Barriers to diabetes self-management in primary care settings – Patient perspectives: Phenomenological design

Abstract

Background: Type 1 diabetes mellitus (T1DM) is an autoimmune disease with a genetic component. Type 1 diabetes mellitus occur due to destruction of pancreatic β-cells, culminating in absolute insulin deficiency. Patients with T1DM need to follow a structured self-management plan including insulin use, blood glucose monitoring, physical activity, and a healthy diet. Objective: To explore perceived barriers to diabetes self-management among adolescents with T1DM attending diabetic clinics at Thika and Kiambu level 5 hospitals. Design: Phenomenological study design. Participants: A total of 40 adolescents aged 10 to 19 years with T1DM were included in the study. Methods: Purposive sampling was used to select adolescents with T1DM from the study areas. Focus group discussion was conducted to collect qualitative data. Content analysis was used to analyze the qualitative data. Results: Five major themes and 14 sub-themes were identified as perceived barriers to diabetes self-management. The five major themes were dynamic and chronic nature of diabetes, personal attributes, inadequate knowledge and skills on diabetes self-management, lack of motivation to perform diabetes self-management and emotional distress. Conclusions: Frequent health education on diabetes self-management for adolescents with T1DM need to be offered by health care workers. Health care workers should refer adolescents with T1DM to self-help support groups for counseling and emotional support.

Keywords

• Adolescents
• Barriers
• Self management
• Type 1 diabetes mellitus