A qualitative study of problem solving and diabetes control in type 2 diabetes self-management.
The purpose of this study was to explore and compare diabetes-related problem solving in urban African Americans in good and poor diabetes control.



Two focus groups were conducted, one with participants in good diabetes control and one with participants in poor control. Based on a theoretical model, focus group interview questions were designed to elicit responses about 3 aspects of diabetes-related problem solving: (1) problem-solving orientation, (2) problem-solving process, and (3) transfer of past experience. Transcripts were analyzed using a qualitative data analysis software program, and expert panel members independently reviewed responses and coding.



The primary types of problems with diabetes self-management were similar in the good control and poor control groups. Predominant problem-solving themes in the good control group reflected a positive orientation toward diabetes self-management and problem solving, a rational problem-solving process, and a positive transfer of past experience. In contrast, predominant themes in the poor control group revealed a negative orientation, careless and avoidant problem-solving processes, and negative transfer of past learning to new situations.



The problem-solving model may help identify ineffective problem-solving patterns in persons with poor diabetes control. Empirical studies testing the model are warranted.
Hill-Briggs
Felicia
F
Department of Physical Medicine and Rehabilitation, Johns Hopkins Medical Institutions, Baltimore, Maryland
Cooper
Denise C
DC
Department of Psychology, University of Maryland Baltimore County, Baltimore
Loman
Kimberly
K
Ms Loman was affiliated to Johns Hopkins Medical Institutions. She currently is with Medtronic MiniMed, Northridge, California
Brancati
Frederick L
FL
Departments of Medicine and Epidemiology, Johns Hopkins Medical Institutions, Baltimore, Maryland
Cooper
Lisa A
LA
Department of Psychology, University of Maryland Baltimore County, Baltimore
D001741:Black or African American / Q000193:education / Q000523:psychology*; D000368:Aged; D001294:Attitude to Health / Q000208:ethnology*; D001362:Avoidance Learning; D015142:Baltimore; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology / Q000517:prevention & control*; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D009341:Negativism; D015404:Nursing Methodology Research; D010353:Patient Education as Topic; D011340:Problem Solving; D036301:Qualitative Research; D012648:Self Care / Q000379:methods / Q000523:psychology*; D014163:Transfer, Psychology; D014505:Urban Population