "chunk_id": 55 }, { "code": "Rude providers", "category": "BARRIER - Provider/System Issues", "subcategory": "Rude or dismissive providers", "quote": "You're crazy", "context": "Patient felt disrespected by provider", "file_id": "dr_DL0111", "chunk_id": 55 }, { "code": "Lack of continuity of care", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of continuity of care", "quote": "the doctors changed at midnight", "context": "Patient experienced change in providers during care", "file_id": "dr_DL0111", "chunk_id": 55 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "they talk to me, not down to me or at me", "context": "Patient feels respected by providers", "file_id": "dr_DL0111", "chunk_id": 56 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "they will explain it so that I understand it", "context": "Patient feels heard and understood by providers", "file_id": "dr_DL0111", "chunk_id": 56 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I've been with Dr", "context": "Patient has established a relationship with their doctor", "file_id": "dr_DL0111", "chunk_id": 56 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "I've been with Dr. P since she was a resident", "context": "Patient has long-term relationship with provider", "file_id": "dr_DL0111", "chunk_id": 57 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Could you explain that so I can understand it?", "context": "Patient asks for clarification from provider", "file_id": "dr_DL0111", "chunk_id": 57 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "Yeah. I do", "context": "Patient feels respected by provider", "file_id": "dr_DL0111", "chunk_id": 57 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "everybody needs to learn to count carbs", "context": "Patient emphasizes importance of health education", "file_id": "dr_DL0111", "chunk_id": 58 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "Dr. P and I made the decision", "context": "Patient feels supported by provider in decision-making", "file_id": "dr_DL0111", "chunk_id": 58 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "She said, 'Yeah?' And I was, 'It is-- the--' what do I want to say? 'The side effects-- the, the benefits far outweigh the side effects.'", "context": "Patient has open and effective communication with provider", "file_id": "dr_DL0111", "chunk_id": 58 }, { "code": "Shared decision-making", "category": "FACILITATOR - Provider Relationship", "subcategory": "Shared decision-making", "quote": "Dr. P and I made the decision", "context": "Patient and provider collaborate in decision-making", "file_id": "dr_DL0111", "chunk_id": 58 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "She said, 'Are you sure?' And I'm , 'Yep.' She said, 'Okay.'", "context": "Patient feels heard and understood by provider", "file_id": "dr_DL0111", "chunk_id": 59 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "I told her, I said, 'Yeah.' I was , 'I think the, the side effects-- the benefits are-- far outweigh the side effects.'", "context": "Patient and provider discuss treatment options", "file_id": "dr_DL0111", "chunk_id": 59 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I think the, the side effects-- the benefits are-- far outweigh the side effects.", "context": "Patient makes informed decision about treatment", "file_id": "dr_DL0111", "chunk_id": 59 }, { "code": "Regular follow-up", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "follow with my PCP regularly", "context": "Patient prioritizes regular follow-up with primary care provider", "file_id": "dr_CJ0406", "chunk_id": 0 }, { "code": "Health monitoring", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Monitor my glucose with the Dexcom G7 sensor", "context": "Patient actively monitors their health using a glucose sensor", "file_id": "dr_CJ0406", "chunk_id": 0 }, { "code": "Medication adherence", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "Novolog, Tresiba, and Ozempic", "context": "Patient takes their prescribed medications regularly", "file_id": "dr_CJ0406", "chunk_id": 0 }, { "code": "Proactive care", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "If I have a problem, I get ahold of it", "context": "Patient takes initiative to address health problems promptly", "file_id": "dr_CJ0406", "chunk_id": 0 }, { "code": "Social support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "I usually tell people I call myself when I'm lonely at home", "context": "Patient has a social support network to cope with loneliness", "file_id": "dr_CJ0406", "chunk_id": 0 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "If I have problems with my feet", "context": "Patient unsure what to watch out for regarding diabetes progression", "file_id": "dr_CJ0406", "chunk_id": 1 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "using the sensors and make sure that, , we made sure we were on a good insulin regimen", "context": "Patient learned about managing diabetes through health education", "file_id": "dr_CJ0406", "chunk_id": 1 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "he put me on Ozempic, , to keep it lower and slower instead of spiking", "context": "Patient feels provider cares about their well-being", "file_id": "dr_CJ0406", "chunk_id": 1 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "what are some things your doctor has discussed with you that's important for you, you to do regarding your diabetes?", "context": "Patient and provider have open discussion about diabetes management", "file_id": "dr_CJ0406", "chunk_id": 1 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "If I have problems with my feet", "context": "Patient unsure of diabetes effects beyond foot problems", "file_id": "dr_CJ0406", "chunk_id": 2 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "then I need to get a hold of him or somebody right away", "context": "Patient anxious about addressing potential issues", "file_id": "dr_CJ0406", "chunk_id": 2 }, { "code": "Healthcare access", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate insurance coverage", "quote": "I usually do blood work every three months", "context": "Patient has regular access to healthcare services", "file_id": "dr_CJ0406", "chunk_id": 2 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "then I need to get a hold of him or somebody right away", "context": "Patient values provider support and responsiveness", "file_id": "dr_CJ0406", "chunk_id": 2 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "If I have problems with my feet", "context": "Patient monitors condition through self-education", "file_id": "dr_CJ0406", "chunk_id": 2 }, { "code": "Lack of awareness", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I really didn't really notice a problem in my eyes", "context": "Patient was unaware of eye problems", "file_id": "dr_CJ0406", "chunk_id": 3 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "it could've just bleeding really bad and-", "context": "Patient fears potential complications", "file_id": "dr_CJ0406", "chunk_id": 3 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "My car was still tied... I had a house in Pennsylvania", "context": "Patient had car registration issues due to out-of-state ownership", "file_id": "dr_CJ0406", "chunk_id": 4 }, { "code": "Lack of access to healthcare", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "I lived in Pennsylvania most of my life", "context": "Patient had to adapt to new healthcare system after moving", "file_id": "dr_CJ0406", "chunk_id": 4 }, { "code": "Education/health literacy barriers", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "I really didn't really notice a problem in my eyes", "context": "Patient lacked awareness of eye problems", "file_id": "dr_CJ0406", "chunk_id": 4 }, { "code": "Accessible providers", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "1. Healthcare System Support", "quote": "I went down to DMV in Elkins", "context": "Patient was able to access local services", "file_id": "dr_CJ0406", "chunk_id": 4 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I couldn't see it", "context": "Patient's initial lack of awareness about vision problems", "file_id": "dr_CJ0406", "chunk_id": 5 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "And they said, 'You need to go get your eye exam'", "context": "Healthcare provider shows concern for patient's condition", "file_id": "dr_CJ0406", "chunk_id": 5 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I saw Dr. Goria", "context": "Patient has access to a healthcare provider", "file_id": "dr_CJ0406", "chunk_id": 5 }, { "code": "Appointment scheduling", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "They told me to come back in April. May, somewhere around there", "context": "Patient experiences uncertainty with appointment scheduling", "file_id": "dr_CJ0406", "chunk_id": 5 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "they told me to come back in April. May, somewhere around there", "context": "Patient had to wait several months for follow-up appointment", "file_id": "dr_CJ0406", "chunk_id": 6 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "And he said, 'Everything looks good. We'll see you in June.'", "context": "Patient receives clear and reassuring communication from provider", "file_id": "dr_CJ0406", "chunk_id": 6 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "So we set up appointment and I went... Actually, I went to see him in April", "context": "Patient is able to schedule and attend follow-up appointments with provider", "file_id": "dr_CJ0406", "chunk_id": 6 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "the blood vessels start blowing out your eyes- ... because the sugar get... , everything's too thick and it blows out the capillaries in your eyes", "context": "Patient describes their understanding of diabetes effects on eyes", "file_id": "dr_CJ0406", "chunk_id": 7 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "you could go blind from it if you don't maintain it", "context": "Patient expresses fear of potential blindness due to diabetes", "file_id": "dr_CJ0406", "chunk_id": 7 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I usually go to, , places LensCrafters or someplace that", "context": "Patient mentions going to accessible eye exam locations", "file_id": "dr_CJ0406", "chunk_id": 7 }, { "code": "Difficulty scheduling", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "It was tough getting an eye exam quickly", "context": "Patient had difficulty scheduling an eye exam", "file_id": "dr_CJ0406", "chunk_id": 7 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "It was tough getting an eye exam quickly", "context": "Patient had difficulty accessing timely eye exams", "file_id": "dr_CJ0406", "chunk_id": 8 }, { "code": "Transportation issues", "category": "BARRIER - SDOH", "subcategory": "Transportation issues", "quote": "I usually go to places LensCrafters or someplace that", "context": "Patient may have transportation limitations for eye exams", "file_id": "dr_CJ0406", "chunk_id": 8 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I was able to get into Spectrum Eye in Bridgeport", "context": "Patient found a provider with available appointments", "file_id": "dr_CJ0406", "chunk_id": 8 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "He's the one that told me, 'You got bleeding in the back of your eyes'", "context": "Provider clearly communicated patient's condition", "file_id": "dr_CJ0406", "chunk_id": 8 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "And, eventually you could go blind from it if you don't maintain it", "context": "Patient has some knowledge about their condition", "file_id": "dr_CJ0406", "chunk_id": 8 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "My sugar was good, my A1C was good, but it is spiking too much", "context": "Patient seems unsure about diabetes management", "file_id": "dr_CJ0406", "chunk_id": 9 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "He told me I needed to...", "context": "Provider clearly explained treatment plan", "file_id": "dr_CJ0406", "chunk_id": 9 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "They give the routine eye exam", "context": "Patient has access to regular eye exams", "file_id": "dr_CJ0406", "chunk_id": 9 }, { "code": "Lack of issues", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "No. Anything?", "context": "Patient reports no problems with their eye exam experience", "file_id": "dr_CJ0406", "chunk_id": 10 }, { "code": "Regular checkups", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "every six months", "context": "Patient is aware of the recommended frequency for eye exams", "file_id": "dr_CJ0406", "chunk_id": 10 }, { "code": "Positive experience", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "No. Anything?", "context": "Patient has a positive interaction with their provider", "file_id": "dr_CJ0406", "chunk_id": 10 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Just you can't see for shit", "context": "Patient expresses lack of understanding about their condition", "file_id": "dr_CJ0406", "chunk_id": 11 }, { "code": "Fear of treatment", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "The laser is discomfort. It's pressure", "context": "Patient expresses fear or discomfort with treatment", "file_id": "dr_CJ0406", "chunk_id": 11 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "Mm-hmm", "context": "Interviewer shows empathy towards patient's experience", "file_id": "dr_CJ0406", "chunk_id": 11 }, { "code": "Accessible care", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "And then I come back, , two or three weeks later, have the other eye done", "context": "Patient has access to follow-up care", "file_id": "dr_CJ0406", "chunk_id": 11 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "he... him and I were talking, he said, 'Most patients try to talk me out doing this.'", "context": "Patient has a conversation with the doctor, indicating a positive relationship", "file_id": "dr_CJ0406", "chunk_id": 12 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "He said, 'You're looking good.' He said, 'But I would recommend touching it up.'", "context": "Doctor clearly communicates with the patient about their condition and treatment", "file_id": "dr_CJ0406", "chunk_id": 12 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I don't want it getting worse.", "context": "Patient takes an active role in their care, indicating a sense of empowerment", "file_id": "dr_CJ0406", "chunk_id": 12 }, { "code": "Accessible scheduling", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Appointment scheduling difficulties", "quote": "Easy.", "context": "Patient finds the scheduling process easy, indicating accessible scheduling", "file_id": "dr_CJ0406", "chunk_id": 12 }, { "code": "Provider recommendation", "category": "FACILITATOR - Provider Relationship", "subcategory": "Shared decision-making", "quote": "He said, 'If you've got time, we can do it today.'", "context": "Doctor involves the patient in the decision-making process", "file_id": "dr_CJ0406", "chunk_id": 12 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "they said, 'We're taking 'em for after January, we're booked up.'", "context": "Patient experienced long wait time for appointment", "file_id": "dr_CJ0406", "chunk_id": 13 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "They got me in pretty quickly.", "context": "Patient had a positive experience with provider availability", "file_id": "dr_CJ0406", "chunk_id": 13 }, { "code": "Appointment scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "they said, 'We're taking 'em for after January, we're booked up.'", "context": "Patient faced challenges scheduling an appointment", "file_id": "dr_CJ0406", "chunk_id": 13 }, { "code": "Provider navigation services", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Patient navigation services", "quote": "When a doctor calls, they got you, they get you in pretty quick", "context": "Patient benefited from provider's ability to navigate the system", "file_id": "dr_CJ0406", "chunk_id": 13 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "they said, 'We're taking 'em for after January, we're booked up.'", "context": "Patient experienced long wait time for appointment", "file_id": "dr_CJ0406", "chunk_id": 14 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Well, when a doctor calls, they got you, they get you in pretty quick.", "context": "Patient found provider to be accessible and responsive", "file_id": "dr_CJ0406", "chunk_id": 14 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "And you got eye drops. You gotta take three different eye drops that you have to take.", "context": "Patient seems unclear about treatment regimen", "file_id": "dr_CJ0406", "chunk_id": 15 }, { "code": "Complex treatment regimen", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "One you take for a week, three times or four times a day for a week. One you take for four weeks, , you take it four times a day.", "context": "Patient describes complicated medication schedule", "file_id": "dr_CJ0406", "chunk_id": 15 }, { "code": "Frequent appointments", "category": "BARRIER - Provider/System Issues", "subcategory": "Long wait times", "quote": "You see the cataract surgeon three times per eye.", "context": "Patient mentions multiple follow-up visits", "file_id": "dr_CJ0406", "chunk_id": 15 }, { "code": "Provider support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "They check you and check you and just make sure.", "context": "Patient describes provider's attentive follow-up care", "file_id": "dr_CJ0406", "chunk_id": 15 }, { "code": "Regular follow-ups", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "But they, they want to do- they wanna follow up while you... It works, excuse me, it works out, you know?", "context": "Patient mentions provider's emphasis on regular follow-ups", "file_id": "dr_CJ0406", "chunk_id": 15 }, { "code": "Helpful providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "they're very, very, helpful", "context": "Patient praises provider's helpfulness", "file_id": "dr_CJ0406", "chunk_id": 16 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "they explain everything", "context": "Patient appreciates clear explanations from providers", "file_id": "dr_CJ0406", "chunk_id": 16 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "he said, 'You're doing really well today'", "context": "Patient feels supported by provider's positive feedback", "file_id": "dr_CJ0406", "chunk_id": 16 }, { "code": "Helpful providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "they're very, very, helpful", "context": "Patient finds providers to be supportive", "file_id": "dr_CJ0406", "chunk_id": 17 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "they explain everything", "context": "Patient feels informed by provider", "file_id": "dr_CJ0406", "chunk_id": 17 }, { "code": "Accessible care", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate insurance coverage", "quote": "if you call an independent doctor of optometry and you need an eye exam and you're a diabetic they need to get you an ASAP", "context": "Patient has access to timely care", "file_id": "dr_CJ0406", "chunk_id": 17 }, { "code": "Rude provider", "category": "BARRIER - Provider/System Issues", "subcategory": "Rude or dismissive providers", "quote": "And that lady is a space cadet and she's just all over the place", "context": "Patient had a negative experience with Dr. Chen", "file_id": "dr_CJ0406", "chunk_id": 18 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "And I had... I got fed up with the way she handled everything", "context": "Patient felt Dr. Chen did not communicate effectively", "file_id": "dr_CJ0406", "chunk_id": 18 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "They don't put you off for a month. These people, once you're a patient down here and they confirm you have an eye problem, they don't put you off", "context": "Patient appreciates prompt attention from other providers", "file_id": "dr_CJ0406", "chunk_id": 18 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "They, they make sure that they do whatever they gotta do and they really, really, really do a great job", "context": "Patient values clear communication from providers", "file_id": "dr_CJ0406", "chunk_id": 18 }, { "code": "Rude provider", "category": "BARRIER - Provider/System Issues", "subcategory": "Rude or dismissive providers", "quote": "I had got fed up with the way she handled everything", "context": "Patient frustrated with PCP's handling of their care", "file_id": "dr_CJ0406", "chunk_id": 19 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "And they said this won't affect it. You can have it done whenever. And she put me off for a month for no reason", "context": "Patient feels provider did not communicate effectively", "file_id": "dr_CJ0406", "chunk_id": 19 }, { "code": "Insurance coverage issues", "category": "BARRIER - SDOH", "subcategory": "Insurance coverage issues", "quote": "the insurance don't pay for 'em", "context": "Patient's insurance does not cover certain expenses", "file_id": "dr_CJ0406", "chunk_id": 19 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "These are $140 a piece", "context": "Patient faces financial burden due to expensive medical devices", "file_id": "dr_CJ0406", "chunk_id": 19 }, { "code": "Insurance coverage issues", "category": "BARRIER - SDOH", "subcategory": "Insurance coverage issues", "quote": "the insurance don't pay for 'em", "context": "Patient's insurance does not cover certain treatments", "file_id": "dr_CJ0406", "chunk_id": 20 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "These are $140 a piece", "context": "Patient faces high out-of-pocket costs for treatment", "file_id": "dr_CJ0406", "chunk_id": 20 }, { "code": "Provider hassle", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "They gave me a hassle", "context": "Patient experiences difficulty with provider communication", "file_id": "dr_CJ0406", "chunk_id": 20 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "And I had no- none of these issues", "context": "Patient has positive experience with new provider", "file_id": "dr_CJ0406", "chunk_id": 20 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "They told me the day before they wanted me on an all-liquid diet.", "context": "Patient feels provider's instructions were unclear or last-minute", "file_id": "dr_CJ0406", "chunk_id": 21 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "I said, 'Oh, I beg to differ with ya . I'm d- I'm drinking it.'", "context": "Patient resists provider's advice, indicating mistrust", "file_id": "dr_CJ0406", "chunk_id": 21 }, { "code": "Rude or dismissive providers", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "They wanted me to not shave for two days... And I said, 'Well, I'll show you what's-' 'We don't care. You're not drinking it.'", "context": "Patient feels provider is dismissive of their concerns", "file_id": "dr_CJ0406", "chunk_id": 21 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "Which was stupid. I mean, just made no sense.", "context": "Patient expresses frustration with provider's instructions", "file_id": "dr_CJ0406", "chunk_id": 22 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "She tried to talk me out of it. She said I didn't need 'em.", "context": "Patient feels provider is not listening to their concerns", "file_id": "dr_CJ0406", "chunk_id": 22 }, { "code": "Rude or dismissive providers", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "She tried to talk me out of it. She said I didn't need 'em.", "context": "Patient feels provider is dismissive of their needs", "file_id": "dr_CJ0406", "chunk_id": 22 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "Jordan saw me.", "context": "Patient mentions provider by name, indicating a positive relationship", "file_id": "dr_CJ0406", "chunk_id": 22 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "I said, 'They're bothering me.'", "context": "Patient is able to express their concerns to the provider", "file_id": "dr_CJ0406", "chunk_id": 22 }, { "code": "Rude provider", "category": "BARRIER - Provider/System Issues", "subcategory": "Rude or dismissive providers", "quote": "She talks 90 miles a minute and she acts she's doing you a favor", "context": "Patient had negative experience with Dr. Chen", "file_id": "dr_CJ0406", "chunk_id": 23 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "She talks 90 miles a minute", "context": "Patient felt Dr. Chen did not communicate effectively", "file_id": "dr_CJ0406", "chunk_id": 23 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "I want nothing to do with that woman", "context": "Patient lost trust in Dr. Chen due to negative experience", "file_id": "dr_CJ0406", "chunk_id": 23 }, { "code": "Rude provider", "category": "BARRIER - Provider/System Issues", "subcategory": "Rude or dismissive providers", "quote": "She talks 90 miles a minute and she acts she's doing you a favor", "context": "Patient describes negative experience with provider", "file_id": "dr_CJ0406", "chunk_id": 24 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "I want nothing to do with that woman", "context": "Patient expresses distrust and dislike for provider", "file_id": "dr_CJ0406", "chunk_id": 24 }, { "code": "Provider Communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "they just said...", "context": "Patient's experience with doctor's response to concern", "file_id": "dr_CJ0406", "chunk_id": 25 }, { "code": "Patient Engagement", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Oh, they've covered that quite well.", "context": "Patient feels informed about diabetes and eye care", "file_id": "dr_CJ0406", "chunk_id": 25 }, { "code": "Positive Provider Relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "I brought it up with the doctor", "context": "Patient feels comfortable discussing concerns with doctor", "file_id": "dr_CJ0406", "chunk_id": 25 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "you might as well talk to the wall 'cause they didn't do a thing about it", "context": "Patient feels unheard by patient advocacy", "file_id": "dr_CJ0406", "chunk_id": 26 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "They explain everything quite well", "context": "Patient appreciates clear explanations from eye doctor", "file_id": "dr_CJ0406", "chunk_id": 26 }, { "code": "Patient-provider trust", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "They're usually very upfront", "context": "Patient trusts eye doctor's honesty", "file_id": "dr_CJ0406", "chunk_id": 26 }, { "code": "Self-advocacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Patient Empowerment", "quote": "Oh, yeah. We discuss-", "context": "Patient actively discusses needs with doctor", "file_id": "dr_CJ0406", "chunk_id": 26 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "They explain everything quite well", "context": "Patient feels informed by provider", "file_id": "dr_CJ0406", "chunk_id": 27 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Patient Empowerment", "quote": "Oh, yeah. We discuss-", "context": "Patient advocates for themselves", "file_id": "dr_CJ0406", "chunk_id": 27 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "She looked at me, she said, 'I don't think you need the surgery.' And I said, 'I'm having trouble with light.'", "context": "Patient feels heard by provider", "file_id": "dr_CJ0406", "chunk_id": 27 }, { "code": "Shared decision-making", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "And she goes... Well, then she agreed to do it.", "context": "Patient and provider collaborate on care", "file_id": "dr_CJ0406", "chunk_id": 27 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "once you're a patient down here, they keep up with you and they make sure that everything is handled", "context": "Patient feels supported by healthcare system", "file_id": "dr_CJ0406", "chunk_id": 28 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "If there's a question all I have to do is just call down and they get me the answer and call me back", "context": "Patient appreciates open communication with provider", "file_id": "dr_CJ0406", "chunk_id": 28 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I have good vision", "context": "Patient is aware of their current health status", "file_id": "dr_CJ0406", "chunk_id": 28 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "once you're a patient down here, they keep up with you and they make sure that everything is handled", "context": "Patient feels valued by healthcare provider", "file_id": "dr_CJ0406", "chunk_id": 28 }, { "code": "Lack of perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "I have good vision", "context": "Patient may not see immediate need for follow-up", "file_id": "dr_CJ0406", "chunk_id": 28 }, { "code": "Lack of perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "I have good vision. , I need glasses to see far.", "context": "Patient believes their current vision is good, reducing motivation for follow-up", "file_id": "dr_CJ0406", "chunk_id": 29 }, { "code": "Education/health literacy barriers", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "I don't think I will lose my eyesight partially or fully because of diabetes", "context": "Patient lacks understanding about potential vision loss due to diabetes", "file_id": "dr_CJ0406", "chunk_id": 29 }, { "code": "Lack of awareness", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "you really don't notice it a lot of the times because, , it, it is just such a gradual thing, , you never really think about it", "context": "Patient describes gradual nature of vision loss", "file_id": "dr_CJ0406", "chunk_id": 30 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "kinda makes you wonder", "context": "Patient expresses concern after being told to see an eye doctor", "file_id": "dr_CJ0406", "chunk_id": 30 }, { "code": "Insurance coverage issues", "category": "BARRIER - SDOH", "subcategory": "Insurance coverage issues", "quote": "they didn't want to take your insurance", "context": "Patient had trouble finding a provider that accepted their insurance", "file_id": "dr_CJ0406", "chunk_id": 31 }, { "code": "Appointment scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "everybody was booked up", "context": "Patient had trouble scheduling an appointment due to providers being booked", "file_id": "dr_CJ0406", "chunk_id": 31 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "they said, 'We'll get you in in a week.'", "context": "Patient was able to get an appointment with a provider relatively quickly", "file_id": "dr_CJ0406", "chunk_id": 31 }, { "code": "Insurance coverage issues", "category": "BARRIER - SDOH", "subcategory": "Insurance coverage issues", "quote": "they didn't want to take your insurance", "context": "Patient experiences difficulty with insurance coverage", "file_id": "dr_CJ0406", "chunk_id": 32 }, { "code": "Appointment scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "they were backed up", "context": "Patient faces challenges in scheduling appointments", "file_id": "dr_CJ0406", "chunk_id": 32 }, { "code": "Provider availability", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of accessible providers", "quote": "A lot of optometrists do not wanna play, they're too busy", "context": "Patient has trouble finding available providers", "file_id": "dr_CJ0406", "chunk_id": 32 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I don't wanna lose my sight", "context": "Patient's fear motivates them to seek care", "file_id": "dr_CJ0406", "chunk_id": 32 }, { "code": "Effective provider communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "And everything from that point went very smooth", "context": "Patient experiences positive interaction with provider", "file_id": "dr_CJ0406", "chunk_id": 32 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I don't wanna lose my sight", "context": "Patient motivated by fear of losing sight", "file_id": "dr_CJ0406", "chunk_id": 33 }, { "code": "Reminder systems", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "They're always sending you notices or when you come in, 'We wanna see in three months.'", "context": "Patient receives reminders for follow-up appointments", "file_id": "dr_CJ0406", "chunk_id": 33 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "They don't let you get into a problem. Once you have a problem-", "context": "Patient has easy access to healthcare providers", "file_id": "dr_CJ0406", "chunk_id": 33 }, { "code": "Regular scheduling", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Appointment scheduling difficulties", "quote": "You're seeing 'em at least twice a year, sometimes four times a year, depending on...", "context": "Patient has regular follow-up appointments scheduled", "file_id": "dr_CJ0406", "chunk_id": 33 }, { "code": "Reminder systems", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "And they send you reminders", "context": "Patient mentions receiving reminders from healthcare system", "file_id": "dr_CJ0406", "chunk_id": 34 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "they don't let you fall through the cracks", "context": "Patient feels supported by healthcare system", "file_id": "dr_CJ0406", "chunk_id": 34 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "Dr. G, Dr. Goria", "context": "Patient mentions a positive experience with a specific provider", "file_id": "dr_CJ0406", "chunk_id": 34 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "When I met him for the first time", "context": "Patient implies a positive initial interaction with provider", "file_id": "dr_CJ0406", "chunk_id": 34 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "And he's been... , I'm gla- I'm really appreciative of having him as one of my providers.", "context": "Patient expresses appreciation for their provider", "file_id": "dr_CJ0406", "chunk_id": 35 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "After he examined me, he was very upfront.", "context": "Provider communicated clearly with the patient", "file_id": "dr_CJ0406", "chunk_id": 35 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "the man's amazing", "context": "Patient praises Dr. Jordan", "file_id": "dr_CJ0406", "chunk_id": 36 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "And the results are... speak for themselves", "context": "Patient implies Dr. Jordan communicated effectively", "file_id": "dr_CJ0406", "chunk_id": 36 }, { "code": "Rude or dismissive providers", "category": "BARRIER - Provider/System Issues", "subcategory": "Rude or dismissive providers", "quote": "Not with eye care, with her specifically", "context": "Patient had negative experience with Dr. Chen", "file_id": "dr_CJ0406", "chunk_id": 36 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "you don't realize it", "context": "Patient may not understand the severity of their condition", "file_id": "dr_CJ0406", "chunk_id": 37 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "or you can lose your sight", "context": "Patient fears losing their sight if they don't follow up", "file_id": "dr_CJ0406", "chunk_id": 37 }, { "code": "Procrastination", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I'll do it later", "quote": "'I'll do it later'", "context": "Patient may put off follow-up appointments", "file_id": "dr_CJ0406", "chunk_id": 37 }, { "code": "Importance of follow-up", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "you have to stay on top of it", "context": "Patient understands the importance of regular follow-up", "file_id": "dr_CJ0406", "chunk_id": 37 }, { "code": "Consequences of non-adherence", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "you could literally have damage in your eye", "context": "Patient is aware of the potential consequences of not following up", "file_id": "dr_CJ0406", "chunk_id": 37 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "you could literally have damage in your eye and you don't realize it", "context": "Patient lacks awareness of potential eye damage", "file_id": "dr_CJ0406", "chunk_id": 38 }, { "code": "No patient support", "category": "BARRIER - Social Determinants of Health (SDOH)", "subcategory": "Social support networks", "quote": "No, I do it myself", "context": "Patient has no one to help with daily diabetes care", "file_id": "dr_CJ0406", "chunk_id": 38 }, { "code": "Limited health education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "they just basically tell you, 'Read labels and watch what you eat'", "context": "Patient received basic diabetes education 25 years ago", "file_id": "dr_CJ0406", "chunk_id": 38 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Yes, I participated in a diabetes education class", "context": "Patient attended a 2-day diabetes education class", "file_id": "dr_CJ0406", "chunk_id": 38 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I thought it was a joke", "context": "Patient initially didn't take health education seriously", "file_id": "dr_CJ0406", "chunk_id": 39 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Read labels and watch what you eat", "context": "Patient received basic health education", "file_id": "dr_CJ0406", "chunk_id": 39 }, { "code": "Education barriers", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "I thought it was a freaking joke", "context": "Patient felt initial health education was inadequate", "file_id": "dr_CJ0406", "chunk_id": 39 }, { "code": "Health literacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "You are what you eat", "context": "Patient gained basic understanding of healthy eating", "file_id": "dr_CJ0406", "chunk_id": 39 }, { "code": "Lack of social support", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Cultural beliefs about healthcare", "quote": "No, any friends and family you ever reach out to about- Speaker 2: No.", "context": "Patient does not have friends or family for support", "file_id": "dr_CJ0406", "chunk_id": 40 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "My PCP. 110103_004 (Completed 06/14/25) Page 37 of 45 Transcript by Rev.com This transcript was exported on Jun 17, 2025 - view latest version here. Speaker 1: Okay. That's, , your main person that go? Speaker 2: Mm-hmm. That's your main contact.", "context": "Patient has a primary care provider they trust", "file_id": "dr_CJ0406", "chunk_id": 40 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I mean, you are what you eat. Speaker 1: Mm-hmm. Speaker 2: And if you're diabetic, it shows worse.", "context": "Patient has some understanding of diabetes management", "file_id": "dr_CJ0406", "chunk_id": 40 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "My PCP. 110103_004 (Completed 06/14/25) Page 37 of 45 Transcript by Rev.com This transcript was exported on Jun 17, 2025 - view latest version here. Speaker 1: Okay. That's, , your main person that go? Speaker 2: Mm-hmm. That's your main contact.", "context": "Patient has a primary care provider they can contact", "file_id": "dr_CJ0406", "chunk_id": 40 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "No. (when asked if eyesight limits ability to do things)", "context": "Patient seems unaware of potential vision limitations due to DR", "file_id": "dr_CJ0406", "chunk_id": 41 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "He said, 'You wanna do both sides today?' I said, 'Why should I come back?'", "context": "Patient appreciates provider's willingness to accommodate their needs", "file_id": "dr_CJ0406", "chunk_id": 41 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "He said, 'Right.' And he goes, 'I appreciate it.'", "context": "Provider communicates clearly and shows appreciation for patient's cooperation", "file_id": "dr_CJ0406", "chunk_id": 41 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I wanted to see how my eyes were doing.", "context": "Patient takes initiative to understand their eye health", "file_id": "dr_CJ0406", "chunk_id": 41 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Did well on the eye exam. Did well on the pictures.", "context": "Patient has access to timely and thorough eye care services", "file_id": "dr_CJ0406", "chunk_id": 41 }, { "code": "Denial of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now' (no perceived urgency)", "quote": "Oh, it's not gonna happen to me. It's gonna happen to the other guy and I'll be fine.", "context": "Patient initially in denial about diabetes diagnosis", "file_id": "dr_CJ0406", "chunk_id": 42 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "maybe I didn't think this out", "context": "Patient lacks understanding of diabetes complications", "file_id": "dr_CJ0406", "chunk_id": 42 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "He goes, 'I appreciate it.'", "context": "Patient appreciates provider's attitude", "file_id": "dr_CJ0406", "chunk_id": 42 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "You wanna do both sides today?", "context": "Provider communicates clearly with patient", "file_id": "dr_CJ0406", "chunk_id": 42 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I feel fine. There's nothing wrong with me.", "context": "Patient doesn't realize the damage of high blood sugar", "file_id": "dr_CJ0406", "chunk_id": 43 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now' (no perceived urgency)", "quote": "I feel fine. There's nothing wrong with me.", "context": "Patient doesn't see the need for follow-up", "file_id": "dr_CJ0406", "chunk_id": 43 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "But they knocks you on your ass real good and you sit there and you think, 'Hm, maybe I didn't think this out'", "context": "Patient fears the consequences of diagnosis", "file_id": "dr_CJ0406", "chunk_id": 43 }, { "code": "Health education needed", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "You're doing damage, you don't realize.", "context": "Patient needs education on diabetes management", "file_id": "dr_CJ0406", "chunk_id": 43 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "And you don't know that?", "context": "Patient's lack of knowledge about diabetes complications", "file_id": "dr_CJ0406", "chunk_id": 44 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "He said, 'Oh, that? That?'", "context": "Patient's fear or denial of diagnosis", "file_id": "dr_CJ0406", "chunk_id": 44 }, { "code": "Poor health literacy", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "I just thought I'd put stuff on it.", "context": "Patient lacks knowledge about proper wound care", "file_id": "dr_CJ0406", "chunk_id": 44 }, { "code": "Social support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "I said, 'Dude, you better get your ass to the ER.'", "context": "Patient receives support and advice from peer", "file_id": "dr_CJ0406", "chunk_id": 44 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I said, 'How long you been a diabetic?'", "context": "Patient educates peer about diabetes management", "file_id": "dr_CJ0406", "chunk_id": 44 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "He said, 'Oh, I stepped on something.' And I, I said, 'Oh, and you didn't go get a check...' 'I just thought I'd put stuff on it.'", "context": "Patient lacks understanding of proper wound care and importance of medical attention", "file_id": "dr_CJ0406", "chunk_id": 45 }, { "code": "Education barriers", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "You don't know what an infection is? You've been a diabetic for a couple years-", "context": "Patient and possibly their spouse lack understanding of basic health concepts", "file_id": "dr_CJ0406", "chunk_id": 45 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "'You gotta be kidding me.'", "context": "Patient expresses fear or disbelief about the severity of their condition and necessary treatment", "file_id": "dr_CJ0406", "chunk_id": 45 }, { "code": "Lack of patient empowerment", "category": "BARRIER - Patient Empowerment", "subcategory": "Health education programs", "quote": "You have no idea what, what's, what you got.", "context": "Patient lacks knowledge about their condition and its management", "file_id": "dr_CJ0406", "chunk_id": 45 }, { "code": "Support from others", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "His wife comes up and she goes, 'What's wrong?'", "context": "Presence of supportive family members who encourage medical attention", "file_id": "dr_CJ0406", "chunk_id": 45 }, { "code": "Patient motivation", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I said, 'Do you wanna see 56?' He goes, 'Yeah.'", "context": "Patient is motivated to take action for their health when presented with potential consequences", "file_id": "dr_CJ0406", "chunk_id": 45 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Oh, I'm fine.", "context": "Patient shows lack of awareness about their condition", "file_id": "dr_CJ0406", "chunk_id": 46 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "He lost his big toe.", "context": "Patient discusses severe consequences of untreated diabetes, implying fear", "file_id": "dr_CJ0406", "chunk_id": 46 }, { "code": "Poor patient education", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "He's got red streaks all up his leg and he", "context": "Patient seems unaware of proper wound care, suggesting inadequate education", "file_id": "dr_CJ0406", "chunk_id": 46 }, { "code": "Denial of condition", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "Oh, I'm fine.", "context": "Patient downplays severity of their condition", "file_id": "dr_CJ0406", "chunk_id": 46 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "'Oh, I'm fine.'", "context": "Patient's friend had a severe complication but was unaware of the severity", "file_id": "dr_CJ0406", "chunk_id": 47 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "'Oh, I'm fine.'", "context": "Patient's friend was in denial about his condition", "file_id": "dr_CJ0406", "chunk_id": 47 }, { "code": "Social support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "We were at a wedding", "context": "Patient has a social network that provides emotional support", "file_id": "dr_CJ0406", "chunk_id": 47 }, { "code": "Financial incentive", "category": "FACILITATOR - Resources & Access", "subcategory": "Financial assistance programs", "quote": "you'll get a $20 gift card to Kroger", "context": "Patient receives financial compensation for participation", "file_id": "dr_FJ0620", "chunk_id": 0 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I try to avoid bad carbohydrates", "context": "Patient has knowledge about diabetes management", "file_id": "dr_FJ0620", "chunk_id": 2 }, { "code": "Health literacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "fruit contains fructose, which is worse than glucose", "context": "Patient understands nutritional aspects of diabetes", "file_id": "dr_FJ0620", "chunk_id": 2 }, { "code": "Lack of self monitoring", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I haven't measured in the last seven days, so I don't know", "context": "Patient not regularly monitoring blood glucose levels", "file_id": "dr_FJ0620", "chunk_id": 3 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "I haven't felt anything out of the ordinary", "context": "Patient does not feel symptoms, so no urgency to follow up", "file_id": "dr_FJ0620", "chunk_id": 3 }, { "code": "Adherence to medication", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I always take my pills", "context": "Patient prioritizes taking medication as part of diabetes care", "file_id": "dr_FJ0620", "chunk_id": 3 }, { "code": "Importance of exercise", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "The highest priority actually is doing exercise", "context": "Patient recognizes exercise as key to managing diabetes", "file_id": "dr_FJ0620", "chunk_id": 3 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "they still don't know", "context": "Patient unsure about diagnosis", "file_id": "dr_FJ0620", "chunk_id": 4 }, { "code": "Diabetes impact unclear", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I'm sure diabetes didn't help", "context": "Patient unsure about diabetes effect on vision", "file_id": "dr_FJ0620", "chunk_id": 4 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "If you let it go, you want to go blind", "context": "Patient implies lack of access to care can lead to severe consequences", "file_id": "dr_FJ0620", "chunk_id": 5 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "If you let it go, you want to go blind – terrible thing to face", "context": "Patient expresses fear of potential diagnosis", "file_id": "dr_FJ0620", "chunk_id": 5 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Here", "context": "Patient mentions receiving care at a convenient location", "file_id": "dr_FJ0620", "chunk_id": 5 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "Dr. Zane Dennison. He's my particular, my, , my doctor", "context": "Patient expresses familiarity and comfort with their provider", "file_id": "dr_FJ0620", "chunk_id": 5 }, { "code": "Lack of recall", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "What am I saying? It's- there is an ophthalmologist. What's his name? Kier, Kaur? Oh, my lord. I can't remember.", "context": "Patient struggles to recall doctor's name", "file_id": "dr_FJ0620", "chunk_id": 6 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "There is an ophthalmologist. ... Tonya Umbel. She's ophthalmologist", "context": "Patient has access to a specialist", "file_id": "dr_FJ0620", "chunk_id": 6 }, { "code": "Positive experience", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "And thank God the pressure in my right- my left eye is normal.", "context": "Patient expresses relief and trust in care", "file_id": "dr_FJ0620", "chunk_id": 6 }, { "code": "Lack of recall", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I can't remember", "context": "Patient has difficulty recalling details about their appointments", "file_id": "dr_FJ0620", "chunk_id": 7 }, { "code": "Poor memory", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "I really don't know", "context": "Patient expresses uncertainty and lack of knowledge about their treatment", "file_id": "dr_FJ0620", "chunk_id": 7 }, { "code": "Easy scheduling", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Yeah, it's easy- easy to schedule", "context": "Patient finds scheduling appointments easy", "file_id": "dr_FJ0620", "chunk_id": 8 }, { "code": "Limited morning availability", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "but not in the morning", "context": "Patient has limited availability for morning appointments", "file_id": "dr_FJ0620", "chunk_id": 8 }, { "code": "Retired flexibility", "category": "FACILITATOR - Resources & Access", "subcategory": "Transportation assistance", "quote": "I always have variability because I'm retired", "context": "Patient's retirement status provides scheduling flexibility", "file_id": "dr_FJ0620", "chunk_id": 8 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "We driving from- from Clark* Clarksburg", "context": "Patient mentions traveling from a different location for appointments", "file_id": "dr_FJ0620", "chunk_id": 9 }, { "code": "Appointment scheduling difficulties", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "3. Provider/System Issues", "quote": "during the winter, we couldn't come, we had to cancel certain appointments", "context": "Patient experienced scheduling issues due to seasonal constraints", "file_id": "dr_FJ0620", "chunk_id": 9 }, { "code": "Accessible providers", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "1. Healthcare System Support", "quote": "Yeah, it's easy- easy to schedule, but not in the morning", "context": "Patient finds scheduling relatively easy", "file_id": "dr_FJ0620", "chunk_id": 9 }, { "code": "Flexible appointment times", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "1. Healthcare System Support", "quote": "Afternoon, late afternoon. That's good for me", "context": "Patient appreciates having options for appointment timing", "file_id": "dr_FJ0620", "chunk_id": 9 }, { "code": "Informative doctors", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "the doctors have been very informative", "context": "Patient praises doctor's communication", "file_id": "dr_FJ0620", "chunk_id": 10 }, { "code": "Great service", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Great service", "context": "Patient appreciates overall care experience", "file_id": "dr_FJ0620", "chunk_id": 10 }, { "code": "No complaints", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I have no complaints", "context": "Patient expresses satisfaction with care", "file_id": "dr_FJ0620", "chunk_id": 10 }, { "code": "No complaints", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I have no complaints", "context": "Patient has no issues with healthcare system", "file_id": "dr_FJ0620", "chunk_id": 11 }, { "code": "Adheres to treatment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I have to take those drops", "context": "Patient follows doctor's orders for eye care", "file_id": "dr_FJ0620", "chunk_id": 11 }, { "code": "Self care practices", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I go and take a nap", "context": "Patient takes initiative to rest eyes when needed", "file_id": "dr_FJ0620", "chunk_id": 11 }, { "code": "No barriers mentioned", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "No", "context": "Patient does not report any challenges in receiving eye care", "file_id": "dr_FJ0620", "chunk_id": 11 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "They didn't have any retinopathy yet, but-", "context": "Patient seems unclear about their condition", "file_id": "dr_FJ0620", "chunk_id": 12 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "Probably had to do with this crap now", "context": "Patient expresses concern about their condition", "file_id": "dr_FJ0620", "chunk_id": 12 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "They have explained to me", "context": "Patient feels informed by their provider", "file_id": "dr_FJ0620", "chunk_id": 12 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "They have explained to me", "context": "Patient receives education about their condition", "file_id": "dr_FJ0620", "chunk_id": 12 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "No, I don't have any", "context": "Patient feels comfortable discussing diabetes-related eye problems", "file_id": "dr_FJ0620", "chunk_id": 13 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "No, I don't have any", "context": "Patient is able to express comfort level with discussing eye problems", "file_id": "dr_FJ0620", "chunk_id": 13 }, { "code": "Lack of concerns", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "No, I don't have any", "context": "Patient does not have concerns about diabetes-related eye problems", "file_id": "dr_FJ0620", "chunk_id": 13 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "They say women talk too much. She look at me.", "context": "Patient feels heard and understood by provider", "file_id": "dr_FJ0620", "chunk_id": 13 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "At this point? Not that serious.", "context": "Patient downplays diabetes severity", "file_id": "dr_FJ0620", "chunk_id": 14 }, { "code": "Perceived slow improvement", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I know that this improvement is very slow.", "context": "Patient has limited knowledge of disease progression", "file_id": "dr_FJ0620", "chunk_id": 14 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "At this point? Not that serious.", "context": "Patient underestimates diabetes severity", "file_id": "dr_FJ0620", "chunk_id": 15 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "It's good for what I do.", "context": "Patient feels current vision is sufficient", "file_id": "dr_FJ0620", "chunk_id": 15 }, { "code": "Lack of perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "It's good for what I do. I can watch TV with this patch here.", "context": "Patient feels their current vision is sufficient", "file_id": "dr_FJ0620", "chunk_id": 16 }, { "code": "Lack of understanding about DR progression", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Not really", "context": "Patient hasn't noticed changes in vision, indicating potential lack of awareness", "file_id": "dr_FJ0620", "chunk_id": 16 }, { "code": "Lack of diagnosis info", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "They haven't told me yet, officially.", "context": "Patient unsure of official diagnosis", "file_id": "dr_FJ0620", "chunk_id": 17 }, { "code": "Family history of diabetes", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "My mother developed, , type two me.", "context": "Patient aware of family history of diabetes", "file_id": "dr_FJ0620", "chunk_id": 17 }, { "code": "Family history awareness", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "my mother developed, , type two me", "context": "Patient aware of family diabetes history", "file_id": "dr_FJ0620", "chunk_id": 18 }, { "code": "Positive experience", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "it's good", "context": "Patient has positive experience with healthcare services", "file_id": "dr_FJ0620", "chunk_id": 18 }, { "code": "Provided information", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Yes. they provided information", "context": "Patient receives adequate information from provider", "file_id": "dr_FJ0620", "chunk_id": 18 }, { "code": "No discouragement", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "No", "context": "Patient not discouraged from using healthcare services", "file_id": "dr_FJ0620", "chunk_id": 18 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "if you have type one diabetes and your eyes are going to pot, it's not too much that a doctor can do", "context": "Patient expresses limited understanding of disease progression", "file_id": "dr_FJ0620", "chunk_id": 19 }, { "code": "Provider limitations", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "This guy is not Jesus here", "context": "Patient implies providers have limitations, affecting trust", "file_id": "dr_FJ0620", "chunk_id": 19 }, { "code": "Lack of trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "This guy is not Jesus here", "context": "Patient expresses distrust in healthcare provider", "file_id": "dr_FJ0620", "chunk_id": 20 }, { "code": "Social support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "Yes, my girlfriend", "context": "Patient has a supportive partner for daily diabetes care", "file_id": "dr_FJ0620", "chunk_id": 20 }, { "code": "Lack of education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "I learn all by myself", "context": "Patient lacks formal diabetes education", "file_id": "dr_FJ0620", "chunk_id": 21 }, { "code": "No social support", "category": "BARRIER - Social Determinants of Health (SDOH)", "subcategory": "Social support networks", "quote": "No. They know I have diabetes.", "context": "Patient has no one to share worries or fears with", "file_id": "dr_FJ0620", "chunk_id": 21 }, { "code": "Self education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I learn all by myself. I think I'm pretty well-versed, I hope.", "context": "Patient takes initiative to learn about diabetes", "file_id": "dr_FJ0620", "chunk_id": 21 }, { "code": "Comfortable sharing worries", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "Oh, yes. Yes.", "context": "Patient is open to sharing concerns with others", "file_id": "dr_FJ0620", "chunk_id": 21 }, { "code": "Lack of perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "Not really", "context": "Patient does not feel their eyesight is currently limiting", "file_id": "dr_FJ0620", "chunk_id": 23 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "maybe I can recover some of my vision within, I don't know, the next five years", "context": "Patient unsure about recovery timeline", "file_id": "dr_FJ0620", "chunk_id": 24 }, { "code": "Positive expectations", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I hope that my- the- the eye pressure will go down", "context": "Patient has positive expectations for treatment outcome", "file_id": "dr_FJ0620", "chunk_id": 24 }, { "code": "Accessible care", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "It went from 25 to 23 now so", "context": "Patient received timely and effective care", "file_id": "dr_FJ0620", "chunk_id": 24 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I try and watch what I eat", "context": "Patient is aware of dietary management", "file_id": "dr_SM1021", "chunk_id": 0 }, { "code": "Self management", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "Try and stay away from a lot of sugars", "context": "Patient is actively managing diet", "file_id": "dr_SM1021", "chunk_id": 0 }, { "code": "Health awareness", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "frequency of the restroom at night", "context": "Patient is aware of symptoms to monitor", "file_id": "dr_SM1021", "chunk_id": 0 }, { "code": "Social Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "we try and keep each other in check", "context": "Patient has a coworker with similar diabetes condition", "file_id": "dr_SM1021", "chunk_id": 1 }, { "code": "Reminder System", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "reminds me", "context": "Coworker reminds patient to check their condition", "file_id": "dr_SM1021", "chunk_id": 1 }, { "code": "Social Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "it's good to have someone, at least having similar experiences with you, around you at times", "context": "Patient finds comfort in having peers with similar experiences", "file_id": "dr_SM1021", "chunk_id": 2 }, { "code": "Healthcare System Support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "it's good to have someone there at work to check you", "context": "Patient appreciates having someone to monitor their condition", "file_id": "dr_SM1021", "chunk_id": 2 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "It just gets a, a darker shadow and people disappear", "context": "Patient describes vision loss without understanding its implications", "file_id": "dr_SM1021", "chunk_id": 3 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I'm a little bit more vigilant when I'm driving", "context": "Patient implies anxiety about vision loss and its consequences", "file_id": "dr_SM1021", "chunk_id": 3 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "They blame everything on sugar", "context": "Patient seems unsure about the relationship between diabetes and vision issues", "file_id": "dr_SM1021", "chunk_id": 4 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "They blame everything on sugar", "context": "Patient feels that provider oversimplifies the cause of their condition", "file_id": "dr_SM1021", "chunk_id": 4 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "And were you able to express the, those issues with your doctor?", "context": "Patient was able to discuss their concerns with their provider", "file_id": "dr_SM1021", "chunk_id": 4 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "They tested my A1C and all that", "context": "Patient received some form of health education about their diabetes management", "file_id": "dr_SM1021", "chunk_id": 4 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "They blame everything on sugar", "context": "Patient seems unsure about diabetes relationship with other health issues", "file_id": "dr_SM1021", "chunk_id": 5 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "after I gave up drinking, Dr. Pepper's and whatever", "context": "Patient made lifestyle changes after possibly receiving health education", "file_id": "dr_SM1021", "chunk_id": 5 }, { "code": "Health literacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I used to drink a good bit of milk, all the breads and pastas and stuff", "context": "Patient demonstrates understanding of dietary impacts on health", "file_id": "dr_SM1021", "chunk_id": 5 }, { "code": "Diabetes self-management", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "after I gave up drinking, Dr. Pepper's and whatever, things started improving", "context": "Patient took action to manage diabetes through lifestyle changes", "file_id": "dr_SM1021", "chunk_id": 5 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "it's not really an eye exam per se", "context": "Patient seems unclear about the purpose of their eye exams", "file_id": "dr_SM1021", "chunk_id": 6 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Yeah. Yeah. Dr. G.", "context": "Patient has a regular provider for eye care", "file_id": "dr_SM1021", "chunk_id": 6 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "they, , talk to me", "context": "Patient reports that providers communicate with them during exams", "file_id": "dr_SM1021", "chunk_id": 6 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "it is hard for me to say, yeah, I should come in once a, once a year", "context": "Patient unsure about follow-up frequency", "file_id": "dr_SM1021", "chunk_id": 7 }, { "code": "Frequency concerns", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Because they do it. They were doing it once a month. Now it's gonna be every two months,", "context": "Patient questions follow-up frequency", "file_id": "dr_SM1021", "chunk_id": 7 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "They bring me in, they talk to me, they get the eye pressures", "context": "Patient receives regular care from providers", "file_id": "dr_SM1021", "chunk_id": 7 }, { "code": "Regular scheduling", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Reminder systems", "quote": "every three months or so", "context": "Patient has regular follow-up schedule", "file_id": "dr_SM1021", "chunk_id": 7 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "They were doing it once a month. Now it's gonna be every two months", "context": "Patient experiences reduced frequency of exams", "file_id": "dr_SM1021", "chunk_id": 8 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "they numb them because they're gonna do the shots", "context": "Patient receives numbing treatment for comfort", "file_id": "dr_SM1021", "chunk_id": 8 }, { "code": "Healthcare System Support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "They were doing it once a month. Now it's gonna be every two months", "context": "Patient has regular exams with provider", "file_id": "dr_SM1021", "chunk_id": 8 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "they also put the Betadine in. To try and hopefully I won't get an infection in my eyes", "context": "Patient is informed about treatment procedures", "file_id": "dr_SM1021", "chunk_id": 8 }, { "code": "Fear of treatment", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "the injections, they just plain hurt", "context": "Patient expresses fear of pain from injections", "file_id": "dr_SM1021", "chunk_id": 9 }, { "code": "Lack of understanding about treatment", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "People say there's no pain in your eyes because you don't have a nerve. No, you get pain in your eyes", "context": "Patient corrects misconception about eye pain", "file_id": "dr_SM1021", "chunk_id": 9 }, { "code": "Emotional distress", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "that doesn't do anything good for me", "context": "Patient expresses anxiety about seeing the needle", "file_id": "dr_SM1021", "chunk_id": 9 }, { "code": "Fear of treatment", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "if I catch a glimpse of the needle coming at me", "context": "Patient expresses fear of medical procedures", "file_id": "dr_SM1021", "chunk_id": 10 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider issues", "quote": "I'm an uncooperative patient", "context": "Patient implies difficulty with healthcare providers", "file_id": "dr_SM1021", "chunk_id": 10 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "I always wore more expensive sunglasses", "context": "Patient mentions financial investment in health-related items", "file_id": "dr_SM1021", "chunk_id": 10 }, { "code": "Emotional distress", "category": "BARRIER - Emotional/Psychological", "subcategory": "Diabetes distress", "quote": "That doesn't do anything good for me", "context": "Patient expresses emotional response to medical procedures", "file_id": "dr_SM1021", "chunk_id": 10 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "I couldn't afford to buy, ? A hundred and some dollar sunglasses or, or more.", "context": "Patient cannot afford expensive sunglasses", "file_id": "dr_SM1021", "chunk_id": 11 }, { "code": "Expensive treatments", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Expensive treatments/surgery", "quote": "I couldn't afford to buy, ? A hundred and some dollar sunglasses or, or more.", "context": "Patient mentions expensive sunglasses as a financial burden", "file_id": "dr_SM1021", "chunk_id": 11 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I tried to take care of my eyes that way and-", "context": "Patient attempts self-care, implying some level of health knowledge", "file_id": "dr_SM1021", "chunk_id": 11 }, { "code": "Access to healthcare", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "I used to wear $300 or $400 sunglasses.", "context": "Patient's past ability to afford expensive sunglasses may indicate current lack of access to necessary eye care", "file_id": "dr_SM1021", "chunk_id": 11 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I don't want to do something that's gonna-", "context": "Patient expresses fear of potential consequences", "file_id": "dr_SM1021", "chunk_id": 12 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't, I don't want to do something that's going to, . , there's always a chance.", "context": "Patient shows uncertainty about treatment effects", "file_id": "dr_SM1021", "chunk_id": 12 }, { "code": "Fear of infection", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I have been told that when you put something that in your eyes that you might get, , an infection or something.", "context": "Patient fears potential infection from treatment", "file_id": "dr_SM1021", "chunk_id": 12 }, { "code": "Lack of self-care", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "I really am bad about that", "context": "Patient admits to neglecting eye care", "file_id": "dr_SM1021", "chunk_id": 12 }, { "code": "Recovery Time", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "it'll take me a day or two for, to recover from this", "context": "Patient needs time to recover after eye care visits", "file_id": "dr_SM1021", "chunk_id": 13 }, { "code": "Limited Scheduling", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "I try to only do Fridays", "context": "Patient has limited scheduling options for follow-up appointments", "file_id": "dr_SM1021", "chunk_id": 13 }, { "code": "Transportation assistance", "category": "FACILITATOR - Resources & Access", "subcategory": "Transportation assistance", "quote": "I can usually have her take me home or take me to her house", "context": "Patient has help with transportation from girlfriend", "file_id": "dr_SM1021", "chunk_id": 14 }, { "code": "Work schedule constraints", "category": "BARRIER - Social Determinants of Health (SDOH)", "subcategory": "Financial constraints", "quote": "it'll take me a day or two for, to recover from this. so it doesn't affect my work", "context": "Patient schedules appointments around work recovery time", "file_id": "dr_SM1021", "chunk_id": 14 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Usually pretty good", "context": "Patient finds doctor's availability satisfactory", "file_id": "dr_SM1021", "chunk_id": 14 }, { "code": "Lack of trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "I feel they do what they can do for me", "context": "Patient's perception of provider's competence", "file_id": "dr_SM1021", "chunk_id": 15 }, { "code": "Poor outcomes", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of continuity of care", "quote": "It healed badly", "context": "Patient experienced complications after treatment", "file_id": "dr_SM1021", "chunk_id": 15 }, { "code": "Physical discomfort", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "It's easier for me to sit here right now in this light", "context": "Patient experiences physical discomfort due to condition", "file_id": "dr_SM1021", "chunk_id": 15 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "I feel they do what they can do for me", "context": "Patient perceives provider as caring", "file_id": "dr_SM1021", "chunk_id": 15 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "It's not quite as bad as it was, so I don't know what happened", "context": "Patient unsure about their condition", "file_id": "dr_SM1021", "chunk_id": 16 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I just know that I'm gonna have this. , for a while. Yeah. And for the rest of my life", "context": "Patient anxious about lifelong condition", "file_id": "dr_SM1021", "chunk_id": 16 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "He says that the shots and all that stuff will hopefully correct a lot of it", "context": "Provider offers reassuring words", "file_id": "dr_SM1021", "chunk_id": 16 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "Just getting here and getting home", "context": "Patient faces challenges in receiving eye care due to transportation", "file_id": "dr_SM1021", "chunk_id": 17 }, { "code": "Lack of discussion about risks", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "2. Patient Beliefs & Perceptions", "quote": "I don't really think that we'd talk too much about it at all", "context": "Patient lacks understanding about vision loss or blindness due to diabetes", "file_id": "dr_SM1021", "chunk_id": 17 }, { "code": "Provider empathy", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "2. Provider Relationship", "quote": "he feels badly when my, you, he gives me a shot and it hurts", "context": "Patient perceives provider as caring and empathetic", "file_id": "dr_SM1021", "chunk_id": 17 }, { "code": "Accessible providers", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "1. Healthcare System Support", "quote": "they try and make it as painless as they can", "context": "Patient has a positive experience with healthcare provider", "file_id": "dr_SM1021", "chunk_id": 17 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "they, the course always wants you to try and keep up after your diabetes and stuff", "context": "Patient seems unclear about diabetes management", "file_id": "dr_SM1021", "chunk_id": 18 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "it depends on what you eat", "context": "Patient implies cost of food affects treatment adherence", "file_id": "dr_SM1021", "chunk_id": 18 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "he wants me to", "context": "Patient feels supported by provider", "file_id": "dr_SM1021", "chunk_id": 18 }, { "code": "Lost wages", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Lost wages due to appointments", "quote": "I lost days of work because I couldn't...", "context": "Patient had to miss work due to treatment side effects", "file_id": "dr_SM1021", "chunk_id": 19 }, { "code": "Lack of self control", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "if you eat greasy foods, then you can't control yourself", "context": "Patient struggles with managing diet due to lack of self-control", "file_id": "dr_SM1021", "chunk_id": 19 }, { "code": "Fear of treatment side effects", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "Because I couldn't handle it", "context": "Patient stopped treatment due to inability to cope with side effects", "file_id": "dr_SM1021", "chunk_id": 19 }, { "code": "Lost wages", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Out-of-pocket costs", "quote": "I lost days of work because I couldn't...", "context": "Patient misses work due to appointments", "file_id": "dr_SM1021", "chunk_id": 20 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "They say that it's something that, , you can get cancer from it or you can get whatever", "context": "Patient fears potential health consequences", "file_id": "dr_SM1021", "chunk_id": 20 }, { "code": "Lack of trust in treatment", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "pills that just seem to mask what's going on", "context": "Patient questions effectiveness of medication", "file_id": "dr_SM1021", "chunk_id": 21 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "watching and changing my diet", "context": "Patient takes initiative in health management", "file_id": "dr_SM1021", "chunk_id": 21 }, { "code": "Self management support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I try and drink no matter what", "context": "Patient actively manages health through diet", "file_id": "dr_SM1021", "chunk_id": 21 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Access to healthcare", "quote": "if they can come up with something that would, ... help make food, - good, better food, . a little bit more accessible to people", "context": "Patient suggests making healthy food more accessible", "file_id": "dr_SM1021", "chunk_id": 22 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "if they could come up with something that would, ... help make food, - good, better food, . a little bit more accessible to people", "context": "Patient implies need for health education on diet", "file_id": "dr_SM1021", "chunk_id": 22 }, { "code": "Accessible resources", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate access to resources", "quote": "if they can come up with something with your diet. Or help make food, - good, better food, . a little bit more accessible to people", "context": "Patient suggests need for accessible resources", "file_id": "dr_SM1021", "chunk_id": 22 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "A little bit more accessible to people", "context": "Patient suggests that better accessibility would improve adherence", "file_id": "dr_SM1021", "chunk_id": 23 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Better food, a little bit more accessible to people", "context": "Patient implies that health education could improve self-management", "file_id": "dr_SM1021", "chunk_id": 23 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I wish that I'd have caught it", "context": "Patient expresses regret over not catching condition earlier, implying fear of diagnosis", "file_id": "dr_SM1021", "chunk_id": 23 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I'm sure that's why what happened to me", "context": "Patient shows limited understanding of their condition and its progression", "file_id": "dr_SM1021", "chunk_id": 23 }, { "code": "Lack of awareness", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Not that I know of. No.", "context": "Patient unsure about other conditions like glaucoma", "file_id": "dr_SM1021", "chunk_id": 24 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "I take care of two houses", "context": "Patient has financial responsibilities for multiple households", "file_id": "dr_SM1021", "chunk_id": 24 }, { "code": "Family History", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "My dad did. My mom had diabetes and she wore glasses and stuff.", "context": "Patient discusses family history of diabetes", "file_id": "dr_SM1021", "chunk_id": 25 }, { "code": "Outdoor Activities", "category": "BARRIER - Social Determinants of Health", "subcategory": "Education/health literacy barriers", "quote": "When I'm out in the sun a lot and I'm on the mower.", "context": "Patient mentions outdoor activities that may impact eye health", "file_id": "dr_SM1021", "chunk_id": 25 }, { "code": "Dry Eyes", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "It drys my eye out quick.", "context": "Patient experiences dry eyes due to outdoor activities", "file_id": "dr_SM1021", "chunk_id": 25 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "it's accessible enough to me that I can get over here", "context": "Patient finds healthcare services easily accessible", "file_id": "dr_SM1021", "chunk_id": 26 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "it's accessible enough to me that I can get over here", "context": "Patient finds healthcare services easily accessible", "file_id": "dr_SM1021", "chunk_id": 27 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I feel Dr. G cares", "context": "Patient has a positive experience with their provider", "file_id": "dr_SM1021", "chunk_id": 27 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "he tries to be accommodating", "context": "Patient feels their provider is understanding and accommodating", "file_id": "dr_SM1021", "chunk_id": 27 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "he's very confident in what he does", "context": "Patient feels their provider communicates effectively", "file_id": "dr_SM1021", "chunk_id": 27 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "he's very confident in what he does", "context": "Patient feels comfortable with provider's confidence", "file_id": "dr_SM1021", "chunk_id": 28 }, { "code": "Accommodating provider", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "he tries to be accommodating", "context": "Patient appreciates provider's accommodating nature", "file_id": "dr_SM1021", "chunk_id": 28 }, { "code": "Lack of understanding about DR progression", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I was hoping that this eye would be fixed", "context": "Patient has unrealistic expectations about treatment outcomes", "file_id": "dr_SM1021", "chunk_id": 28 }, { "code": "Fear of diagnosis/treatment", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I worry that that was what happened with my wrinkle thing", "context": "Patient is anxious about potential complications", "file_id": "dr_SM1021", "chunk_id": 28 }, { "code": "Lack of social support", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Cultural beliefs about healthcare", "quote": "No, I don't have someone to help me with my daily diabetes care", "context": "Patient lacks support for daily care", "file_id": "dr_SM1021", "chunk_id": 29 }, { "code": "Patient confidence", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "Well, I try", "context": "Patient attempts self-care despite challenges", "file_id": "dr_SM1021", "chunk_id": 29 }, { "code": "Provider communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "And they were , 'Oh, you calm down. It's okay.'", "context": "Provider response to patient's awareness during procedure", "file_id": "dr_SM1021", "chunk_id": 29 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I worry that that was what happened with my, , that wrinkle thing", "context": "Patient's anxiety about medical procedure", "file_id": "dr_SM1021", "chunk_id": 29 }, { "code": "Lack of confidence", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I mean, I could do a lot better", "context": "Patient expresses self-doubt in managing diabetes", "file_id": "dr_SM1021", "chunk_id": 30 }, { "code": "Poor diet habits", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Usually I eat trash at night", "context": "Patient admits to unhealthy eating habits", "file_id": "dr_SM1021", "chunk_id": 30 }, { "code": "Food accessibility", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate food supply", "quote": "I have a full kitchen of stuff for myself", "context": "Patient has access to groceries and food", "file_id": "dr_SM1021", "chunk_id": 30 }, { "code": "Convenient food options", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I'm stopping at Sheetz, or I'm stopping at, something I'm bringing home hot dogs or-", "context": "Patient relies on convenient but unhealthy food options", "file_id": "dr_SM1021", "chunk_id": 30 }, { "code": "Healthy food choices", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I try and have, some salad and I buy rotisserie chicken meat and things that", "context": "Patient makes effort to choose healthier food options at work", "file_id": "dr_SM1021", "chunk_id": 30 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "it's not really helping my vision", "context": "Patient unsure if healthy eating helps their vision", "file_id": "dr_SM1021", "chunk_id": 31 }, { "code": "Social support networks", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "Just Ed at work. We talk about stuff that a lot.", "context": "Patient has someone to share worries with", "file_id": "dr_SM1021", "chunk_id": 31 }, { "code": "Lack of education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "No, I haven't participated in a diabetes education class", "context": "Patient lacks formal diabetes education", "file_id": "dr_SM1021", "chunk_id": 32 }, { "code": "Self education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I do watch a lot of, or look up a lot of stuff about it", "context": "Patient takes initiative to learn about diabetes", "file_id": "dr_SM1021", "chunk_id": 32 }, { "code": "Social support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "Just Ed at work. We talk about stuff that a lot", "context": "Patient has someone to share concerns with", "file_id": "dr_SM1021", "chunk_id": 32 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I do watch a lot of stuff about it", "context": "Patient seeks health information", "file_id": "dr_SM1021", "chunk_id": 33 }, { "code": "Food awareness", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "See if there's something that I would eat", "context": "Patient explores dietary options for health", "file_id": "dr_SM1021", "chunk_id": 33 }, { "code": "Self management", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I've been trying to eat more beets", "context": "Patient actively manages diet for health", "file_id": "dr_SM1021", "chunk_id": 33 }, { "code": "Limited access due to eyesight", "category": "BARRIER - Social Determinants of Health", "subcategory": "Lack of access to healthcare", "quote": "My eyesight currently limit my ability to do things I want to do", "context": "Patient's eyesight affects daily activities", "file_id": "dr_SM1021", "chunk_id": 33 }, { "code": "Lack of understanding about DR progression", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I do watch a lot of stuff about it", "context": "Patient seeks information, possibly due to lack of understanding", "file_id": "dr_SM1021", "chunk_id": 33 }, { "code": "Education barriers", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "But a lot of jobs that I could do because of my education, I can't do with my eyes where they are", "context": "Patient's education does not help with current job due to eyesight", "file_id": "dr_SM1021", "chunk_id": 34 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "I don't make a ton of money", "context": "Patient has limited financial resources", "file_id": "dr_SM1021", "chunk_id": 34 }, { "code": "Feeling overwhelmed", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "To a point. I mean, with, as anybody would do, but-", "context": "Patient feels discouraged by their situation", "file_id": "dr_SM1021", "chunk_id": 34 }, { "code": "Depression/anxiety", "category": "BARRIER - Emotional/Psychological", "subcategory": "Depression/anxiety", "quote": "To a point. I mean, with, as anybody would do, but-", "context": "Patient shows signs of emotional distress", "file_id": "dr_SM1021", "chunk_id": 34 }, { "code": "Healthcare System Support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I have a decent job. I mean, I'm, I'm okay. I'm comfortable enough that I'm-", "context": "Patient has access to necessary resources", "file_id": "dr_SM1021", "chunk_id": 34 }, { "code": "Social support networks", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "I'm, I'm okay. I'm comfortable enough that I'm-", "context": "Patient has a support system", "file_id": "dr_SM1021", "chunk_id": 34 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "I don't make a ton of money", "context": "Patient has limited financial resources", "file_id": "dr_SM1021", "chunk_id": 35 }, { "code": "Lack of enthusiasm", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of perceived urgency", "quote": "Get through it", "context": "Patient lacks motivation for follow-up visits", "file_id": "dr_SM1021", "chunk_id": 35 }, { "code": "Acceptance of condition", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I know that I have to come in every month or every two months", "context": "Patient understands the importance of regular follow-ups", "file_id": "dr_SM1021", "chunk_id": 35 }, { "code": "Positive expectations", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "My eyes actually looked pretty decent for having gone", "context": "Patient has positive experience with healthcare provider", "file_id": "dr_SM1021", "chunk_id": 35 }, { "code": "Lack of perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "I could see a decline. And now I'm, I didn't see a decline this time.", "context": "Patient doesn't feel urgent need for follow-up when symptoms improve", "file_id": "dr_SM1021", "chunk_id": 36 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "he told me no new bleeding, no, nothing that.", "context": "Patient receives clear and reassuring communication from provider", "file_id": "dr_SM1021", "chunk_id": 36 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "So, I mean, I, I know that I have to come in every month or every two months", "context": "Patient has regular access to provider for follow-up appointments", "file_id": "dr_SM1021", "chunk_id": 36 }, { "code": "Flexible appointment scheduling", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Appointment scheduling difficulties", "quote": "So he said, 'Well, let's try every two.'", "context": "Provider accommodates patient's needs by adjusting appointment schedule", "file_id": "dr_SM1021", "chunk_id": 36 }, { "code": "Fear of treatment", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I don't look forward to the needles", "context": "Patient expresses fear of treatment procedures", "file_id": "dr_SM1021", "chunk_id": 37 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "It depends on who you, who you get that helps you", "context": "Patient implies varying quality of care from different providers", "file_id": "dr_SM1021", "chunk_id": 37 }, { "code": "Rude or dismissive providers", "category": "BARRIER - Provider/System Issues", "subcategory": "Rude or dismissive providers", "quote": "There was one woman, she, if it was up to her, she'd grab on my eyeball and aim it", "context": "Patient describes uncomfortable experience with a provider", "file_id": "dr_SM1021", "chunk_id": 37 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "It depends on who you, who you get that helps you", "context": "Patient suggests some providers are more considerate than others", "file_id": "dr_SM1021", "chunk_id": 37 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "So I'm not having to come in every", "context": "Patient appreciates reduced frequency of appointments", "file_id": "dr_SM1021", "chunk_id": 37 }, { "code": "Rude providers", "category": "BARRIER - Provider/System Issues", "subcategory": "Rude or dismissive providers", "quote": "she'd grab on my eyeball and aim it", "context": "Patient had a negative experience with a provider", "file_id": "dr_SM1021", "chunk_id": 38 }, { "code": "Vision loss", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "vision loss", "context": "Patient mentions vision loss as a concern", "file_id": "dr_BN1103", "chunk_id": 0 }, { "code": "Blurry vision", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Some blurry vision", "context": "Patient experiences blurry vision due to diabetes", "file_id": "dr_BN1103", "chunk_id": 0 }, { "code": "Floaters", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I've had some floaters", "context": "Patient experiences floaters as a symptom", "file_id": "dr_BN1103", "chunk_id": 0 }, { "code": "Expensive surgeries", "category": "BARRIER - Cost-Related Barriers", "subcategory": "Expensive treatments/surgery", "quote": "I've had a couple of surgeries", "context": "Patient has undergone costly surgeries for diabetes-related eye issues", "file_id": "dr_BN1103", "chunk_id": 0 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "it was due to having a sickle cell trait and also diabetes not under control", "context": "Patient lacks clear understanding of diabetes impact on eyes", "file_id": "dr_BN1103", "chunk_id": 1 }, { "code": "Importance of exams", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Very", "context": "Patient values regular eye exams", "file_id": "dr_BN1103", "chunk_id": 1 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "The Fairmont Clinic", "context": "Patient has access to a clinic for eye exams", "file_id": "dr_BN1103", "chunk_id": 1 }, { "code": "Regular check-ups", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "At least once a year", "context": "Patient believes in regular eye check-ups", "file_id": "dr_BN1103", "chunk_id": 1 }, { "code": "Lack of understanding about DR progression", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Patient Beliefs & Perceptions", "quote": "at this point, my vision is stable", "context": "Patient may not fully understand the risks of vision loss", "file_id": "dr_BN1103", "chunk_id": 2 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "I trust her with my life", "context": "Patient has a strong trust in their doctor", "file_id": "dr_BN1103", "chunk_id": 2 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "whenever I had a blood vessel bust in my eye, I couldn't see out of it, and she was able to get me right in", "context": "Patient feels heard and helped by their doctor", "file_id": "dr_BN1103", "chunk_id": 2 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Patient Empowerment", "quote": "Just a better, , view of the eye", "context": "Patient has some understanding of the importance of eye exams", "file_id": "dr_BN1103", "chunk_id": 2 }, { "code": "Risk of vision loss", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Patient Beliefs & Perceptions", "quote": "Of course, there's always the risk of losing my vision", "context": "Patient is aware of the potential risks of not managing their diabetes", "file_id": "dr_BN1103", "chunk_id": 2 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I trust her with my life", "context": "Patient expresses high level of trust in doctor", "file_id": "dr_BN1103", "chunk_id": 3 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "what questions you typically ask your doctor", "context": "Patient actively engages with doctor through questioning", "file_id": "dr_BN1103", "chunk_id": 3 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "when will the next injection be, or will I be able to fully see again?", "context": "Patient seeks information about treatment and prognosis", "file_id": "dr_BN1103", "chunk_id": 3 }, { "code": "Family history awareness", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "My mom had it, my dad had it, my brother has it", "context": "Patient is aware of family history of diabetes", "file_id": "dr_BN1103", "chunk_id": 3 }, { "code": "Family history awareness", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "My mom had it, my dad had it, my brother has it.", "context": "Patient aware of family diabetes history", "file_id": "dr_BN1103", "chunk_id": 4 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "it was scary at first", "context": "Patient initially fearful of diagnosis", "file_id": "dr_BN1103", "chunk_id": 4 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "she was able to get me right in because she was worried about it as well", "context": "Patient values provider's concern and prompt attention", "file_id": "dr_BN1103", "chunk_id": 4 }, { "code": "Healthcare system support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "she was able to get me right in", "context": "Patient appreciates timely access to healthcare services", "file_id": "dr_BN1103", "chunk_id": 4 }, { "code": "Perceived importance of follow-ups", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "just knowing that we're trying to stay on top of things", "context": "Patient understands value of regular follow-ups", "file_id": "dr_BN1103", "chunk_id": 4 }, { "code": "Self-management motivation", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "just knowing that I know what I have to do", "context": "Patient motivated to manage condition through regular appointments", "file_id": "dr_BN1103", "chunk_id": 4 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Long wait times", "quote": "I think the wait times are a little long sometimes, but.", "context": "Patient experiences long wait times at the clinic", "file_id": "dr_BN1103", "chunk_id": 5 }, { "code": "Lack of updates", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "at least, leave or give people updates-- on how long they'll be sitting in there.", "context": "Patient suggests providing updates to improve experience", "file_id": "dr_BN1103", "chunk_id": 5 }, { "code": "Transportation issues", "category": "BARRIER - SDOH", "subcategory": "Transportation issues", "quote": "Driving at night is the biggest challenge.", "context": "Patient faces challenges with driving at night", "file_id": "dr_BN1103", "chunk_id": 5 }, { "code": "Accessible provider", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "she was able to get me right in because she was worried about it as well.", "context": "Patient appreciates provider's prompt attention", "file_id": "dr_BN1103", "chunk_id": 5 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "how long they'll be sitting in there", "context": "Patient is concerned about waiting time at the clinic", "file_id": "dr_BN1103", "chunk_id": 6 }, { "code": "Lack of updates", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "leave or give people updates", "context": "Patient suggests providing updates to improve experience", "file_id": "dr_BN1103", "chunk_id": 6 }, { "code": "Social support networks", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "Family. S1: 07:46 Family, okay.", "context": "Patient has a support system in their family", "file_id": "dr_BN1103", "chunk_id": 6 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "getting, glaucoma or even kidney disease", "context": "Patient fears potential complications of diabetes", "file_id": "dr_BN1103", "chunk_id": 6 }, { "code": "Fear of complications", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "being a diabetic, you're always worried about getting, , glaucoma or even kidney disease", "context": "Patient expresses fear of diabetes-related complications", "file_id": "dr_BN1103", "chunk_id": 7 }, { "code": "Social support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "they always wanna go to appointments with me, or they'll have questions that maybe I didn't think of", "context": "Patient receives support from family/friends", "file_id": "dr_BN1103", "chunk_id": 7 }, { "code": "Accessible provider communication", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I always reach out on MyChart", "context": "Patient uses online portal to communicate with provider", "file_id": "dr_BN1103", "chunk_id": 7 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "MyChart is, , a good point of access for you to speak with your-- with your provider", "context": "Patient values online communication with provider", "file_id": "dr_BN1103", "chunk_id": 7 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I participated in a diabetes education class", "context": "Patient received diabetes education", "file_id": "dr_BN1103", "chunk_id": 7 }, { "code": "Connection issues", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "there's no signal or low signal, , , connection issues", "context": "Patient mentions potential technical barriers to telemedicine", "file_id": "dr_BN1103", "chunk_id": 8 }, { "code": "Telehealth options", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Telehealth options", "quote": "I actually this. S1: 09:48 You telemedicine? Okay. S2: 09:49 Mm-hmm.", "context": "Patient expresses comfort with using telemedicine for follow-ups", "file_id": "dr_BN1103", "chunk_id": 8 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Very good", "context": "Patient describes interactions with eye doctor as very good", "file_id": "dr_BN1103", "chunk_id": 8 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "carb counting", "context": "Patient mentions attending a class on carb counting, indicating health education", "file_id": "dr_BN1103", "chunk_id": 8 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I'm comfortable with her", "context": "Patient feels at ease with their eye doctor", "file_id": "dr_BN1103", "chunk_id": 9 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "She'll normally tell me what she thinks is best or gimme options and let me choose from there", "context": "Patient's eye doctor communicates clearly and involves patient in decision-making", "file_id": "dr_BN1103", "chunk_id": 9 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "She respects me", "context": "Patient feels respected by their eye doctor", "file_id": "dr_BN1103", "chunk_id": 9 }, { "code": "Shared decision-making", "category": "FACILITATOR - Provider Relationship", "subcategory": "Shared decision-making", "quote": "let me choose from there", "context": "Patient is involved in making decisions about their eye care", "file_id": "dr_BN1103", "chunk_id": 9 }, { "code": "No rushing communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Poor communication", "quote": "I don't think she rushes", "context": "Patient's eye doctor takes time to communicate effectively", "file_id": "dr_BN1103", "chunk_id": 9 }, { "code": "Clear explanations", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "She's good at explaining", "context": "Patient's eye doctor explains results and recommendations clearly", "file_id": "dr_BN1103", "chunk_id": 9 }, { "code": "Provider Empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "she explained, yeah, my pressure was high in the eye, and what we could do to lower that", "context": "Patient feels understood by provider", "file_id": "dr_BN1103", "chunk_id": 10 }, { "code": "Positive Patient-Provider Relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "No, she respects me", "context": "Patient feels respected by provider", "file_id": "dr_BN1103", "chunk_id": 10 }, { "code": "Effective Communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "she explained, yeah, my pressure was high in the eye, and what we could do to lower that", "context": "Provider clearly explains patient's condition", "file_id": "dr_BN1103", "chunk_id": 10 }, { "code": "Lack of pancreas", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't have a pancreas", "context": "Patient discusses their medical condition", "file_id": "dr_WD0321(part2)", "chunk_id": 1 }, { "code": "Dependence on insulin", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I'm totally dependent on insulin", "context": "Patient explains their reliance on medication", "file_id": "dr_WD0321(part2)", "chunk_id": 1 }, { "code": "Self management efforts", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "watch my carbs", "context": "Patient discusses their self-care routine", "file_id": "dr_WD0321(part2)", "chunk_id": 1 }, { "code": "Medication adherence", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I take two different types of insulin", "context": "Patient explains their medication regimen", "file_id": "dr_WD0321(part2)", "chunk_id": 1 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I can't really say specifically anything that", "context": "Patient unsure of diabetes progression indicators", "file_id": "dr_WD0321(part2)", "chunk_id": 2 }, { "code": "Health monitoring", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "keep a check on my sugar", "context": "Patient actively monitors blood sugar levels", "file_id": "dr_WD0321(part2)", "chunk_id": 2 }, { "code": "Diabetes self-management", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "keep a close lid on to what I", "context": "Patient attempts to manage diabetes through self-regulation", "file_id": "dr_WD0321(part2)", "chunk_id": 2 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "keeping my numbers low. Keep my A1C good", "context": "Patient has knowledge of diabetes management goals", "file_id": "dr_WD0321(part2)", "chunk_id": 2 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't think. I'm not sure.", "context": "Patient unsure if diabetes affects eyes", "file_id": "dr_WD0321(part2)", "chunk_id": 3 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I don't think. I'm not sure.", "context": "Patient hesitant to acknowledge potential eye issues", "file_id": "dr_WD0321(part2)", "chunk_id": 3 }, { "code": "Healthcare System Support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "that's what started me coming up here, so.", "context": "Patient has been attending follow-up appointments", "file_id": "dr_WD0321(part2)", "chunk_id": 3 }, { "code": "Patient Empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I try to keep, , a close watch. That's my main thing, keeping a close watch on my GCN.", "context": "Patient taking initiative to monitor health", "file_id": "dr_WD0321(part2)", "chunk_id": 3 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "it's all a big mismash", "context": "Patient is unsure about the impact of diabetes on their eyes", "file_id": "dr_WD0321(part2)", "chunk_id": 4 }, { "code": "Regular check-ups", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I have the diabetic eye exam every year", "context": "Patient has regular eye exams to monitor their condition", "file_id": "dr_WD0321(part2)", "chunk_id": 4 }, { "code": "Access to care", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate insurance coverage", "quote": "Most of the time up here, but sometimes I get, , I'll get it in Cumberland", "context": "Patient has access to multiple healthcare locations", "file_id": "dr_WD0321(part2)", "chunk_id": 4 }, { "code": "Lack of detail", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "the retina and stuff that", "context": "Patient lacks detailed understanding of their condition", "file_id": "dr_WD0321(part2)", "chunk_id": 5 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "There's a place in town that will do this", "context": "Patient has access to local healthcare providers", "file_id": "dr_WD0321(part2)", "chunk_id": 5 }, { "code": "Transportation flexibility", "category": "FACILITATOR - Resources & Access", "subcategory": "Transportation assistance", "quote": "Most of the time up here, but sometimes I get, I'll get it in Cumberland", "context": "Patient has options for receiving care in different locations", "file_id": "dr_WD0321(part2)", "chunk_id": 5 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "I don't go to Cumberland too often unless I have an issue", "context": "Patient implies limited access to care", "file_id": "dr_WD0321(part2)", "chunk_id": 6 }, { "code": "Healthcare system support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "And then I come see her next month again, so", "context": "Patient has a scheduled follow-up appointment", "file_id": "dr_WD0321(part2)", "chunk_id": 6 }, { "code": "Provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "And that would've been back, in the last November. Speaker 1: Okay. Patient WD-0321: Yeah. Last-", "context": "Patient seems to have a comfortable relationship with Dr. Lagson", "file_id": "dr_WD0321(part2)", "chunk_id": 6 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "I don't go to Cumberland too often unless I have an issue", "context": "Patient implies limited access to care", "file_id": "dr_WD0321(part2)", "chunk_id": 7 }, { "code": "Healthcare System Support", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I come see Dr. Lagson twice a year, and I see Dr. Palko twice a year", "context": "Patient has regular appointments with multiple providers", "file_id": "dr_WD0321(part2)", "chunk_id": 7 }, { "code": "Provider Relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I come see her next month again", "context": "Patient has a scheduled follow-up with a provider", "file_id": "dr_WD0321(part2)", "chunk_id": 7 }, { "code": "Adequate provider availability", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Oh, yeah. Yeah. Especially up here.", "context": "Patient feels doctor has adequate availability", "file_id": "dr_WD0321(part2)", "chunk_id": 8 }, { "code": "Limited eye doctors", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of access to healthcare", "quote": "I guess per capita, there's not that many eye doctors.", "context": "Patient notes limited availability of eye doctors", "file_id": "dr_WD0321(part2)", "chunk_id": 8 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "I guess per capita, there's not that many eye doctors", "context": "Patient mentions limited availability of eye doctors", "file_id": "dr_WD0321(part2)", "chunk_id": 9 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Long wait times", "quote": "Well, we can't see you for two weeks", "context": "Patient experiences delay in getting an appointment", "file_id": "dr_WD0321(part2)", "chunk_id": 9 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I called up here that afternoon the same day", "context": "Patient finds alternative provider with shorter wait time", "file_id": "dr_WD0321(part2)", "chunk_id": 9 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "getting scheduled in up here works out great", "context": "Patient praises ease of scheduling appointments", "file_id": "dr_WD0321(part2)", "chunk_id": 10 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "The care I receive up here? Oh, I think it's excellent", "context": "Patient expresses satisfaction with care received", "file_id": "dr_WD0321(part2)", "chunk_id": 10 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "So I called my doctor in Cumberland, 'Come see me.' Next day I went to see him", "context": "Patient reports prompt communication with provider", "file_id": "dr_WD0321(part2)", "chunk_id": 10 }, { "code": "Appointment scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "And they said, 'Well, we can't see you for two weeks'", "context": "Patient experiences delay in scheduling appointment", "file_id": "dr_WD0321(part2)", "chunk_id": 10 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "it's an hour and 10 minutes", "context": "Patient mentions long drive time to receive eye care", "file_id": "dr_WD0321(part2)", "chunk_id": 11 }, { "code": "Lack of health education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "I don't wear sunglasses", "context": "Patient lacks knowledge about eye protection", "file_id": "dr_WD0321(part2)", "chunk_id": 12 }, { "code": "Access to prescribed treatment", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate insurance coverage", "quote": "I use the eyedrops that are prescribed to me", "context": "Patient has access to necessary medication", "file_id": "dr_WD0321(part2)", "chunk_id": 12 }, { "code": "Health literacy", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I take four different types of eyedrops", "context": "Patient understands and manages their medication regimen", "file_id": "dr_WD0321(part2)", "chunk_id": 12 }, { "code": "Lack of clarity on medication", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "Or no, I take, I'm sorry", "context": "Patient seems uncertain about their medication regimen", "file_id": "dr_WD0321(part2)", "chunk_id": 13 }, { "code": "Complex medication regimen", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I take three for glaucoma", "context": "Patient has a complex medication schedule", "file_id": "dr_WD0321(part2)", "chunk_id": 13 }, { "code": "Accessible provider", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "Speaker 1: Mm-hmm", "context": "Provider is engaged and responsive to patient's concerns", "file_id": "dr_WD0321(part2)", "chunk_id": 13 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Speaker 1: Okay", "context": "Provider is actively listening to patient", "file_id": "dr_WD0321(part2)", "chunk_id": 13 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't do much of TV or a computer", "context": "Patient may not fully understand the importance of eye care", "file_id": "dr_WD0321(part2)", "chunk_id": 14 }, { "code": "Financial constraints", "category": "BARRIER - SDOH", "subcategory": "Financial constraints", "quote": "None mentioned explicitly, but multiple eyedrops imply potential cost burden", "context": "Patient is taking multiple medications, potentially incurring significant costs", "file_id": "dr_WD0321(part2)", "chunk_id": 14 }, { "code": "Health literacy", "category": "BARRIER - SDOH", "subcategory": "Education/health literacy barriers", "quote": "I take two drops of brimonidine, and I take two drops of timolol for the glaucoma", "context": "Patient seems to understand their medication regimen, but may not fully comprehend the underlying conditions", "file_id": "dr_WD0321(part2)", "chunk_id": 14 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "None mentioned explicitly", "context": "No mention of provider accessibility, but patient is able to manage their condition with multiple medications", "file_id": "dr_WD0321(part2)", "chunk_id": 14 }, { "code": "Patient self-management", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I'll look at it for about 10 minutes and I say, okay, I can't take none, so I'll set it down because it makes my eyes tired", "context": "Patient is taking steps to manage their eye health by resting their eyes", "file_id": "dr_WD0321(part2)", "chunk_id": 14 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I've just heard that it can do, it can cause you blindness, but not really how that works. I, I, I don't know. I really don't know.", "context": "Patient lacks knowledge about diabetes-related vision loss", "file_id": "dr_WD0321(part2)", "chunk_id": 15 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "Oh, perfectly comfortable", "context": "Patient feels at ease discussing concerns with doctor", "file_id": "dr_WD0321(part2)", "chunk_id": 15 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Yeah, I actually, today I asked Dr. Palko because he put a shunt in eye", "context": "Patient is able to express concerns and ask questions to doctor", "file_id": "dr_WD0321(part2)", "chunk_id": 15 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "He said, 'Just let me know, we'll do it.'", "context": "Patient feels supported by provider's willingness to accommodate their needs", "file_id": "dr_WD0321(part2)", "chunk_id": 16 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "He said, 'I think you're doing well with the drops'", "context": "Provider clearly explains patient's condition and treatment", "file_id": "dr_WD0321(part2)", "chunk_id": 16 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "He said, 'Anytime you feel , or we see a change in that, we, we can do that for you.'", "context": "Provider shows understanding and adaptability to patient's needs", "file_id": "dr_WD0321(part2)", "chunk_id": 16 }, { "code": "Lack of detailed explanations", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "I wish they would be more detailed with explanations or something that", "context": "Patient desires more comprehensive information from provider", "file_id": "dr_WD0321(part2)", "chunk_id": 16 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "They take their time", "context": "Patient feels heard and understood by providers", "file_id": "dr_WD0321(part2)", "chunk_id": 17 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't think about it", "context": "Patient lacks awareness of diabetes-related vision loss", "file_id": "dr_WD0321(part2)", "chunk_id": 17 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "Anytime I ask a question of the doctors up here, they tell me", "context": "Patient receives clear explanations from providers", "file_id": "dr_WD0321(part2)", "chunk_id": 17 }, { "code": "No perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "I don't think about it", "context": "Patient does not prioritize follow-up due to lack of symptoms", "file_id": "dr_WD0321(part2)", "chunk_id": 17 }, { "code": "Lack of perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "because, because everything seems to be going good for me", "context": "Patient does not think about vision loss due to current good health", "file_id": "dr_WD0321(part2)", "chunk_id": 18 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "And I know that the doctors up here keep a good check on my eye", "context": "Patient feels cared for by healthcare providers", "file_id": "dr_WD0321(part2)", "chunk_id": 18 }, { "code": "Lack of understanding about DR progression", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't think about it", "context": "Patient lacks awareness of diabetes-related vision loss", "file_id": "dr_WD0321(part2)", "chunk_id": 18 }, { "code": "Lack of perceived urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "I can see fine now", "quote": "I think my vision's good. Really good.", "context": "Patient does not feel urgent need for follow-up", "file_id": "dr_WD0321(part2)", "chunk_id": 19 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "He said, 'You're one of the few that have done this well.'", "context": "Patient feels supported by doctor's positive comment", "file_id": "dr_WD0321(part2)", "chunk_id": 19 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "She said something about my glasses. I said, 'Well, I can see better with my glasses off than I can on.'", "context": "Patient is discussing their vision with a healthcare provider", "file_id": "dr_WD0321(part2)", "chunk_id": 19 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I do, but I think it's psychosomatic.", "context": "Patient is hesitant to acknowledge potential vision problems", "file_id": "dr_WD0321(part2)", "chunk_id": 19 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't know if any of my siblings do, but I know two of my siblings had diabetes", "context": "Patient shows lack of understanding about family history and its relation to their condition", "file_id": "dr_WD0321(part2)", "chunk_id": 20 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I had a Fuchs dystrophy is actually why I ended up having to have cornea transplants", "context": "Patient's experience with previous diagnosis and treatment may influence their perception of follow-up appointments", "file_id": "dr_WD0321(part2)", "chunk_id": 20 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "He said, 'You're one of the few that have done this well'", "context": "Patient receives positive feedback from provider, potentially strengthening their relationship", "file_id": "dr_WD0321(part2)", "chunk_id": 20 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "You are, you are. You're fine. If you're not, I'll just ask a question", "context": "Provider shows understanding and reassures patient, demonstrating effective communication", "file_id": "dr_WD0321(part2)", "chunk_id": 20 }, { "code": "Lack of access", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "Because there weren't my", "context": "Patient implies lack of access to care", "file_id": "dr_WD0321(part2)", "chunk_id": 21 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "And then when they said, come back in two weeks when I was already having problems", "context": "Patient feels communication about follow-up was inadequate", "file_id": "dr_WD0321(part2)", "chunk_id": 21 }, { "code": "Appointment scheduling difficulties", "category": "BARRIER - Provider/System Issues", "subcategory": "Appointment scheduling difficulties", "quote": "And then when they said, come back in two weeks", "context": "Patient had issues with follow-up appointment scheduling", "file_id": "dr_WD0321(part2)", "chunk_id": 21 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "So that's when I started coming here", "context": "Patient found a more accessible provider", "file_id": "dr_WD0321(part2)", "chunk_id": 21 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Provider/System Issues", "quote": "it's , nah", "context": "Patient had a bad experience with previous provider", "file_id": "dr_WD0321(part2)", "chunk_id": 22 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "She talked me through it, and she said it'll be okay", "context": "Patient had a positive experience with current provider", "file_id": "dr_WD0321(part2)", "chunk_id": 22 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider Relationship", "quote": "She reaffirmed to me", "context": "Patient felt comforted by provider's approach", "file_id": "dr_WD0321(part2)", "chunk_id": 22 }, { "code": "Positive provider approach", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "But the way she approached it", "context": "Patient appreciates provider's empathetic approach", "file_id": "dr_WD0321(part2)", "chunk_id": 23 }, { "code": "Effective treatment outcome", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "The shunt that he put in, Dr. Palko put in, to relieve the pressure, that's turned out great", "context": "Patient experiences positive outcome from treatment", "file_id": "dr_WD0321(part2)", "chunk_id": 23 }, { "code": "Good patient-provider interaction", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "She reaffirmed to me and then she, she did the shots", "context": "Patient values clear communication with provider", "file_id": "dr_WD0321(part2)", "chunk_id": 23 }, { "code": "Positive experience", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I think the whole system is great up here", "context": "Patient expresses satisfaction with healthcare system", "file_id": "dr_WD0321(part2)", "chunk_id": 24 }, { "code": "Social support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "my wife. she would help me if I need it", "context": "Patient has a supportive family member", "file_id": "dr_WD0321(part2)", "chunk_id": 24 }, { "code": "Emotional support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "Yeah, what about if you were to have a worry or fear, do you feel you could share that with her also? Yeah", "context": "Patient feels comfortable sharing concerns with spouse", "file_id": "dr_WD0321(part2)", "chunk_id": 24 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "she would help me if I need it", "context": "Patient feels supported by provider", "file_id": "dr_WD0321(part2)", "chunk_id": 25 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Yeah. So, , what about if you were to have a worry or fear, do you feel you could share that with her also?", "context": "Patient feels comfortable sharing concerns with provider", "file_id": "dr_WD0321(part2)", "chunk_id": 25 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "Oh, yeah. Yeah. In Cumberland I've done them", "context": "Patient has participated in diabetes education programs", "file_id": "dr_WD0321(part2)", "chunk_id": 25 }, { "code": "Diabetes self-management support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I've been to two and I have another one that's coming up, so I had three hours into it this year", "context": "Patient is engaged in ongoing diabetes education", "file_id": "dr_WD0321(part2)", "chunk_id": 25 }, { "code": "Lack of health literacy", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "I don't eat vegetables, and I don't eat salads, and I love ice cream", "context": "Patient lacks understanding of healthy diet", "file_id": "dr_WD0321(part2)", "chunk_id": 26 }, { "code": "Patient empowerment", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "It gives me insight and perspective and things that I'm doing, well-", "context": "Patient feels empowered by health education", "file_id": "dr_WD0321(part2)", "chunk_id": 26 }, { "code": "Health education support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "I, I do still try to keep a little up-", "context": "Patient receives support for diabetes management", "file_id": "dr_WD0321(part2)", "chunk_id": 26 }, { "code": "Limited access to care", "category": "BARRIER - SDOH", "subcategory": "Lack of access to healthcare", "quote": "I had to work on my diet because I'm not a vegetable, I don't eat vegetables, and I don't eat salads, and I love ice cream", "context": "Patient has limited access to healthy food options", "file_id": "dr_WD0321(part2)", "chunk_id": 26 }, { "code": "Positive patient attitude", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health literacy", "quote": "I, I, I had to work on my diet", "context": "Patient has positive attitude towards health changes", "file_id": "dr_WD0321(part2)", "chunk_id": 26 }, { "code": "Lack of urgency", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "'I can see fine now'", "quote": "But in the evening- ... a lamp won't do it because a lamp's up here.", "context": "Patient perceives their vision as sufficient", "file_id": "dr_WD0321(part2)", "chunk_id": 27 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "And he reaffirmed, he said, 'Well, we can do it.'", "context": "Patient feels supported by their provider", "file_id": "dr_WD0321(part2)", "chunk_id": 27 }, { "code": "Provider empathy", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "And he said, 'But think about it'", "context": "Provider shows understanding and consideration", "file_id": "dr_WD0321(part2)", "chunk_id": 27 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Provider empathy", "quote": "he said, 'Well, we can do it.' But he said, 'I think you're doing well with the drops and stuff.'", "context": "Patient feels supported by provider", "file_id": "dr_WD0321(part2)", "chunk_id": 28 }, { "code": "Shared decision-making", "category": "FACILITATOR - Provider Relationship", "subcategory": "Shared decision-making", "quote": "He said, 'And I will do it if you want it done.'", "context": "Patient is involved in treatment decisions", "file_id": "dr_WD0321(part2)", "chunk_id": 28 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "he reaffirmed, he said, 'Well, we can do it.'", "context": "Patient understands provider's message", "file_id": "dr_WD0321(part2)", "chunk_id": 28 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I do now", "context": "Patient currently receives care at the clinic", "file_id": "dr_RA0605", "chunk_id": 1 }, { "code": "Regular monitoring", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I just keep monitoring that", "context": "Patient uses CGM to track diabetes", "file_id": "dr_RA0605", "chunk_id": 1 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "we find an available date and--", "context": "Patient finds scheduling process easy", "file_id": "dr_RA0605", "chunk_id": 2 }, { "code": "Lack of awareness", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "It was fine", "context": "Patient seems unaware of potential complications", "file_id": "dr_RA0605", "chunk_id": 2 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "That distracted me", "context": "Patient experiences distraction during conversation", "file_id": "dr_RA0605", "chunk_id": 2 }, { "code": "Effective scheduling", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Appointment scheduling difficulties", "quote": "Just at the front desk, we find an available date and--", "context": "Patient finds scheduling process easy", "file_id": "dr_RA0605", "chunk_id": 2 }, { "code": "Lack of patient engagement", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I never really pay attention to that", "context": "Patient shows lack of interest in doctor's availability", "file_id": "dr_RA0605", "chunk_id": 2 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "when I come in for a shot, I have to tell them I can only accept a shot in one of the eyes 'cause you gotta use the other one to drive home with", "context": "Patient needs to drive themselves home after appointment", "file_id": "dr_RA0605", "chunk_id": 3 }, { "code": "Appointment scheduling ease", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "1. Healthcare System Support", "quote": "Just at the front desk, we find an available date and--", "context": "Patient finds scheduling process to be straightforward", "file_id": "dr_RA0605", "chunk_id": 3 }, { "code": "Provider accommodation", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "2. Provider Relationship", "quote": "I just tell them I'm only available for Monday, Wednesday, and Friday", "context": "Patient's schedule is accommodated by provider", "file_id": "dr_RA0605", "chunk_id": 3 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "some people, they have to drive a far distance", "context": "Patient mentions transportation as a challenge for others", "file_id": "dr_RA0605", "chunk_id": 4 }, { "code": "Transportation constraints", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "you gotta use the other one to drive home with", "context": "Patient has to consider transportation after treatment", "file_id": "dr_RA0605", "chunk_id": 4 }, { "code": "Rude provider", "category": "BARRIER - Provider/System Issues", "subcategory": "Rude or dismissive providers", "quote": "'You're not the doctor. I am.'", "context": "Patient experienced rude behavior from a healthcare provider", "file_id": "dr_RA0605", "chunk_id": 5 }, { "code": "Lack of patient-provider trust", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of patient-provider trust", "quote": "'You're not the doctor. I am.'", "context": "Patient lost trust in their provider due to rude behavior", "file_id": "dr_RA0605", "chunk_id": 5 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I went and found another doctor", "context": "Patient sought a new provider with a better relationship", "file_id": "dr_RA0605", "chunk_id": 5 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "Yes", "context": "Patient feels comfortable discussing diabetes-related problems with their current doctor", "file_id": "dr_RA0605", "chunk_id": 5 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "is it progressing-- is it getting worse--", "context": "Patient expresses concern about disease progression", "file_id": "dr_RA0605", "chunk_id": 6 }, { "code": "Provider disagreement", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "the doctor said, 'Well, the in-- they don't have one to do with the other.' I said, 'Oh, yes, they do. They most certainly do.'", "context": "Patient disagrees with provider's assessment", "file_id": "dr_RA0605", "chunk_id": 6 }, { "code": "Symptom variability", "category": "BARRIER - Emotional/Psychological", "subcategory": "Feeling overwhelmed", "quote": "there are days when, when the floaters are heavier--", "context": "Patient experiences fluctuating symptoms", "file_id": "dr_RA0605", "chunk_id": 6 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "the doctor said, 'Well, the in-- they don't have one to do with the other.' I said, 'Oh, yes, they do. They most certainly do.'", "context": "Patient engages in open discussion with provider", "file_id": "dr_RA0605", "chunk_id": 6 }, { "code": "Health education", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "since I've been receiving the shots, they seem to think my eyes are getting better.", "context": "Patient receives treatment and observes improvement", "file_id": "dr_RA0605", "chunk_id": 6 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I guess if I li-live long enough, it'll happen", "context": "Patient shows limited understanding of disease progression", "file_id": "dr_RA0605", "chunk_id": 7 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "that at all. I'm gonna be very sad", "context": "Patient expresses fear of potential vision loss", "file_id": "dr_RA0605", "chunk_id": 7 }, { "code": "Positive provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "they seem to be optimistic", "context": "Patient feels reassured by provider's optimism", "file_id": "dr_RA0605", "chunk_id": 7 }, { "code": "Effective communication", "category": "FACILITATOR - Provider Relationship", "subcategory": "Effective communication", "quote": "just from what your doctors explained to you", "context": "Patient feels informed by provider's explanations", "file_id": "dr_RA0605", "chunk_id": 7 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I thought it was diabetic neuropathy", "context": "Patient misunderstands their diagnosis", "file_id": "dr_RA0605", "chunk_id": 8 }, { "code": "Provider communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "the doctor seemed to be-- this is my old doctor-- more concerned with macular degeneration", "context": "Patient experiences unclear provider communication", "file_id": "dr_RA0605", "chunk_id": 8 }, { "code": "Healthcare system issues", "category": "BARRIER - Provider/System Issues", "subcategory": "Lack of continuity of care", "quote": "this is my old doctor", "context": "Patient has changed doctors, indicating potential lack of continuity", "file_id": "dr_RA0605", "chunk_id": 8 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "No one had ever said anything about that before", "context": "Patient was not informed about cataracts previously", "file_id": "dr_RA0605", "chunk_id": 9 }, { "code": "Poor communication", "category": "BARRIER - Provider/System Issues", "subcategory": "Poor communication", "quote": "No one had ever said anything about that before", "context": "Patient was not properly communicated with by providers", "file_id": "dr_RA0605", "chunk_id": 9 }, { "code": "Fear of vision loss", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "I really don't wanna lose my vision", "context": "Patient motivated by fear of vision loss", "file_id": "dr_RA0605", "chunk_id": 10 }, { "code": "Access to specialty care", "category": "FACILITATOR - Resources & Access", "subcategory": "Adequate insurance coverage", "quote": "Morgantown is a transplant hospital for kidneys", "context": "Patient has access to specialized care", "file_id": "dr_RA0605", "chunk_id": 10 }, { "code": "Health management skills", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Diabetes self-management support", "quote": "Just being able to manage them", "context": "Patient has ability to manage health", "file_id": "dr_RA0605", "chunk_id": 10 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "In King George, Virginia", "context": "Patient lives far from the clinic", "file_id": "dr_RA0605", "chunk_id": 11 }, { "code": "Lack of access to healthcare", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "Morgantown is a transplant hospital for kidneys", "context": "Patient has to travel for specialized care", "file_id": "dr_RA0605", "chunk_id": 11 }, { "code": "Healthcare System Support", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "1. Healthcare System Support", "quote": "Morgantown is a transplant hospital for kidneys", "context": "Patient has access to specialized care", "file_id": "dr_RA0605", "chunk_id": 11 }, { "code": "Social Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "I have a sister", "context": "Patient has family support for daily tasks and transportation", "file_id": "dr_RA0605", "chunk_id": 12 }, { "code": "Transportation Assistance", "category": "FACILITATOR - Resources & Access", "subcategory": "Transportation assistance", "quote": "my-- sister drove me here today", "context": "Patient received help with transportation to the clinic", "file_id": "dr_RA0605", "chunk_id": 12 }, { "code": "Transportation issues", "category": "A. BARRIERS TO FOLLOW-UP", "subcategory": "1. Social Determinants of Health (SDOH)", "quote": "Because I can't drive because of this.", "context": "Patient cannot drive due to their condition", "file_id": "dr_RA0605", "chunk_id": 13 }, { "code": "Social support", "category": "B. FACILITATORS TO FOLLOW-UP", "subcategory": "3. Patient Empowerment", "quote": "my-- sister drove me here today.", "context": "Patient has family support for transportation", "file_id": "dr_RA0605", "chunk_id": 13 }, { "code": "Family Caregiving Burden", "category": "BARRIER - SDOH", "subcategory": "Social Determinants of Health", "quote": "My sister's the only fully functioning adult", "context": "Patient's family member has caregiving responsibilities", "file_id": "dr_RA0605", "chunk_id": 14 }, { "code": "Lack Of Diabetes Education", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Education/health literacy barriers", "quote": "not really. No", "context": "Patient hasn't participated in diabetes education classes", "file_id": "dr_RA0605", "chunk_id": 14 }, { "code": "Emotional Support", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Social support networks", "quote": "Yes. She's receptive of that", "context": "Patient has emotional support from sister", "file_id": "dr_RA0605", "chunk_id": 14 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "No quote directly supports this, but the conversation implies a lack of discussion about disease progression", "context": "Patient doesn't discuss their understanding of DR", "file_id": "dr_RA0605", "chunk_id": 15 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "I generally would call the doctor's office or something", "context": "Patient has a means to contact their healthcare provider", "file_id": "dr_RA0605", "chunk_id": 15 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I generally would call the doctor's office or something", "context": "Patient implies a comfortable relationship with their provider by planning to call them", "file_id": "dr_RA0605", "chunk_id": 15 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "No direct quote, but the discussion about eyesight and reading implies some level of health awareness", "context": "Patient shows awareness of their condition's impact on daily activities", "file_id": "dr_RA0605", "chunk_id": 15 }, { "code": "Lack of understanding", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Lack of understanding about DR progression", "quote": "I don't really know what's going on with my eyes", "context": "Patient lacks knowledge about DR", "file_id": "dr_RA0605", "chunk_id": 16 }, { "code": "Fear of diagnosis", "category": "BARRIER - Patient Beliefs & Perceptions", "subcategory": "Fear of diagnosis/treatment", "quote": "I'm scared of what the doctor might say", "context": "Patient fears bad news from doctor", "file_id": "dr_RA0605", "chunk_id": 16 }, { "code": "Long wait times", "category": "BARRIER - Provider/System Issues", "subcategory": "Long wait times", "quote": "I have to wait too long at the clinic", "context": "Patient experiences long wait times", "file_id": "dr_RA0605", "chunk_id": 16 }, { "code": "Accessible providers", "category": "FACILITATOR - Healthcare System Support", "subcategory": "Accessible providers", "quote": "My doctor is always available to answer questions", "context": "Patient has easy access to provider", "file_id": "dr_RA0605", "chunk_id": 16 }, { "code": "Positive patient-provider relationship", "category": "FACILITATOR - Provider Relationship", "subcategory": "Positive patient-provider relationship", "quote": "I really like my doctor, she's very nice", "context": "Patient has good relationship with provider", "file_id": "dr_RA0605", "chunk_id": 16 }, { "code": "Health education programs", "category": "FACILITATOR - Patient Empowerment", "subcategory": "Health education programs", "quote": "The classes I took really helped me understand my diabetes", "context": "Patient benefits from health education", "file_id": "dr_RA0605", "chunk_id": 16 } ] }