People with type 2 diabetes struggling for self-management: A part study from the randomized controlled trial in RENEWING HEALTH.
Lis Ribu, Marit Rønnevig, Juliet Corbin
PMID 31367434WHAT IT FOUND
People with type 2 diabetes described self-management as a daily struggle between what they wanted to do and what they ought to do.
Nurses can assess each person's situation and tailor support, because some need checking, some need strategies, and some need tighter follow-up.
Key findings
01The core theme was a constant struggle between what participants wanted to do and what they felt they ought to do.
02The analysis identified three situations: less struggle, more struggle with vacillation, and giving up the struggle.
03Some participants in the more struggling group described lacking competent and caring support, including a diabetes nurse who was unavailable.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Qualitative interviews cannot show whether any support approach improves diabetes outcomes or blood sugar control. Participants came from a larger randomized controlled trial in which volunteers were provided with smartphones with a diabetes diary app, so they may have been more motivated than people not in the trial. The study did not use theoretical sampling, which the authors state is a limitation for grounded theory. Only 26 participants were interviewed and only 24 interviews were analysed because of mechanical problems with the recorder. Many eligible people did not take part: 15 of the first 50 eligible did not participate, 7 of 35 willing declined, and 2 became too ill. Participants gave one interview each at the end of a year-long trial. The sample was limited to adults in Norway with HbA1c 7.1% or higher who could complete questionnaires in Norwegian.
Declared interests
The article states no conflict of interest declaration. It does not report funding sources.
The easy way to misread this
Do not read these themes as proof that tailored nurse support improves diabetes outcomes. The study asked patients about their experiences after an RCT and did not test an intervention or measure blood glucose results.