Diabetes Mellitus: Experiencing a Chronic Illness

Abstract

Diabetes is a chronic, complex disease involving numerous pathophysiological features. There is a paucity of studies relating to psychological factors. The available research is not conclusive and in addition is largely quantitative in nature. The aim of this investigation was to gain an understanding of the life-world of people with diabetes and to acquire insight into the demanding aspects of their lives. The research procedure involved interviewing subjects who suffer from diabetes. A pilot study was conducted in order to test a number of openended questions. On the basis of these results, a set of semi-structured questions was formulated for the main study. The main study involved interviews with 13 subjects aged between 20 and 45 years who belonged to a diabetic organization and who volunteered for the investigation. The interviews were recorded on audiotape and later transcribed. Five of the protocols obtained were analyzed according to the method outlined by Giorgi and they produced an encompassing description of the life-world of a diabetic. The themes which emerged included the appearance of the first symptoms and their effect on people with diabetes, the impact of the diagnosis, the emerging pattern of the life-world of people with diabetes and the prospects for the future. The phenomenological approach proved valuable in highlighting many aspects of diabetes. Recommendations are made which may be of benefit to people with diabetes and their families.Diabetes is 'n chroniese, komplekse siekte waarby verskeie patofisiologiese verskynsels betrokke is. Daar is baie min studies in verband met psigologiese faktore. Beskikbare navorsing lewer nie afdoende antwoorde nie en is boonop meestal kwantitatief van aard. As prosedure vir die huidige navorsing is onderhoude met mense met diabetes gevoer. Nadat 'n reeks loodsvrae vooraf getoets is, is 'n stel oop vrae gebaseer op die resultate van die toetsvrae vir die hoofstudie geformuleer. Die hoofstudie het onderhoude behels met 13 Iyers, tussen die ouderdomme van 20 en 45 jaar, en wat aan 'n organisasie vir diabete behoort en wat vrywillig aan die studie deelgeneem het. Die onderhoude is op oudioband opgeneem en later oorgetik. Die protokolle is ontleed volgens Giorgi se metode en het 'n omvattende beskrywing van die leet-wereld van 'n diabeet daargestel. Temas wat duidelik opval, sluit in die verskyning van die eerste simptome en die effek daarvan op die persoon, die skok wat met die diagnose gepaard gaan, die nuwe lewenspatroon wat die persoon moet volg en die vooruitsigte vir die toekoms. Die fenomenologiese benadering het waardevolle lig gewerp op baie van die aspekte van die siekte. Aanbevelings word gedoen wat moontlik vir persone met diabetes en hul gesinne van waarde kan wees.

The Relationship of Depression to Treatment Adherence, Quality of Life and Health Outcomes in Type 1 Diabetes Mellitus

“…With specific regard to diabetes, Ciechanowski, Katon, and Russo (2000) found that depression was associated with poorer adherence to dietary recommendations and medication regimes. Several investigators suggest that factors, such as disease duration or age of onset, are also important in altering compliance and health outcomes in diabetes (Cleaver & Pallourios, 1994;Jacobson & Hauser, 1983). However, fluctuating glycaemic or long-term complications can also deplete emotional strength and determination, creating a negative self-image, and consequently lowering adherence (Rubin, Walen, & Ellis, 1990).…”

Organizações Patológicas e Equilíbrio Psíquico em Pacientes Diabéticos Tipo 2

“…Muitos autores, como Krall (1983), Haynal (1983), Clayer & Harris (1985), Ebigo (1985), Jensen (1985), Dunn (1986), Davies (1989), Lima (1991), Heleno (1992), Kreger (1992), Vazquez et al (1994) e Cleaver & Pallourios (1994), têm demonstrado a importância dos aspectos psicológicos tanto no desencadeamento como no curso do diabetes mellitus. Ross (1987), revisando a literatura, aponta para um aspecto muito importante: o fato de um número significativo de casos terem o diagnóstico após situações de perda.…”