Health literacy self-management by patients with type 2 diabetes and stage 3 chronic kidney disease.

This is a qualitative study report from a parent study that used a concurrent mixed methods design whose aim was to describe the transition and self-management experiences of patients diagnosed with type 2 diabetes mellitus (T2DM) and stage 3 chronic kidney disease (CKD). Six adult men and women recruited from outpatient clinics completed two focus group interviews. Discerned in the ethnographic analysis of interviews and field notes using ATLAS/ti was a pattern of Health Literacy Self-Management with two major threads: (a) transition experience to self-advocacy characterized as seeking useful resources and difficulties in resource use and (b) partnering with the health care provider (HCP) characterized as helpful messaging and messaging confusion. Self-management support includes a shared responsibility and developmental process by the patient and the HCP to achieve quality care. Description of behavioral factors and self-management processes provides a foundation for future study.