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Open Access Highly Accessed Research article

Self-management of type 2 diabetes mellitus: a qualitative investigation from the perspective of participants in a nurse-led, shared-care programme in the Netherlands

Albine Moser1*, Harry van der Bruggen2, Guy Widdershoven1 and Cor Spreeuwenberg3

Author Affiliations

1 Department of Health Ethics and Philosophy, Care and Public Health Research Institute, Maastricht University, The Netherlands

2 Department of Nursing Science, Care and Public Health Research Institute, Maastricht University, The Netherlands

3 Department of Health Care Studies, Care and Public Health Research Institute, Maastricht University, The Netherlands

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BMC Public Health 2008, 8:91  doi:10.1186/1471-2458-8-91

Published: 18 March 2008

Abstract

Background

Diabetes mellitus is a major public health problem. Little is known about how people with type 2 diabetes experience self-management in a nurse-led, shared-care programme. The purpose of this article is to report an empirically grounded conceptualization of self-management in the context of autonomy of people with type 2 diabetes.

Methods

This study has a qualitative descriptive, and exploratory design with an inductive approach. Data were collected by means of in-depth interviews. The sample consisted of older adults with type 2 diabetes in a nurse-led, shared-care setting. The data analysis was completed by applying the constant comparative analysis as recommended in grounded theory.

Results

People with type 2 diabetes use three kinds of self-management processes: daily, off-course, and preventive. The steps for daily self-management are adhering, adapting, and acting routinely. The steps for off-course self-management are becoming aware, reasoning, deciding, acting, and evaluating. The steps for preventive self-management are experiencing, learning, being cautious, and putting into practice. These processes are interwoven and recurring.

Conclusion

Self-management consists of a complex and dynamic set of processes and it is deeply embedded in one's unique life situation. Support from diabetes specialist nurses and family caregivers is a necessity of self-managing diabetes.