title: Lifestyle change in type 2 diabetes a process model.
abstract: BACKGROUND
  Integration is an emerging concept in the study of self-management and chronic illness, yet this process and how it occurs is not well understood.
  
  
  OBJECTIVE
  This investigation, part of a triangulated study, focused on the experience of integrating type 2 diabetes treatment recommendations into an existing lifestyle while participating in a nurse-coaching intervention.
  
  
  METHODS
  An interpretive method elicited data from nurse-coaching sessions (4), field notes, and an interview in 9 women with type 2 diabetes. The process of data reduction and analysis (Miles & Huberman, 1994) was used to interpret data.
  
  
  RESULTS
  The core process of integrating lifestyle change in type 2 diabetes was multifaceted and complex. Challenges to the process of integrating lifestyle change included reconciling emotions, composing a structure, striving for satisfaction, exploring self and conflicts, discovering balance, and developing a new cadence to life. These challenges required acknowledgment in order for participants to progress toward integration.
  
  
  CONCLUSIONS
  Balance was an integral component to the experience of integration, between structure and flexibility, fear and hope, conflict and acceptance, diabetes and life. Conceptualizations identified with this investigation extend understanding of theories of integration and lifestyle change and invite the development and testing of nursing interventions.
authors.affiliation: Yale University School of Nursing, New Haven, CT 06536-0740, USA. robin.whittemore@yale.edu
authors.forename: Robin
authors.initials: R
authors.lastname: Whittemore
authors.forename: Susan K
authors.initials: SK
authors.lastname: Chase
authors.forename: Carol Lynn
authors.initials: CL
authors.lastname: Mandle
authors.forename: Callista
authors.initials: C
authors.lastname: Roy
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000451:nursing*; D004644:Emotions; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D016294:Models, Nursing; D009042:Motivation; D010353:Patient Education as Topic / Q000379:methods*; D010549:Personal Satisfaction; D012648:Self Care / Q000523:psychology