‘Change means sacrificing a good life’: perceptions about severity of type 2 diabetes and preventive lifestyles among people afflicted or at high risk of type 2 diabetes in Iganga Uganda

Abstract

BackgroundInterventions for prevention of type 2 diabetes ought to be acceptable to target communities. We assessed perceptions about type 2 diabetes and lifestyle change among people afflicted or at high risk of this disease in a low income setting in Iganga Uganda.MethodsTwelve focus group discussions (FGDs) of eight participants each were conducted, balancing rural and peri-urban (near the Municipality) residence and gender. The FGDs involved people with suspected type 2 diabetes (based on fasting plasma glucose (FPG), people with suspected pre-diabetes and obese people with normal FPG. Content analysis was conducted.ResultsDiabetes was perceived to be a very severe disease. Its severity was attributed to its incurability and its numerous health effects. Men were also concerned about reduced sexual performance. However, participants’ strong concerns about the severity of diabetes were not reflected in their perceptions about the risk factors and lifestyles associated with it. While people with diabetes perceive obesity as ‘sickness’, those without diabetes perceive it as a sign of ‘success’. Although participants are willing to change their diet, they mention numerous barriers including poverty, family size, and access to some foods. Because of their good taste, reduction of high risk foods like sugar and fried food is perceived as ‘sacrificing a good life’. Increments in physical activity were said to be feasible, but only in familiar forms like domestic work. An over-arching theme emerged that ‘lifestyle changes are viewed as sacrificing a good life’.ConclusionsHealth promotion should target both community norms and individual awareness regarding obesity, physical activity and diet, and should address the notion that obesity and unhealthy foods represent a good life. Health educators should plan with clients on how to overcome barriers and misconceptions to lifestyle change, leveraging the pervasive perception of type 2 diabetes as a severe disease to motivate change.

Adherence challenges encountered in an intervention programme to combat chronic non-communicable diseases in an urban black community, Cape Town

“…These findings are in line with those reported in previous studies that healthy food is perceived to be costly and that readily available foods in an area influence eating behaviour (Farhamand, Tehrni, Amiri, & Azizi, 2012;Mayega et al, 2014;Muzigaba & Puoane, 2014;Verstraeten et al, 2014).…”

“…Similarly, previous research showed that the implementation of, and adherence to lifestyle changes are influenced by people's social environment and personal characteristics (Levesque, Li, & Pahal, 2012;Mayega, Etajak, Rutebemberwa, Tomson, & Kiguli, 2014;Muchiri, Gericke, & Rheeder, 2012;Steyl & Phillips, 2014). Participants also questioned the benefits of health interventions probably because of clearly visible consequences of not conforming to recommended actions not being disseminated.…”

Perceived severity of diabetes and associated factors among patients attending a referral hospital in Port Harcourt, Nigeria

“…23 Most studies on perception of severity of diabetes explored the several dimensions of the health belief model, including perceived susceptibility, perceived severity, perceived benefits, perceived barriers, as they impinge on patients' health actions and behaviours including self-care activities. 12,13,[15][16][17][18][24][25][26] This study is thus limited by investigating only perceived severity, although other researchers have as well examined subdimensions of the health belief model among diabetes patients. [27][28][29] The variables relating to perception of severity of diabetes that the study measured showed acceptable interactions between the items and our composite measure of perceived severity.…”

“…11 Perceived severity has been reported to be associated with adherence with diabetes self-care behaviours. [14][15][16][17][18] The importance of studying self-perception of disease severity lies in the fact that individuals are more likely to modify their behaviours if they perceive that they are susceptible to developing diabetes, or that the consequences of developing diabetes are severe. 14 A study in Iran among diabetes patients at a care centre reported that perceived susceptibility and severity predicted 12.1% of variances in self-care management.…”

Pattern and correlates of obesity among public service workers in Ondo State, Nigeria: a cross-sectional study

“…Some African women still wrongly perceive being obese or overweight as a sign of affluence. 10,31,32 Also, women have also been shown to be less active than men. 16,33 Given the significant role played by physical activity in maintaining energy balance, obesity is therefore unavoidable in the presence of physical inactivity.…”