<p>Barriers to Self-Management of Type 2 Diabetes During COVID-19 Medical Isolation: A Qualitative Study</p>

Abstract

Purpose: Diabetes self-management behaviors are necessary to obtain optimum glycemic control, reduce the risk of complications, and improve health outcomes. The COVID-19 pandemic imposes an additional struggle for self-management by diabetes patients. Although previous studies have reported socio-demographic, behavioral, psychological, and cultural barriers to diabetes self-management, little is known about perceived barriers to diabetes self-management among patients during isolation following their recovery from COVID-19. The purpose of this study was to explore perceived barriers among type 2 diabetes patients during isolation following their recovery from COVID-19. Patients and Methods: A qualitative, exploratory, and descriptive research design was utilized. Semi-structured telephonic interviews were conducted with 12 patients with diabetes who had been discharged from one COVID-19 designated hospital and underwent isolation in the designated facilities in Wuhan City, Hubei Province, China. Data were analyzed using Colaizzi's seven steps. Results: Barriers to diabetes self-management identified by patients with diabetes during isolation were categorized into five major themes: inadequate knowledge and behavioral beliefs, shortage of resources, suffering from health problems, negative emotions, and lack of support. Conclusion: Perceived barriers to diabetes self-management described by diabetes patients indicated a lack of environmental resources and support strategies to meet their needs. Efforts to remove barriers are important in assisting patients with diabetes to improve their quality of life and health outcomes.

The effect of the COVID-19 pandemic on self-management in patients with type 2 diabetics

“…It was found that the fasting blood sugar values of individuals in the control group were higher than those of individuals in the intervention group. Also, although no significant difference was found in diastolic and sistolic blood pressure values in the control group in the COVID-19 pandemic compared with the beginning, a significant decrease was seen in the intervention group [3]. Thus, it can be said that the traditional face-to-face medical treatment needs of the individuals with type 2 diabetes participating in our study could not be met.…”

“…In order to protect themselves during the outbreak, diabetic patients are spending more time indoors. Measures taken during the COVID-19 pandemic, isolation and social distancing restrictions have made it difficult for people with diabetes to exercise regularly and remain physically active [3,6]. In this time, many diabetics have chosen to delay or cancel their health service appointments.…”

“…It can be said that factors such as inadequate self-management skills, irregular nutrition, a decrease in physical activity and an increase in stress and anxiety levels make the management of blood sugar and blood pressure more difficult. In a randomized controlled study, Kang et al [3] researched the effectiveness in diabetic individuals of management at a distance over a period of three months by mobile phone using the WeChat app on comprehensive diabetic management. It was found that the fasting blood sugar values of individuals in the control group were higher than those of individuals in the intervention group.…”

“…Item 16 is not included in any subscales. The scale includes four subscales: glucose management (1,4,6,10,12), diet control (2,5,9,13), physical activity (8,11,15), and use of health services (3,7,14).…”

“…Thus, it is a significant health problem which constitutes a heavy burden on society [11][12][13]. The worry of diabetic individuals about going to a hospital during the pandemic makes it more difficult for health professionals to monitor them and to support their self-confidence [3,14]. Holistic self-management in diabetes includes regular glucose monitoring, medical nutrition treatment, adherence to regular drug use, and self-care behaviors ensuring adherence to physical activity [11,13].…”