Diabetes self-management experience: a focus group study of Taiwanese patients with type 2 diabetes.

AIMS AND OBJECTIVES The purpose of this study was to understand and document the perspectives of Taiwanese patients with type 2 diabetes regarding the processes and strategies used to self-manage their chronic condition. BACKGROUND The importance of patients learning self-management through self-regulation has been recognized in the literature, but little of this research has focused on skills to manage symptoms. Besides, studies about how patients self-manage their diabetes in term of patients' perspectives have been scant. Sociocultural context is also an influencing factor in disease management. METHODS Focus groups were used to collect data from 41 adult participants with type 2 diabetes at three teaching hospitals located in southern Taiwan. The five focus groups ranged in size from six to ten people. The focus groups were recorded, transcribed and analysed. RESULTS Three themes and ten subthemes were revealed. The first theme 'the impact of the illness' includes three subthemes: facing the predicament of stigmatization, concern about inheritance of diabetes and seeking alternative therapy for hope. The second theme 'self-regulation process' includes four subthemes: struggling for diet control, adjusting to psychological barriers, identifying body response and developing strategies for dealing with diabetes. The third theme 'transformation process' includes three subthemes: resuming conventional illness, support from families and fellow patients and learning to live with the disease. CONCLUSIONS Findings obtained from the themes of the study illustrated that self-management of patients with diabetes is highly related to their own sociocultural environment and experiences. Understanding the cultural features and the meaning of illness can help in the development of interventions tailored to the needs of this cultural group. RELEVANCE TO CLINICAL PRACTICE The findings have important implications for healthcare providers to consider individuals' sociocultural backgrounds in which they make choices about their treatment and manage their illness. This recognition will enhance patients with diabetes to transform being active in self-management through the skills of self-regulation.