A secondary qualitative analysis exploring the emotional and physical challenges of living with type 2 diabetes

Authors

  • Michelle Hadjiconstantinou Diabetes Research Centre, College of Life Sciences, University of Leicester
  • Helen Eborall University of Edinburgh
  • Jacqui Troughton Leicester Diabetes Centre, NHS Trust, University Hospitals of Leicester, Leicester, United Kingdom
  • Noelle Robertson School of Clinical Psychology, University of Leicester
  • Kamlesh Khunti Diabetes Research Centre, University of Leicester, College of Life Sciences
  • Melanie J Davies Diabetes Research Centre, University of Leicester, College of Life Sciences

DOI:

https://doi.org/10.15277/bjd.2021.309

Keywords:

qualitative, type 2 diabetes, biographical disruption, emotional wellbeing

Abstract

Background: Many feel that their new identity as ‘someone living with diabetes’ does not fit with their biography. Some individuals may be able to re-assess life goals, adapt their identity and adjust to living with type 2 diabetes mellitus (T2DM). For others, the biographical disruption experienced with their condition may negatively affect their emotional well-being and identity.

Aim: To conceptualise and explore the emotional challenges experienced living with T2DM, using biographical disruption as analytical references.

Design and setting: Secondary qualitative analysis of data collected from 31 semi-structured interviews.

Method: Semi-structured interviews were conducted with people with T2DM in England. Data analysis was informed by constant comparative techniques.

Results: People with T2DM undergo a cognitive process when their biography suddenly becomes interrupted. Suboptimal T2DM can bring a feeling of loss of control over one’s future, and loss of independence. What used to be perceived as ‘normal’ is now perceived as something that requires regular management, negatively impacting their daily routine and ability to carry out activities that once used to be effortless.

Conclusions: Living with T2DM that is socially stigmatised can lead to poor well-being and may disturb one’s life biography. Strategies must take place to bring awareness to healthcare professionals of the impact and disruption that T2DM can have on an individual’s biography, identity and diabetes management.

Author Biographies

Michelle Hadjiconstantinou, Diabetes Research Centre, College of Life Sciences, University of Leicester

Diabetes Research Centre, Research Associate, PhD

Helen Eborall, University of Edinburgh

Jacqui Troughton, Leicester Diabetes Centre, NHS Trust, University Hospitals of Leicester, Leicester, United Kingdom

Leicester Diabetes Centre, Senior Research Associate

Noelle Robertson, School of Clinical Psychology, University of Leicester

Schoole of Clinical Psychology, Professor

Kamlesh Khunti, Diabetes Research Centre, University of Leicester, College of Life Sciences

Diabetes Research Centre, Professor

Melanie J Davies, Diabetes Research Centre, University of Leicester, College of Life Sciences

Diabetes Research Centre, Professor

References

Diabetes UK. Facts and Figures 2020. Available from: https://www.diabetes.org.uk/Professionals/Position-statements-reports/Statistics

Cyrino AP, Schraiber LB, Teixeira RR. Education for type 2 diabetes mellitus self-care: from compliance to empowerment. Interface (Botucatu) 2009;13(30).

Bury M. Chronic illness as biographical disruption. Sociol Health Illn 1982;4(2):167–82. https://doi.org/10.1111/1467-9566.ep11339939

Locock L, Ziebland S. Mike Bury: Biographical disruption and long-term and other health conditions. In: Collyer F, ed. The Palgrave Handbook of Social Theory in Health, Illness and Medicine, Palgrave Macmillan, 2015.

Thorne S, Paterson B. Shifting images of chronic illness. Image J Nurs Sch 1998;30(2):173–8. https://doi.org/10.1111/j.1547-5069.1998.tb01275.x

Charmaz. K. Constructing grounded theory: a practical guide through qualitative analysis. London: Sage Publications, 2006.

Charmaz K. The body, identity, and self: adapting to impairment. The Sociological Quarterly 1995;36(4):657–80. https://doi.org/10.1111/j.1533-8525.1995.tb00459.x

Albrecht G, Fitzpatrick R, Scrimshaw SC, eds. The Handbook of Social Studies in Health and Medicine. London: Sage Publications, 2000.

Hubbard G, Forbat L. Cancer as biographical disruption: constructions of living with cancer. Support Care Cancer 2012;20(9):2033–40. https://doi.org/10.1007/s00520-011-1311-9

Ussher JM, Perz J, Miller A, et al. Threat of biographical disruption: the gendered construction and experience of infertility following cancer for women and men. BMC Cancer 2018;18(1):250. https://doi.org/10.1186/s12885-018-4172-5

Trusson D, Pilnick A, Roy S. A new normal?: Women's experiences of biographical disruption and liminality following treatment for early stage breast cancer. Soc Sci Med 2016;151:121–9. https://doi.org/10.1016/j.socscimed.2016.01.011

Early F, Lettis M, Winders S-J, Fuld J. What matters to people with COPD: outputs from Working Together for Change. npj Prim Care Respir Med 2019;29(1):11. https://doi.org/10.1038/s41533-019-0124-z

Jowsey T, Yen LE, Bagheri N, McRae IS. Time spent by people managing chronic obstructive pulmonary disease indicates biographical disruption. Int J Chron Obstruct Pulmon Dis 2014;9:87–97. https://doi.org/10.2147/COPD.S53887

Sanders T, Elliott J, Norman P, Johnson B, Heller S. Disruptive illness contexts and liminality in the accounts of young people with type 1 diabetes. Sociol Health Illn 2019;41(7):1289–304. https://doi.org/10.1111/1467-9566.12906

Pesantes MA, Somerville C, Singh SB, et al. Disruption, changes, and adaptation: experiences with chronic conditions in Mozambique, Nepal and Peru. Global Public Health 2020;15(3):372–83. https://doi.org/10.1080/17441692.2019.1668453

Estecha Querol S, Clarke P, Sattler ELP, Halford JCG, Gabbay M. Non-visible disease, the hidden disruptive experiences of chronic illness in adversity. Int J Qual Stud Health Well-being 2020;15(1):1857579. https://doi.org/10.1080/17482631.2020.1857579

Wilson AL, McNaughton D, Meyer SB, Ward PR. Understanding the links between resilience and type-2 diabetes self-management: a qualitative study in South Australia. Arch Public Health 2017;75(1):56. https://doi.org/10.1186/s13690-017-0222-8

Corbin J, Strauss A. Managing chronic illness at home: three lines of work. Qual Sociol 1985;8(3):224–47. https://doi.org/10.1007/BF00989485

Atkinson P. Illness narratives revisited: the failure of narrative reductionism. Sociol Res Online 2009;14(5):16. https://doi.org/10.5153/sro.2030

DESMOND (Diabetes education and self-management for ongoing and newly diagnosed) Ongoing study 2011. ISRCTN registry: http://www.isrctn.com/ISRCTN71467886

Korstjens I, Moser A. Series: Practical guidance to qualitative research. Part 4: Trustworthiness and publishing. Eur J Gen Pract 2018;24(1):120–4. https://doi.org/10.1080/13814788.2017.1375092

Ruggiano N, Perry TE. Conducting secondary analysis of qualitative data: Should we, can we, and how? Qual Soc Work 2017;18(1):81–97. https://doi.org/10.1177/1473325017700701

Archer A. Shame and diabetes self-management. Pract Diabetes 2014; 31(3):102–6. https://doi.org/10.1002/pdi.1842

Browne JL, Ventura A, Mosely K, Speight J. ‘I'm not a druggie, I'm just a diabetic’: a qualitative study of stigma from the perspective of adults with type 1 diabetes. BMJ Open 2014;4(7). https://doi.org/10.1136/bmjopen-2014-005625

Browne JL, Ventura A, Mosely K, Speight J. ‘I call it the blame and shame disease’: a qualitative study about perceptions of social stigma surrounding type 2 diabetes. BMJ Open 2013;3(11). https://doi.org/10.1136/bmjopen-2013-003384

Gredig D, Bartelsen-Raemy A. Diabetes-related stigma affects the quality of life of people living with diabetes mellitus in Switzerland: implications for healthcare providers. Health Soc Care Community 2017;25(5):1620–33. https://doi.org/10.1111/hsc.12376

Beverly EA, Ritholz MD, Brooks KM, et al. A qualitative study of perceived responsibility and self-blame in type 2 diabetes: reflections of physicians and patients. J Gen Intern Med 2012;27(9):1180–7. https://doi.org/10.1007/s11606-012-2070-0

Kadirvelu A, Sadasivan S, Ng SH. Social support in type II diabetes care: a case of too little, too late. Diabetes Metab Syndr Obes 2012;5:407–17. https://doi.org/10.2147/DMSO.S37183

Nicolucci A, Kovacs Burns K, Holt RI, et al. Diabetes Attitudes, Wishes and Needs second study (DAWN2): cross-national benchmarking of diabetes-related psychosocial outcomes for people with diabetes. Diabet Med 2013;30(7):767–77. https://doi.org/10.1111/dme.12245

Diabetes UK. Position Statement: Emotional and psychological support for people with diabetes. 2016. https://www.diabetes.org.uk/professionals/position-statements-reports/diagnosis-ongoing-management-monitoring/emotional-and-psychological-support-for-people-with-diabetes

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Published

2021-12-17

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Original Research

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