Education and self-management for people newly diagnosed with type 2 diabetes: a qualitative study of patients' views.
OBJECTIVE
We explored the perceptions, views and experiences of diabetes education in people with type 2 diabetes who were participating in a UK randomized controlled trial of methods of education. The intervention arm of the trial was based on DESMOND, a structured programme of group education sessions aimed at enabling self-management of diabetes, while the standard arm was usual care from general practices.


METHODS
Individual semi-structured interviews were conducted with 36 adult patients, of whom 19 had attended DESMOND education sessions and 17 had been randomized to receive usual care. Data analysis was based on the constant comparative method.


RESULTS
Four principal orientations towards diabetes and its management were identified: 'resisters', 'identity resisters, consequence accepters', 'identity accepters, consequence resisters' and 'accepters'. Participants offered varying accounts of the degree of personal responsibility that needed to be assumed in response to the diagnosis. Preferences for different styles of education were also expressed, with many reporting that they enjoyed and benefited from group education, although some reported ambivalence or disappointment with their experiences of education. It was difficult to identify striking thematic differences between accounts of people on different arms of the trial, although there was some very tentative evidence that those who attended DESMOND were more accepting of a changed identity and its implications for their management of diabetes.


CONCLUSIONS
No one single approach to education is likely to suit all people newly diagnosed with diabetes, although structured group education may suit many. This paper identifies varying orientations and preferences of people with diabetes towards forms of both education and self-management, which should be taken into account when planning approaches to education.
Ockleford
Elizabeth
E
Social Science Group, Department of Health Sciences, University of Leicester, 22-28 Princess Road West, Leicester, LE1 6TP, UK. emo1@leicester.ac.uk
Shaw
Rachel L
RL
Willars
Janet
J
Dixon-Woods
Mary
M
D003924:Diabetes Mellitus, Type 2 / Q000523:psychology* / Q000628:therapy; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010342:Patient Acceptance of Health Care / Q000523:psychology; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods*; D036301:Qualitative Research; D016032:Randomized Controlled Trials as Topic; D012648:Self Care / Q000523:psychology*; D006113:United Kingdom