Redefining diabetes and the concept of self-management from a patient’s perspective: implications for disease risk factor management

Abstract

The colliding epidemics of non-communicable diseases including diabetes with chronic infectious diseases in Sub-Saharan Africa requires contextualized innovative disease management strategies. This qualitative study conducted in a peri-urban township near Cape Town, South Africa aimed to identify and gain in-depth understanding of contextual and environmental issues pertinent to the patient that could influence Type 2-diabetes mellitus (T2DM) care and self-management. Participants included purposively sampled diabetics or pre-diabetics from the community, PURE study database, facility health club and health care providers. Data collection employed in-depth interviews, focus group discussions (FGDs) using structured interviews and FGD topic guides. Thematic data analysis was done to identify recurrent themes. Themes identified: knowledge and awareness about T2DM; health-seeking behaviour; weight perceptions; healthy lifestyles; self-management; health education needs and health care provider experiences. Patients defined T2DM as a physically and emotionally dangerous disease caused by socio-cultural factors, influenced by the sufferers’ food and socio-cultural environment with significance placed on physical, social and emotional effects of T2DM diagnosis. Patient-centred definition of T2DM is key to enhancing T2DM self-management. Patients suggested that personally rewarding benefits of physical activity and healthy diet such as anti-ageing, brain boosting, energy boosting which are commonly harnessed by food, tobacco and beauty industry should be considered in T2DM self-management strategies.

<p>Polish Adaptation of the Self-Care of Diabetes Inventory (SCODI)</p>

“…A conscious patient who understands his or her role in the therapeutic process becomes an active participant in the fight against the disease. 4 The IDF Clinical Practice Recommendations for Managing Type 2 Diabetes in Primary Care guidelines of 2017 emphasise that diabetes education and self-care are the pillars of diabetes administration. 5 Nowadays, patientcentred care with self-care is an international problem which needs multidisciplinary team collaboration.…”

“…A conscious patient who understands his or her role in the therapeutic process becomes an active participant in the fight against the disease. 4 …”

A spotlight on the surfacing of self-management of employees with diabetes seen by professional nurses in selected occupational health clinics in Cape Town

“…Challenging the existing ‘one-size-fits-all’ mode of delivery of health promotion for patients with diabetes is a further measure to augment lifestyle adaptations. In support of an individualised health education provision, the manner in which patients define the recommendations for self-care and self-management should be explored rather than the interpretation of these concepts by health professionals (Masupe et al 2018 :52).…”

<p>Chinese Hospitalized Cardiovascular Patients’ Attitudes Towards Self-Management: A Qualitative Study</p>

“…A phenomenological design using semi-structured interviews was chosen. 22 Thematic analysis was used to produce the results, for the study aimed to gain a deeper understanding of the patients' attitudes towards self-management and perceived challenges when they were engaged in the management.…”