Identifying decision-making biases in self-care behaviours among patients with type 2 diabetes mellitus: A qualitative study from a behavioural economics perspective

Abstract

Background: Patients with type 2 diabetes mellitus often make self-care behaviour decisions according to their immediate needs and desires in the real world. Deviations from optimal choices in seeking satisfying options are known as decision-making biases, which are not obvious in the self-care behaviours of patients with type 2 diabetes mellitus. Qualitative research can provide insights into patients' descriptions of and experiences in self-care, aiding in systematically identifying decision-making biases.

Objective: To identify the decision-making biases of patients with type 2 diabetes mellitus from their descriptions of and experiences in self-care to guide targeted strategies for supplementing existing intervention paradigms.

Design: Qualitative, descriptive design.

Participants: We used purposive sampling to recruit 18 participants with type 2 diabetes mellitus at the endocrinology outpatient unit of a large urban general hospital in Lanzhou, China, between July and September 2023.

Methods: We conducted individual, semi-structured interviews to identify decision-making biases of self-care behaviours from the behavioural economics perspective. The interviews were transcribed verbatim, and the thematic analysis approach was utilized to code the transcribed data and identify themes.

Results: We found that patients with type 2 diabetes mellitus showed emotion-driven and short-term-oriented decision-making biases regarding self-maintenance. Self-monitoring decisions tend to be personal experiences and based on individual perceptions. Self-management decisions depend heavily on accessibility to and sources of information.

Conclusions: Decision-making biases clearly impact the self-care behaviours of patients with type 2 diabetes mellitus. We identified 10 decision-making biases related to self-care behaviour maintenance, monitoring, and management, suggesting that future research can leverage these biases to improve the health-related behaviours of patients with type 2 diabetes mellitus.

Keywords: Behavioural economics; Decision-making biases; Qualitative study; Self-care; Type 2 diabetes mellitus.