What are the self-management experiences of the elderly with diabetes? A systematic review of qualitative research

Abstract

BACKGROUND The number of elderly individuals with diabetes is dramatically increasing. Diabetes is a long-term condition and a noncommunicable disease and requires intensive daily self-management. Understanding of self-management from the patients’ perspectives is important to nurses, healthcare providers, and researchers and benefits people by improving their self-management skills. AIM To examine and synthesize qualitative studies that explore the experiences of elderly people in self-managing diabetes. METHODS Electronic databases were searched, including MEDLINE, CINAH, PsycINFO, PubMed, CNKI, and WANFADATA. Relevant research was identified by manually searching reference lists and gray literature. Only English and Chinese publications were included. The Critical Appraisal Skills Program was used to assess the quality of the research. The Confidence in the Evidence from Reviews of Qualitative research approach was used to assess the confidence of the findings. RESULTS A total of 10 qualitative studies were included, and content analysis was performed. Five themes were identified: The need for knowledge about diabetes care, support systems, functional decline, attitudes toward diabetes, and healthy lifestyle challenges. CONCLUSION This present review provides a deep and broad understanding of the experiences in the self-management of diabetes and can be valuable to nursing practice and provide recommendations for future research.

Financial protection and equity in the healthcare financing system in Iran: a cross-sectional study among slum dwellers with type 2 diabetes

“…According to a study in Delhi, even though T2D is common in slums, it fails to be adequately understood, treated and controlled among the elderly 36. The results of a systematic review showed that there are five themes for diabetes self-management among elderly patients including the need for information on T2D care, support from the health system and social, functional decline, attitude of persons with T2D and challenges of adopting a healthy lifestyle 37. As a result, elderly patients need more financial, social and informational support from the health system, society and government.…”

Sex differences in the reciprocal relationship between glycemic control and depressive symptoms among older adults with diabetes: Using a nationwide population‐based sample

“…7,8 However, older adults are more likely to experience disease burden in dealing with physical and emotional symptoms, which is related to the contradictory information provided by multiple healthcare providers, 9 the possibility of functional decline, and whether there is an accessible support system. 10 To decrease the disease burden of diabetes in older adults, individualized interventions are urgently required.…”

“…Older adults diagnosed with diabetes need to perform regular daily management tasks such as considering meal timings, diet content, and daily injections, and to perform these tasks for the rest of their lives 7,8 . However, older adults are more likely to experience disease burden in dealing with physical and emotional symptoms, which is related to the contradictory information provided by multiple healthcare providers, 9 the possibility of functional decline, and whether there is an accessible support system 10 . To decrease the disease burden of diabetes in older adults, individualized interventions are urgently required.…”

Activities of daily living and its influencing factors for older people with type 2 diabetes mellitus in urban communities of Fuzhou, China

“…Older T2DM patients were found to have an accelerated decline in leg lean mass, muscle strength and functional capacity when compared with normoglycemic control groups ( 5 ). Evidence has shown that T2DM is an independent risk factor for functional limitations among the older population ( 6 ), impairing about 60% of activities of daily living (ADL) for diabetic people aged>65 years compared with only 34% for the same age group without T2DM in the USA ( 7 ), especially among older Mexican Americans with T2DM ( 8 ). Moreover, T2DM patients were two to three times more likely to suffer from disability than their counterparts ( 9 ), and utilized healthcare services more frequently as well.…”

“…Effective diabetes self-management is critical for maintaining health and preventing the occurrence of further diabetes-related complications such as diabetic ketoacidosis, hypoglycemia, cardiovascular diseases, retinopathy, nephropathy, vascular nephropathy, and foot complications ( 6 ). However, self-management can be especially challenging for elderly people with T2DM, as they are more likely to suffer from functional limitations and develop geriatric syndromes than those without diabetes ( 8 , 9 ).…”