Struggling with behavior changes: a special case for clients with diabetes.

Health professionals expect clients with diabetes to change multiple behaviors as a way to decrease the risk of complications of the disease. The purpose of this study was to gain an in-depth understanding of the client's response to lifestyle change expectations. Using the transtheoretical model of change as framework for this study, clients were asked to address the level of difficulty they encountered when making lifestyle changes relating to their diabetes. Ten clients who participated in a taped telephone survey and a videotaped focus group reported that most change was difficult but not impossible. Most clients admitted that maintaining changes was a continuing battle. Both the transcripts and focus group revealed a wide variation in the clients' understanding of self-management. It was evident that successful management involves a fairly high level of cognition as well as willingness to change. Successful management involves thinking through and comprehending how diet, exercise, and medication relate to blood glucose levels. This preliminary study will be used as the basis for a more inclusive study that will focus on developing interventions that relate directly to helping clients change behavior.