The internal realities of individuals with type 2 diabetes  – a functional framework of self-management practices via Grounded Theory approach

Abstract

BackgroundAn upward trend is observed in the prevalence of Type 2 diabetes (T2D) in South-East Asian and Western Pacific regions. These patterns incur a costly health burden to developing nations around the world. A clear understanding of the mechanics behind self-management practices of T2D patients might help overcome this impasse. This information can help unlock specific problem areas that warrant specific intervention. We aim to uncover prevailing T2D self-management habits and its deviations from optimal behaviour.MethodsWe adopted a Grounded Theory approach to guide in-depth interviews (IDI) with T2D patients and healthcare providers (HCP) at a regional primary care clinic in Malaysia. Twenty-four T2D patients and 10 HCPs were recruited through purposive sampling to examine their inner psychological narratives related to self-management practices. 2 focus group discussions (FGD) were conducted as a part of the data triangulation process.ResultsA functional framework for self-management practices in T2D patients was developed. Self-management behavior was characterized by 2 major processes– 1) helpful and, 2) unhelpful practices. Self-efficacy, taking responsibility and being rational define helpful behaviour in these patients. On the other hand, unhelpful traits (neglect, poor restraint, and experimentation) often trigger violations with regards to medication compliance and therapeutic lifestyle changes.ConclusionsWe outlined a roadmap that navigates through the positive and negative mindset in relation to self-management practices of T2D patients. These results highlight the importance of devising individualized strategies by taking into account the personal challenges, emotions, and motivations that define the inner self of the patient.

The external realities of people with type 2 diabetes—Understanding disease perspective and self-management behaviour via Grounded Theory Approach

“…The results from this study is an extension of a larger qualitative inquiry designed to decipher the intricate web of interaction behind the dynamics of self-management practices in people with T2D [ 10 , 11 ]. This article demonstrates that self-management behaviour in individuals with T2D consists of a rich interplay between factors associated with their external reality, inner psychological environment, and appropriate behavioural mediators ( Fig 1 ) [ 10 , 11 ]. More importantly, we have clearly delineated the thoughts and beliefs concerning the external realities that affect the daily lives of people with T2D.…”

“…This study builds upon a larger initiative to create a comprehensive qualitative framework that describes the characteristics of disease management in people with T2D [ 10 , 11 ]. In previous papers, we have expounded on the drivers of ’internal realities’ related to self-management behaviour [ 10 , 11 ]. This analysis led to the discovery of 2 main categories– 1) internal reality (the inner psychological environment and personal volition), and 2) salient mediators that govern this behaviour ( Fig 1 ).…”

The Internal Realities of Individuals With Type 2 Diabetes: Mediators Influencing Self-Management Beliefs via Grounded Theory Approach

“…On the other hand, the hypotheses generated from our study using theory-building techniques (Figure 1 and Appendix A) clearly outlines the mediators of self-care behavior in the form of actionable codes that are amenable to the development of a realistic psychometric inventory. 14,24 This specifically designed inventory can help to identify predictors of self-management behaviour and facilitate the implementation of targeted behavioral change interventions in people with T2D.…”

Crowdsourcing Users’ Comments for Clinical and Operational Features Analysis of Diabetes Mobile Apps

“…It is important to state that grounded theory has been used for numerous studies relating to diabetes such as the exploration of the sources of information for newly diagnosed patients with diabetes [46]. The psychological narratives of diabetes self-management and the efficacy of different practices needed for the successful implementation have also been studied with grounded theory [47] while treatment selection for diabetes type 2 was determined by other researchers [48]. Giving the importance of this technique and its previous use for assisting an understanding around the barriers to effective utilization and adoption of mobile apps for mental health [49] to evaluate the effectiveness of different treatment options, we affirm that it will provide a viable option for understanding the challenges of DMAS.…”