title: Living with diabetes - development of learning patterns over a 3-year period.
abstract: BACKGROUND
  Learning involves acquiring new knowledge and skills, and changing our ways of thinking, acting, and feeling. Learning in relation to living with diabetes is a lifelong process where there is limited knowledge of how it is experienced and established over time. It was considered important to explore how learning was developed over time for persons living with diabetes.
  
  
  OBJECTIVE
  The aim of the study was to identify patterns in learning when living with diabetes, from recently being diagnosed, and over a 3-year period.
  
  
  METHODS
  A longitudinal qualitative descriptive design was used. Thirteen participants, with both type I and type II diabetes, were interviewed at three different occasions during a 3-year period. Qualitative content analysis was used in different steps in order to distinguish patterns.
  
  
  RESULTS
  Five main patterns of learning were identified. Two of the patterns (I and II) were characterized by gradually becoming comfortable living with diabetes, whereas for one pattern (IV) living with diabetes became gradually more difficult. For pattern V living with diabetes was making only a limited impact on life, whereas for Pattern III there was a constant management of obstacles related to illness. The different patterns in the present study showed common and different ways of learning and using different learning strategies at different timespans.
  
  
  CONCLUSIONS
  The present study showed that duration of illness is not of importance for how far a person has come in his own learning process. A person-centered care is needed to meet the different and changing needs of persons living with diabetes in relation to learning to live with a lifelong illness.
authors.affiliation: Department of Health Care Sciences, Ersta Sköndal University College, Stockholm, Sweden; Division of Nursing, Department of Neurolobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden; asa.kneck@esh.se.
authors.forename: Åsa
authors.initials: Å
authors.lastname: Kneck
authors.affiliation: Department of Health Care Sciences, Ersta Sköndal University College, Stockholm, Sweden; Division of Nursing, Department of Neurolobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden.
authors.forename: Ingegerd
authors.initials: I
authors.lastname: Fagerberg
authors.affiliation: Division of Nursing, Department of Neurolobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden; Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden; School of Health Sciences, City University London, London, United Kingdom.
authors.forename: Lars E
authors.initials: LE
authors.lastname: Eriksson
authors.affiliation: Department of Nursing, Umeå Universitet, Umeå, Sweden.
authors.forename: Berit
authors.initials: B
authors.lastname: Lundman
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology*; D019468:Disease Management; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007858:Learning; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011340:Problem Solving; D036301:Qualitative Research; D012648:Self Care / Q000523:psychology; D013548:Sweden
keywords: Activities of daily living; chronic illness; knowledge; problem-solving self-care; self-management