Patient and Provider Dilemmas of Type 2 Diabetes Self-Management: A Qualitative Study in Socioeconomically Disadvantaged Communities in Stockholm

Juliet Aweko, Jeroen De Man, Pilvikki Absetz, Claes-Göran Östenson, Stefan Swartling Peterson, Helle Mölsted Alvesson and Meena Daivadanam
Additional contact information
Juliet Aweko: Department of Public Health Sciences, Karolinska Institutet, SE-171 76 Stockholm, Sweden
Jeroen De Man: Department of Public Health, Institute of Tropical Medicine, 43, 2000 Antwerp, Belgium
Pilvikki Absetz: Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 111, FI-80101 Joensuu, Finland
Claes-Göran Östenson: Department of Molecular Medicine and Surgery, Karolinska University Hospital, SE-171 77 Stockholm, Sweden
Stefan Swartling Peterson: Department of Women’s and Children’s Health, International Maternal and Child Health, Uppsala University, 751 85 Uppsala, Sweden
Helle Mölsted Alvesson: Department of Public Health Sciences, Karolinska Institutet, SE-171 76 Stockholm, Sweden
Meena Daivadanam: Department of Public Health Sciences, Karolinska Institutet, SE-171 76 Stockholm, Sweden

IJERPH, 2018, vol. 15, issue 9, 1-18

Abstract: Studies comparing provider and patient views and experiences of self-management within primary healthcare are particularly scarce in disadvantaged settings. In this qualitative study, patient and provider perceptions of self-management were investigated in five socio-economically disadvantaged communities in Stockholm. Twelve individual interviews and four group interviews were conducted. Semi-structured interview guides included questions on perceptions of diabetes diagnosis, diabetes care services available at primary health care centers, patient and provider interactions, and self-management support. Data was analyzed using thematic analysis. Two overarching themes were identified: adopting and maintaining new routines through practical and appropriate lifestyle choices (patients), and balancing expectations and pre-conceptions of self-management (providers). The themes were characterized by inherent dilemmas representing confusions and conflicts that patients and providers experienced in their daily life or practice. Patients found it difficult to tailor information and lifestyle advice to fit their daily life. Healthcare providers recognized that patients needed support to change behavior, but saw themselves as inadequately equipped to deal with the different cultural and social aspects of self-management. This study highlights patient and provider dilemmas that influence the interaction and collaboration between patients and providers and hinder uptake of self-management advice.

Keywords: Self-management; type 2 diabetes; immigrants; health systems; chronic diseases; qualitative study; lifestyle change; thematic analysis; socioeconomically disadvantaged; Sweden (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2018
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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