Korean J Fam Med.  2021 Mar;42(2):123-131. 10.4082/kjfm.19.0177.

Understanding the Turning Point of Patients with Diabetes

Affiliations
  • 1Department of Family Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
  • 2Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
  • 3Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
  • 4Department of Psychiatry, University of Cyberjaya, Selangor, Malaysia
  • 5Freelance Public Health Physician, Dhaka, Bangladesh

Abstract

Background
The patient’s intention to engage in diabetes care is the hallmark of role acceptance as a health manager and implies one’s readiness to change. The study aimed to understand the process of having the intention to engage in diabetes care.
Methods
A qualitative study using narrative inquiry was conducted at a public primary care clinic. Ten participants with type 2 diabetes of more than a 1-year duration were selected through purposive sampling. In-depth interviews were conducted using a semi-structured protocol guide and were audio-taped. The interviews were transcribed and the texts were analyzed using a thematic approach with the Atlas.ti ver. 8.0 software (Scientific Software Development GmbH, Berlin, Germany).
Results
Three themes emerged from the analysis. The first theme, “Initial reactions toward diabetes,” described the early impression of diabetes encompassing negative emotions, feeling of acceptance, a lack of concern, and low level of perceived efficacy. “Process of discovery” was the second overarching theme marking the journey of participants in finding the exact truth about diabetes and learning the consequences of ignoring their responsibility in diabetes care. The third theme, “Making the right decision,” highlighted that fear initiated a decision-making process and together with goal-setting paved the way for participants to reach a turning point, moving toward engagement in their care.
Conclusion
Our findings indicated that fear could be a motivator for change, but a correct cognitive appraisal of diabetes and perceived efficacy of the treatment as well as one’s ability are essentially the pre-requisites for patients to reach the stage of having the intention to engage.

Keyword

Intention; Diabetes; Engagement; Self Care; Self-Efficacy
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