A qualitative investigation into the experiences, perceptions, beliefs and self-care management of people with type 2 diabetes
, PhD thesis, University of Salford.
Diabetes is a complex, chronic, insidious metabolic disorder. The marked prevalence in individuals with diabetes due to obesity, sedentary lifestyles and a poor diet, is proving a considerable challenge for healthcare systems across the world. In order to reduce diabetes related complications, it is imperative that individuals are able to effectively self-manage their condition. For this to be achieved it is crucial that the appropriate healthcare professionals provide on-going support and education. To date, this aspect has not been explored and we do not know what people with diabetes need in relation to support and education. Therefore, the aim of this study was to understand the experiences, perceptions and beliefs of what is important to a person with diabetes, in order to effectively self-care manage.
A qualitative enquiry was undertaken, using a grounded theory approach to underpin sampling, data collection and analysis. Seventeen participants with type 2 diabetes were interviewed using a conversational style approach. Formal ethical approval was obtained from the NHS National Research Ethics Service and the University of Salford Research and Ethics Committee. All participants gave consent prior to data collection.
Five principal concepts emerged from the data:
i) Education, what education?
ii) Why can’t they just tell you what diabetes is?
iii) They just tell you what to do, they never ask about me
iv) I just wanted a leaflet I could read and understand, they make you feel stupid
v) I just carry on as normal
The key theory to emerge illustrated that at the point of diagnosis limited significance was placed on the self-care management of type 2 diabetes. This study has revealed for the first time, that due to the apparent lack of significance the participants placed on type 2 diabetes, people do not sufficiently engage in appropriate self-care management. The participants did not necessarily view type 2 diabetes as a chronic condition due to experiencing little or no signs or symptoms, pre or post diagnosis. Despite the lack of full acceptance, participants passively recognised that ‘something needed to be done.’ Participants expressed a desire to be treated as a person with diabetes rather than the clinician’s focus on treating the disease in a generic manner.
The theory suggests that there is a crucial and urgent need for timely, person focused, tailored information to be communicated effectively. Person centered care delivered in this way would maximise the effectiveness of self-care management in order to reduce the risk of serious consequences of diabetes.
Further research opportunities could investigate the dialogue that takes place between healthcare professionals and individuals with type 2 diabetes. By establishing the individual’s comprehension of the information or education provided, this may afford a greater insight into patient understanding towards self-care management.
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