title: Perceptions of diabetes, barriers to disease management, and service needs: a focus group study of working adults with diabetes in Hawaii.
abstract: BACKGROUND
  Research about the support needs for and barriers to successful disease management of working adults with diabetes is limited. Our objective was to gain an in-depth understanding of how working adults in Hawaii perceive diabetes, barriers to disease management, and the services needed to keep people healthy and working.
  
  
  METHODS
  From November 2008 through March 2009, we conducted focus group interviews with 74 employed adults with diabetes enrolled in the Hawaii Demonstration to Maintain Independence and Employment project. Responses to questions were analyzed within and across groups to identify recurring themes. A third layer of analysis examined themes across responses to all questions, specifically, how barriers related to identified service needs.
  
  
  RESULTS
  Employed participants with diabetes experienced pervasive effects on their lives as a result of the disease, although they interpreted these effects positively or negatively. Barriers to disease management, such as additional health issues, social prejudice, and lack of social support, indicated a need to educate the general public about the disease. Participants identified needing social support from other people with diabetes, psychological support to address the emotional side of diabetes, and coordinated teams of specialists to address medication side effects and other health-related barriers to disease management. Many participants discussed the challenge of integrating diabetes management with work and family responsibilities and the need for monetary support.
  
  
  CONCLUSIONS
  This study provides insight into how employed adults perceived their disease and what they perceived as challenges to successfully managing diabetes. The findings provide future directions for community and workplace diabetes initiatives.
authors.affiliation: Center on Disability Studies, University of Hawaii at Manoa, Honolulu, HI 96822, USA. lfukunag@hawaii.edu
authors.forename: Landry L
authors.initials: LL
authors.lastname: Fukunaga
authors.forename: Denise L
authors.initials: DL
authors.lastname: Uehara
authors.forename: Tammy
authors.initials: T
authors.lastname: Tom
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D006293:Health Promotion; D006296:Health Services / Q000600:supply & distribution; D006801:Humans; D008297:Male; D008875:Middle Aged; D044468:Native Hawaiian or Pacific Islander; D010349:Patient Compliance; D055815:Young Adult