Diagnosis of diabetes mellitus and living with a chronic condition: participatory study

Abstract

Background: Diabetes mellitus is one of the most serious chronic illnesses in the world due to its prevalence, economic and social effects, and negative impact on the quality of life of the affected people. The diagnosis implies changes in life habits especially related to feeding, physical activity, and constant self-care, requiring greater personal autonomy.

Methods: This study aims to understand how individuals living with diabetes deal with the recognition of the chronic condition in their health care practices. This is a participatory research with a qualitative approach focusing on reflexivity. Sixteen people with diabetes mellitus were intentionally chosen, and qualified to participate in the study. The selected methodology allowed the constitution of life stories and focused on the multiple ways human beings deal with their illnesses.

Results: The participants attended eight closed group meetings, with an specific methodology which benefited them to retrieve their own history as well as the multiple experiences to deal with the disease, here called Strategic Health Promotion Group (SHPG). The data produced and the dialogue between researcher and researched subjects were related to three major thematic perspectives: I) recognizing diabetes II) living with diabetes III) exercising personal autonomy. This work contains the meanings attributed to the Perspective I from which the following three categories emerged: The impact of the diagnosis, the denial of the illness, and the acceptance of the illness. It was observed that the diagnosis of a chronic illness generates a multiplicity of feelings, moving through narratives of complications and death events shared between generations. The participants expressed feelings related to denial or acceptance of the chronic condition which required an active adaptation exercising. From the current diagnosis, it was observed that new signs were added to the person's existence, influencing their habits, health care practices and quality of life.

Conclusions: The emotional aspects of subjects diagnosed with diabetes mellitus strongly influence the acceptance or denial of the illness, interfering in their personal adherence to treatment. As a chronic condition, involving life-longing care practices, which intervenes in therapeutic participation, it is indispensable to respect and to encourage the personal autonomy of the subjects.

Keywords: Chronic illness; Health promotion; Participatory research; Personal autonomy.