Salutogenic model of health to identify turning points and coping styles for eating practices in type 2 diabetes mellitus

Abstract

Background: It is important for people with Type 2 Diabetes Mellitus (T2DM) to eat healthily. However, implementing dietary advice in everyday life is difficult, because eating is not a distinguishable action, but a chain of activities, embedded in social practices and influenced by previous life experiences. This research aims to understand why and how eating practices are developed over the life-course by investigating influential life experiencesturning pointsand coping strategies for eating practices of people with T2DM. Methods: The Salutogenic Model of Health guided the study's objective, study design and analysis. Seventeen interviews were performed and analysed based on the principles of interpretative phenomenological analysis. Narrative inquiry and the creation of timelines and food boxes were used as tools to facilitate reflection on turning points and eating practices. Results: Turning points for unhealthier eating were experiences that strongly disturbed the participants' emotional stability. These experiences included psychosocial trauma, physical health disorders, job loss, and smoking cessation. Turning points for healthier eating were experiences that significantly changed participants views on life and made participants reflective about the effects of current eating practices on future health and life goals. These turning points included confrontation with ill-health, becoming a parent, psychosocial therapy, and getting married. Notably, turning points for healthier eating seemed only to happen when life was relatively stress-free. All participants experienced turning points for healthier eating, yet, not all participants succeeded in improving their diets. Two coping styles were distinguished: active and passive coping. Active coping individuals were able to act in line with their personal intentions, whereas passive coping individuals could not. Differences between active and passive coping styles seemed to be explained by differences in available resources important for adapting and maintaining a healthy diet.

Three Mediating Pathways of Anxiety and Security in the Relationship between Coping Style and Disordered Eating Behaviors among Chinese Female College Students

“…And there were significant differences in anxiety, sense of security, and disordered eating behaviors between positive coping style and negative coping style. These results correspond to previous research findings, which have indicated negative coping style could lead to more severe disordered eating behaviors [ 20 ], higher level of anxiety [ 21 ], and lower sense of security [ 22 ]. Next, when analyzing the mediating roles of anxiety and sense of security between coping style and disordered eating behaviors, we found an overall mediating role of 71.8%.…”

The COVID-19 Crisis as a Teachable Moment for Lifestyle Change in Dutch Cardiovascular Disease Patients

“…Consistent with previous studies, approximately one fifth of our sample reported increased motivation to improve their diet due to the pandemic. These findings add to the evidence base suggesting significant life events such as a disease diagnosis or becoming a parent are associated with improved eating behaviors (Polhuis et al, 2020 ). In contrast to previous studies (Chopra et al, 2020 ; Hu et al, 2020 ; Knell et al, 2020 ), the best-represented TM in our study related to improving physical activity, with a quarter expressing greater motivation to increase their activity.…”

“…Events that endanger positive expectations about their future self are usually experienced as most relevant to individuals, which in turn evoke greater behavioral responses (Aspinwall and Brunhart, 1996 ; McBride et al, 2003 ). In an extensive qualitative study, it was explained that major life events impacted an individual's outlook on life and thereby made them increasingly thoughtful regarding the effects of their current diet (Polhuis et al, 2020 ). Our finding that a higher level of altered self-concept was associated with increased intentions toward behavioral change provides evidence that the COVID-19 crisis induces a comparable effect.…”

Lifestyle Parameters in Patients with Diabetes Mellitus and in the General Adult Population—Trends over Five Years: Results of the Austrian National Health Interview Series

“…Additionally, circumstances change over time, as do lifestyle factors. Unforeseen, traumatic or positive events have additional impacts on lifestyle choices, such as eating habits, thereby influencing the adherence to recommendations [ 13 ]. Additionally, public health measures and policies to promote healthy lifestyles, such as anti-smoking policies [ 12 , 14 , 15 ], nutritional regulations [ 16 , 17 , 18 ], or policies to promote PA [ 19 , 20 ], have impacts on the health behaviour of people with and without DM.…”