Julie Ayre1, Carissa Bonner1, Danielle M Muscat1, Sian Bramwell2, Sharon McClelland2, Rajini Jayaballa2,3, Glen Maberly2,4, Kirsten McCaffery1. 1. Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia. 2. Western Sydney Diabetes, Western Sydney Local Health District, Blacktown, Australia. 3. School of Medicine, Western Sydney University, Blacktown, Australia. 4. Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
Abstract
OBJECTIVE: The aim of this study was to explore how people with diabetes and diverse health literacy levels conceptualise their experience and efforts to engage in self-management behaviours (their self-management 'schemas'). DESIGN: A qualitative design was applied. METHODS: Twenty-six people in Sydney, Australia, took part in semi-structured interviews, which were audio-recorded and coded using Framework analysis. RESULTS: Half the participants (54%) had limited health literacy, whereas 38% adequate health literacy (using Newest Vital Sign). Regardless of health literacy, people described how monitoring increased self-management awareness and signalled periods of low self-management ('lulls'). Accounts of monitoring to sustain motivation were more apparent for participants with adequate health literacy. Most participants described simple and flexible rules (e.g. use artificial sweeteners; eat in moderation). Two schemas related to 'lulls': a 'problem-solving orientation' depicted lulls as inevitable and was associated with varied coping strategies; a 'willpower orientation' attributed lulls to lack of 'willpower,' and described willpower as a main coping strategy. CONCLUSION: There is considerable variation in how people think about their diabetes self-management and the strategies they use. Health literacy may contribute to some of this variation. Self-management interventions could benefit from depicting motivation as fluctuating and challenging ideas about willpower and self-blame.
OBJECTIVE: The aim of this study was to explore how people with diabetes and diverse health literacy levels conceptualise their experience and efforts to engage in self-management behaviours (their self-management 'schemas'). DESIGN: A qualitative design was applied. METHODS: Twenty-six people in Sydney, Australia, took part in semi-structured interviews, which were audio-recorded and coded using Framework analysis. RESULTS: Half the participants (54%) had limited health literacy, whereas 38% adequate health literacy (using Newest Vital Sign). Regardless of health literacy, people described how monitoring increased self-management awareness and signalled periods of low self-management ('lulls'). Accounts of monitoring to sustain motivation were more apparent for participants with adequate health literacy. Most participants described simple and flexible rules (e.g. use artificial sweeteners; eat in moderation). Two schemas related to 'lulls': a 'problem-solving orientation' depicted lulls as inevitable and was associated with varied coping strategies; a 'willpower orientation' attributed lulls to lack of 'willpower,' and described willpower as a main coping strategy. CONCLUSION: There is considerable variation in how people think about their diabetes self-management and the strategies they use. Health literacy may contribute to some of this variation. Self-management interventions could benefit from depicting motivation as fluctuating and challenging ideas about willpower and self-blame.
Entities:
Keywords:
Health literacy; behaviour change; qualitative; self-management; self-regulation; type 2 diabetes
Authors: Samuel Bonet Olivencia; Arjun H Rao; Alec Smith; Farzan Sasangohar Journal: Int J Environ Res Public Health Date: 2021-12-23 Impact factor: 3.390