Qualitative and Quantitative Study on Components of Future Time Perspective and Their Association with Persistent Treatment for Type 2 Diabetes

Abstract

Introduction: Future time perspective (FTP) means the capacity to foresee, anticipate, and plan for future desired outcomes, and it contributes to persistent treatment for type 2 diabetes mellitus (T2DM). However, the components of FTP specific to T2DM patients have not been clarified. This study aimed to explore the components of FTP and to examine the associations between such components and persistent/impersistent diabetes treatment. Methods: In this cross-sectional study, using qualitative and quantitative methods, 106 T2DM patients were enrolled by purposive sampling. The participants were interviewed in October and November 2018 by public health nurses in Koriyama City Public Health Center, Japan. In addition to the participants' status of treatment engagement (persistent/impersistent), their responses regarding reasons for persistent/impersistent treatment were collected and then summarized into nine subthemes, which were then merged into two main themes according to the presence or absence of FTP with a sense of T2DM ownership for analysis. Results: The main theme, ''presence of FTP with a sense of T2DM ownership,'' included subthemes such as ''securing social independence,'' ''planning on living a long and healthy life,'' ''prioritizing avoiding being a burden on family and friends,'' ''valuing improvement of diabetes,'' ''avoiding tragic results,'' ''optimistically viewing treatment as a form of self-development,'' and ''improving mental health,'' whereas the main theme, ''absence of FTP with a sense of T2DM ownership,'' included ''lack of consciousness of disease'' and ''living a dissipated life.'' The association between the presence of FTP with a sense of T2DM ownership and persistent treatment for T2DM was found using Fisher's exact test (p \ 0.001). Conclusion: Health care professionals should support T2DM patients in having an FTP with a sense of T2DM ownership and purpose in life instead of treatment goals when such patients mention their dissipated life or lack of insight into the disease.

Perceived Future Outcomes of Unsuccessful Treatment and Their Association with Treatment Persistence Among Type-2 Diabetes Patients: A Cross-Sectional Content Analysis

“…The data in this cross-sectional study are consistent with those in a published study [ 19 ], as part of our research project. Using purposive sampling, the potential participants comprised 110 individuals aged ≥ 40 years who resided in Koriyama City, Fukushima Prefecture, Japan, as of 2018.…”

“…However, detailed knowledge of the association between T2DM outcomes and treatment persistence have yet to be clarified as Simmons et al [ 17 ] inquired only about medicine-related knowledge in exploring potential future problems of T2DM. Notably, the perception of a threat to T2DM outcomes is a key factor of treatment engagement among patients with T2DM [ 18 ], and such outcomes include poor-quality human relationships and social life, including heavy burden of family caregivers and discontinued employment [ 19 ].…”