title: The self-management experience of patients with type 2 diabetes and chronic kidney disease: A qualitative study.
abstract: BACKGROUND
  The purpose of this study was to explore views related to the self-management of type 2 diabetes and chronic kidney disease.
  
  
  METHODS
  We conducted three semi-structured focus groups in participants with type 2 diabetes and chronic kidney disease. Interviews were transcribed, coded, and analyzed using thematic analysis. Credibility was supported through triangulation of data sources and the use of multiple investigators from different disciplines.
  
  
  RESULTS
  Twenty-three adults participated. Three major themes were identified: emotional reactions to health state, the impact of family dynamics on self-management, and the burden of self-management regimens. Family dynamics were found to be a barrier and support to self-management, while complicated self-management regimens were found to be a barrier. Additionally, participants expressed several emotional reactions related to their CKD status, including regret related to having developed CKD and distress related both to their treatment regimens and the future possibility of dialysis.
  
  
  CONCLUSIONS
  This exploratory study of patients with type 2 diabetes and chronic kidney disease describes barriers and supports to self-management and emotional reactions to chronic kidney disease status. Future research should confirm these findings in a larger population and should include family members and/or health care providers to help further define problems with self-management in patients with type 2 diabetes and chronic kidney disease.
authors.affiliation: Department of Medicine, Winthrop University Hospital, Mineola, NY, USA sshirazian@winthrop.org.
authors.forename: Shayan
authors.initials: S
authors.lastname: Shirazian
authors.affiliation: Program in Public Health, Stony Brook University, Stony Brook, NY, USA.
authors.forename: Natalie
authors.initials: N
authors.lastname: Crnosija
authors.affiliation: Clinical, Behavioral and Outcomes Research, Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA.
authors.forename: Katie
authors.initials: K
authors.lastname: Weinger
authors.affiliation: Winthrop Research Institute, Winthrop University Hospital, Mineola, NY, USA.
authors.forename: Alan M
authors.initials: AM
authors.lastname: Jacobson
authors.affiliation: Department of Medicine, Winthrop University Hospital, Mineola, NY, USA.
authors.forename: Joonho
authors.initials: J
authors.lastname: Park
authors.affiliation: Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA.
authors.forename: Molly L
authors.initials: ML
authors.lastname: Tanenbaum
authors.affiliation: Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA.
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Gonzalez
authors.affiliation: Department of Medicine, Winthrop University Hospital, Mineola, NY, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Mattana
authors.affiliation: Program in Public Health, Stony Brook University, Stony Brook, NY, USA.
authors.forename: Amy C
authors.initials: AC
authors.lastname: Hammock
mesh_terms: D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000628:therapy*; D005195:Family Relations; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010817:Physician-Patient Relations; D036301:Qualitative Research; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000628:therapy*; D012648:Self Care / Q000523:psychology; D011795:Surveys and Questionnaires
keywords: Adherence; chronic kidney disease; diabetes; patient education