Redefining diabetes and the concept of self-management from a patient’s perspective implications for disease risk factor management

• Published in: Health education research Vol. 33; no. 1; pp. 40 - 54
• Main Authors: Masupe, T. K., Ndayi, K., Tsolekile, L., Delobelle, P., Puoane, T.
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.02.2018
• Subjects: Adult; Adults; Aged; Cultural Influences; Definitions; Diabetes; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - psychology; Diabetes Mellitus, Type 2 - therapy; Exercise; Female; Focus Groups; Foreign Countries; Health Behavior; Health Education; Health Services; Health technology assessment; Healthy Diet; Humans; Hypertension - epidemiology; Interviews; Knowledge Level; Life Style; Male; Middle Aged; Original; ORIGINAL ARTICLES; Patient Acceptance of Health Care; Perception; Phenomenology; Qualitative Research; Risk Factors; Self Management; Self-Management - psychology; Social Influences; Socioeconomic Factors; South Africa; South Africa (Cape Town); South Africa
• ISSN: 0268-1153; 1465-3648
• DOI: 10.1093/her/cyx077

The colliding epidemics of non-communicable diseases including diabetes with chronic infectious diseases in Sub-Saharan Africa requires contextualized innovative disease management strategies. This qualitative study conducted in a peri-urban township near Cape Town, South Africa aimed to identify and gain in-depth understanding of contextual and environmental issues pertinent to the patient that could influence Type 2-diabetes mellitus (T2DM) care and self-management. Participants included purposively sampled diabetics or pre-diabetics from the community, PURE study database, facility health club and health care providers. Data collection employed in-depth interviews, focus group discussions (FGDs) using structured interviews and FGD topic guides. Thematic data analysis was done to identify recurrent themes. Themes identified: knowledge and awareness about T2DM; health-seeking behaviour; weight perceptions; healthy lifestyles; self-management; health education needs and health care provider experiences. Patients defined T2DM as a physically and emotionally dangerous disease caused by socio-cultural factors, influenced by the sufferers’ food and socio-cultural environment with significance placed on physical, social and emotional effects of T2DM diagnosis. Patientcentred definition of T2DM is key to enhancing T2DM self-management. Patients suggested that personally rewarding benefits of physical activity and healthy diet such as anti-ageing, brain boosting, energy boosting which are commonly harnessed by food, tobacco and beauty industry should be considered in T2DM self-management strategies.