TY - JOUR

T1 - Preferring to manage by myself

T2 - A qualitative study of the perspectives of hardly reached people with type 2 diabetes on social support for diabetes management

AU - Bech, Laura K

AU - Borch Jacobsen, Camilla

AU - Mathiesen, Anne Sophie

AU - Thomsen, Thordis

N1 - © 2019 John Wiley & Sons Ltd.

PY - 2019/5

Y1 - 2019/5

N2 - AIMS AND OBJECTIVES: To explore the perspectives of hardly reached people with type 2 diabetes on social support for diabetes management from their formal and informal networks.BACKGROUND: People with low socioeconomic status and poorly controlled type 2 diabetes may be categorised as hardly reached. Social support is increasingly perceived to be a cornerstone in the management of type 2 diabetes. Few studies have, however, explored social support for diabetes management from the perspective of hardly reached people.METHODS: A qualitative design with individual semi-structured interviews captured the unique perspectives of hardly reached people. Data from 14 participants were analysed using conventional content analysis. The article adheres to the COREQ guidelines for reporting qualitative research.RESULTS: Participants preferred not to involve family and friends (the informal network) in diabetes management due to dysfunctional or lacking networks, existing norms and not wanting to burden vulnerable relationships. Others simply did not perceive themselves as sick and therefore saw no need for support. Opposed to this, participants wished for continuity and a personalised relationship with health professionals (the formal network). This entailed consultations that facilitated discussion of issues of importance to the participants.CONCLUSIONS: Hardly reached people with type 2 diabetes preferred to spare their informal networks from diabetes management. Instead, they wished for more presence and individualised support from health professionals.RELEVANCE TO CLINICAL PRACTICE: It appears timely to rethink the current "one-size-fits-all" approach for people with type 2 diabetes in order to allocate resources to those most in need. It is important that health professionals elicit perceptions of support needs and potential sources of support in hardly reached people with type 2 diabetes both from the formal and from informal networks in regard to managing their diabetes. To better reach hardly reached people with type 2 diabetes, specialised education of health professionals may be necessary to capture the complex underlying dynamics influencing disease management.

AB - AIMS AND OBJECTIVES: To explore the perspectives of hardly reached people with type 2 diabetes on social support for diabetes management from their formal and informal networks.BACKGROUND: People with low socioeconomic status and poorly controlled type 2 diabetes may be categorised as hardly reached. Social support is increasingly perceived to be a cornerstone in the management of type 2 diabetes. Few studies have, however, explored social support for diabetes management from the perspective of hardly reached people.METHODS: A qualitative design with individual semi-structured interviews captured the unique perspectives of hardly reached people. Data from 14 participants were analysed using conventional content analysis. The article adheres to the COREQ guidelines for reporting qualitative research.RESULTS: Participants preferred not to involve family and friends (the informal network) in diabetes management due to dysfunctional or lacking networks, existing norms and not wanting to burden vulnerable relationships. Others simply did not perceive themselves as sick and therefore saw no need for support. Opposed to this, participants wished for continuity and a personalised relationship with health professionals (the formal network). This entailed consultations that facilitated discussion of issues of importance to the participants.CONCLUSIONS: Hardly reached people with type 2 diabetes preferred to spare their informal networks from diabetes management. Instead, they wished for more presence and individualised support from health professionals.RELEVANCE TO CLINICAL PRACTICE: It appears timely to rethink the current "one-size-fits-all" approach for people with type 2 diabetes in order to allocate resources to those most in need. It is important that health professionals elicit perceptions of support needs and potential sources of support in hardly reached people with type 2 diabetes both from the formal and from informal networks in regard to managing their diabetes. To better reach hardly reached people with type 2 diabetes, specialised education of health professionals may be necessary to capture the complex underlying dynamics influencing disease management.

KW - Adult

KW - Attitude to Health

KW - Diabetes Mellitus, Type 2/psychology

KW - Female

KW - Humans

KW - Middle Aged

KW - Professional-Patient Relations

KW - Qualitative Research

KW - Self-Management/psychology

KW - Social Support

KW - Socioeconomic Factors

U2 - 10.1111/jocn.14783

DO - 10.1111/jocn.14783

M3 - Journal article

C2 - 30667563

VL - 28

SP - 1889

EP - 1898

JO - Journal of Clinical Nursing

JF - Journal of Clinical Nursing

SN - 0962-1067

IS - 9-10

ER -