How patients adapt diabetes self-care recommendations in everyday life.
BACKGROUND
Our study explored behavioral factors affecting what patients with type 2 diabetes do for self-care and why they do it. The findings were used to develop clinical recommendations to improve intervention strategies.


METHODS
Interviewers, using open-ended questions, explored patients' own perceptions and assessments of self-care behaviors. The fifty-one subjects were self-identified Mexican Americans who had type 2 diabetes for at least 6 months, and had no major impairment as a result of this diabetes. Texts of patient interviews were analyzed by building and refining matrixes to display and compare central themes regarding treatment strategies and their contexts.


RESULTS
All patients were trying to control their diabetes, but none of them followed recommendations completely. Instead, they adapted self-care behaviors to the exigencies of everyday life. Key factors influencing patients' treatment choices were: (1) the belief in the power of modern medicine; (2) the desire to act and feel "normal"; (3) the desire to avoid physical symptoms; and (4) limited economic resources.


CONCLUSIONS
As patients apply treatment recommendations in the context of their everyday lives, they continually must make many small decisions affecting self-care behavior. The specific contexts of patients' lives, including their economic, educational, and cultural circumstances, determine how the generalized principles of type 2 diabetes management are implemented. Clinical strategies must be responsive to these circumstances in order to enable patients to make appropriate decisions when adapting their self-care behaviors to their own situations.
Hunt
L M
LM
School of Nursing, University of Texas Health Science Center at San Antonio 78284-7947, USA. huntl@uthscsa.edu
Pugh
J
J
Valenzuela
M
M
D000328:Adult; D000368:Aged; D001294:Attitude to Health; D001786:Blood Glucose / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000208:ethnology / Q000523:psychology* / Q000628:therapy*; D003927:Diet, Diabetic; D005260:Female; D015438:Health Behavior; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D017058:Mexican Americans / Q000523:psychology*; D008875:Middle Aged; D011203:Poverty; D012648:Self Care / Q000523:psychology; D012959:Socioeconomic Factors; D013781:Texas
D001786:Blood Glucose; D007004:Hypoglycemic Agents