Lived experience of diabetes among older, rural people
Version of Record online: 22 MAR 2010
© 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd
Journal of Advanced Nursing
Volume 66, Issue 5, pages 1092–1100, May 2010
How to Cite
George, S. R. and Thomas, S. P. (2010), Lived experience of diabetes among older, rural people. Journal of Advanced Nursing, 66: 1092–1100. doi: 10.1111/j.1365-2648.2010.05278.x
- Issue online: 1 APR 2010
- Version of Record online: 22 MAR 2010
- Accepted for publication 16 January 2010
- older people;
- rural health;
george s.r. & Thomas s.p. (2010) Lived experience of diabetes among older, rural people. Journal of Advanced Nursing 66(5), 1092–1100.
Title. Lived experience of diabetes among older, rural people.
Aim. This paper is a report of a study conducted to elucidate experiences and perceptions of self-management of diabetes as narrated by older people diagnosed with insulin-dependent diabetes living in a rural area.
Background. Older people worldwide are disproportionately affected by diabetes and are more likely to have co-morbidities and disabilities. Guidelines for management, developed by the American Diabetes Association, are not targeted for this population. A plethora of quantitative research has investigated self-management issues, with little change to outcomes. This pleads for consideration of a new diabetes education model, which includes consideration of experiences within clients’ worldviews.
Method. Unstructured interviews starting with an open question were conducted from a purposive sample in 2005. Interviews were transcribed and analysed according to the tenets of existential phenomenology, a process which began with bracketing the researcher’s biases.
Findings. Living with poorly controlled diabetes led participants to introspection and existential questioning. Four connected themes were identified: ‘Your Body Will Let You Know’; ‘I Thought I Was Fine, But I Wasn’t’; ‘The Only Way Out is to Die’; and ‘You Just Go On’.
Conclusion. Currently designed from a medical perspective, diabetes education should be based on a nursing model incorporating the client’s insights and experiences. When managing diabetes is viewed from a client’s perspective, the focus becomes solving problems that arise in self-regulation of one’s own regimen rather than in complying with doctor’s orders. Nurses need to reframe the problem by excluding the compliance/noncompliance model and developing a conceptual perspective on self-management that is grounded in world and body.