title: Fears and worries associated with hypoglycaemia and diabetes complications: perceptions and experience of Hong Kong Chinese clients.
abstract: OBJECTIVE
  This paper reports the second phase of a study that explored the perceptions and experience of Hong Kong Chinese insulin-treated clients who demonstrated fear of hypoglycaemia and worry about diabetes complications.
  
  
  BACKGROUND
  The first phase of the study, a descriptive survey (n = 120), identified 15% of respondents as simultaneously sustaining fears and worries associated with hypoglycaemia and diabetes complications. Although a small percentage, given the increasing number of clients using insulin treatment, this finding suggests a pocket of clients suffering from undesirable emotional health. However, a search of the literature identified few studies exploring Chinese clients' perceptions and experience in this area.
  
  
  METHODS
  The second phase of the study employed a purposive sampling method and semi-structured interviews to collect data from 13 participants experiencing these fears and worries. FINDINGS; Two researchers independently used content analysis to code and categorize data. Six categories identified were: the influence of perceptions of glycaemic control on emotion, hypo- and hyperglycaemia as a constant threat, keeping optimal glycaemic control or maintaining a working life, financial and psychological burden of blood glucose self-monitoring, being alone with the threat and finally distancing as the coping method. An overriding issue, a sense of losing control, emerged from the findings that described participants' perceptions and experience. This issue and two major health needs, developing self-efficacy and emotional support from nurses, were drawn from the findings for discussion. It is suggested that self-efficacy theory can be adopted as a conceptual framework to guide nursing practice for enhancing clients' capacity to exercise control over diabetes self-management.
  
  
  CONCLUSIONS
  Findings obtained from the second phase of the study illuminated those from the first phase. Implications for nursing practice were identified, including facilitating both technical and psychosocial self-efficacy, assessing clients' total life situation, strengthening competence in counselling skills and forming alliances with clients.
authors.affiliation: The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong, China. annshiu@cuhk.edu.hk
authors.forename: Ann Tak-Ying
authors.initials: AT
authors.lastname: Shiu
authors.forename: Rebecca Yee-Man
authors.initials: RY
authors.lastname: Wong
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000451:nursing / Q000523:psychology*; D005260:Female; D006723:Hong Kong; D006801:Humans; D007003:Hypoglycemia / Q000150:complications / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D012648:Self Care / Q000523:psychology; D020377:Self Efficacy