Barriers and facilitators of lifestyle management among diabetic patients in palestine: a qualitative exploration of physician perspectives

This study explores physicians’ perspectives on the barriers and facilitators to lifestyle management among diabetic patients in Palestine, with the aim of understanding how systemic, sociocultural, and conflict-related factors shape diabetes care. The study utilized a qualitative research design through semi-structured interviews. Questions were adapted from similar published studies. Purposive sampling was used to identify and interview 17 male and female physicians in internal medicine, family medicine, and specialties who care for patients with Diabetes in the West Bank. Informed consent was obtained, and the interviews were audio recorded, transcribed, and analyzed using Braun and Clarke’s thematic analysis method. Financial, educational, and personal factors were the patients’ barriers to their diabetes management. Government clinic logistics and staff limitations were the challenges physicians encountered. Worsening economics, lack of medications, travel difficulties, and stress and mental health challenges were barriers related to the war. Family support, doctors’ encouragement, the doctor-to-patient relationship acted as facilitators. For patients, concrete improvements in diabetes symptoms and laboratory results due to their self-care and fear of complications were motivators to continue lifestyle management efforts. The findings highlight how military occupation and wartime conditions compound existing barriers to diabetes lifestyle management in Palestine. Policy initiatives must concurrently address the social determinants fueling diabetes prevalence and mitigate occupation-related health constraints, while strengthening healthcare system capacity—a dual approach essential for sustainable impact in Palestine’s complex humanitarian context.