PERCEPTIONS OF ADULTS WITH INSULIN-REQUIRING DIABETES OF FACTORS INFLUENCING THEIR SELF-MANAGEMENT (DIABETES MELLITUS).
Contributors: University of Georgia.
Published: 1990
Number of pages: 203
Subjects: Health Sciences, Nursing.; Health Sciences, Education.
Description: The purpose of this qualitative study was to identify factors perceived by insulin-requiring diabetic (IRD) adults as influencing their diabetes self-management. Twenty-six (13 male, 13 female) participants 26 to 68 years of age, with insulin-requiring diabetes for 3 to 45 years, 10 to 18 years of education, and an annual income of $10,800 to \$100,000 were interviewed. Based on glycosylated hemoglobin test results and interview data, 22 were in good to excellent diabetes control and four were in poor control.

A nonschedule standardized interview guide consisting of 46 primary questions about self-management activities, influences affecting self-management, and demographic information was used. A tape-recorded interview was conducted in the participants' location of choice (home, place of employment, university office) for an average of 90 minutes each.

Constant comparison data analysis was used with the grounded theory approach to data collection. Data analysis supports two theoretical statements: (a) Diabetes self-management behaviors of IRD persons are cyclical in that they are influenced by and influencers of the individual's experienced diabetes-specific factors (diabetes-driven affective responses, health expectations and realities, and regimen demands), personal meaning of diabetes (meaningfulness of coping with diabetes), resource availability (personal and professional support, educational, technological, financial), and a sense of unrelenting vulnerability; and (b) The success of diabetes self-management behaviors of IRD persons is most influenced by the individual's sense of unrelenting vulnerability and the availability of resources for management.

A sense of unrelenting vulnerability occurs when insulin-requiring diabetic persons replace denial with an acceptance of the reality posed by diabetes of its long-term complications if they do not make and follow through with positive self-management decisions. The more vulnerable they perceive themselves to be, the greater the tendency to engage in positive self-management behaviors, given the resources to do so. Two identified critical resources, with implications for the diabetes field, are sharing by significant others of the responsibility for diabetes management and lifestyle; and individualized, readily accessible, nonjudgmental, interactive communication with knowledgeable diabetes health professionals. Additional findings were (a) a frustration-cheat-repent cycle experienced by all participants, but with fewer and shorter cheat periods among the more successful self-managers, and (b) successful diabetes control can occur with varying combinations of self-management behaviors.
Notes: Source: Dissertation Abstracts International, Volume: 51-08, Section: B, page: 3774.

Thesis (PH.D.)--UNIVERSITY OF GEORGIA, 1990.

School code: 0077.