title: Personal accounts of the negative and adaptive psychosocial experiences of people with diabetes in the second Diabetes Attitudes, Wishes and Needs (DAWN2) study.
abstract: OBJECTIVE
  To identify the psychosocial experiences of diabetes, including negative accounts of diabetes and adaptive ways of coping from the perspective of the person with diabetes.
  
  
  METHODS
  Participants were 8,596 adults (1,368 with type 1 diabetes and 7,228 with type 2 diabetes) in the second Diabetes Attitudes, Wishes and Needs (DAWN2) study. Qualitative data were responses to open-ended survey questions about successes, challenges, and wishes for improvement in living with diabetes and about impactful experiences. Emergent coding developed with multinational collaborators identified thematic content about psychosocial aspects. The κ measure of interrater reliability was 0.72.
  
  
  RESULTS
  Analysis identified two negative psychosocial themes: 1) anxiety/fear, worry about hypoglycemia and complications of diabetes, depression, and negative moods/hopelessness and 2) discrimination at work and public misunderstanding about diabetes. Two psychosocial themes demonstrated adaptive ways of coping with diabetes: 1) having a positive outlook and sense of resilience in the midst of having diabetes and 2) receiving psychosocial support through caring and compassionate family, friends, health care professionals, and other people with diabetes.
  
  
  CONCLUSIONS
  The personal accounts give insight into the psychosocial experiences and coping strategies of people with diabetes and can inform efforts to meet those needs and capitalize on strengths.
authors: Department of Medicine, Pennsylvania State University College of Medicine, Hershey, PA hstuckey@hmc.psu.edu.
authors: Heather L
authors: HL
authors: Stuckey
authors: Public Health Evidence and Insights, Global Public Affairs, Novo Nordisk A/S, Copenhagen, Denmark.
authors: Christine B
authors: CB
authors: Mullan-Jensen
authors: Department of Endocrinology, Diabetes and Metabolic Diseases, Avicenne Hospital, and Centre de Recherche en Nutrition Humaine d'Ile-de-France, University Paris 13, Sorbonne Paris Cité, Bobigny, France.
authors: Gérard
authors: G
authors: Reach
authors: Interdisciplinary Health Research Academy, Edmonton Clinic Health Academy, University of Alberta, Edmonton, Canada.
authors: Katharina
authors: K
authors: Kovacs Burns
authors: Healthy Lifestyle Institute, Centro Universitario di Ricerca Interdipartimentale Attività Motoria, University of Perugia, Perugia, Italy.
authors: Natalia
authors: N
authors: Piana
authors: Departments of Family Medicine and Psychiatry, Dalhousie University, Halifax, Canada.
authors: Michael
authors: M
authors: Vallis
authors: Department of Medicine and Health Sciences, Primary and Interdisciplinary Care Antwerp, University of Antwerp, Antwerp, Belgium.
authors: Johan
authors: J
authors: Wens
authors: Steno Health Promotion Center, Steno Diabetes Center, Gentofte, Denmark.
authors: Ingrid
authors: I
authors: Willaing
authors: Public Health Evidence and Insights, Global Public Affairs, Novo Nordisk A/S, Copenhagen, Denmark.
authors: Søren E
authors: SE
authors: Skovlund
authors: Department of Sociology, Loyola University Maryland, Baltimore, MD.
authors: Mark
authors: M
authors: Peyrot
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000453:epidemiology; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology* / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology* / Q000628:therapy; D005260:Female; D006801:Humans; D007390:International Agencies; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D011379:Prognosis