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Learning to live with diabetes: as experiencing an expanding life world
Karolinska institutet.ORCID iD: 0000-0002-2135-2684
2011 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

Introduction: Chronic illness, such as diabetes, results in a transition process involving a variety of changes in both bodily function and conditions for living, and requiring broad knowledge and understanding in order to meet new demands. The outcomes of a healthy transition are described as well-being and mastery, in contrast to vulnerability and dependency. Little is known about how time for experience contributes to the transition of living with a chronic illness. 

Aim: The overall aim of the thesis was to illuminate the transition of living with diabetes during the first three years after diagnosis, in order to reach an understanding of how better to create more person-centred care.

Design: The study has a life world phenomenological approach with a longitudinal, descriptive and interpretive design. Thirteen participants were interviewed within two months after diagnosis and again after three years. A selected sample approach was used. For study I a qualitative inductive content analysis was used and for study II a phenomenological-hermeneutic method.

Findings: In study I four themes were found; ‘taken over by a new reality,’ ‘the body plays a role in life’, ‘different ways of learning’ and ‘the health care service as a necessary partner’ and in study II one overall theme; Experience for understanding the individual meaning of freedom and control in living with diabetes and two themes ´Solving the life-puzzle – a delicate balance to create the desired life´ and ´The need for being in control of your own health´.

Discussion: For a healthy transition when living with diabetes, the ability to interact with others in order to share their experiences was crucial and contributed towards participants understanding themselves and their life world. In order to be able to interact, participants had to understand their body as a subject, interlaced with the self and the life, the lived body. Being able to listen to the body and interpret body cues and circumstantial information also contributed to a healthy transition. When the body with diabetes was objectified, a struggle ensued where incompatible needs were experienced and contradictory information created insecurity. The person then preferred not to interact with others but to be dependent on advice and information from the health care service.

Conclusion: This study showed that duration of illness was not of importance for the understanding of living with diabetes. Three years after being diagnosed, living with diabetes meant an experience both of overall balance in one’s existence and of a daily struggle. Health care personnel are open to the unique experience of the person living with diabetes as well as to where the person is in the transition. Patient education in a group setting, with the goal of sharing experiences in a learning process, will be meaningful only if the person has the ability to interact with others.

Place, publisher, year, edition, pages
Stockholm: Karolinska institutet , 2011. , p. 38
Keywords [en]
Illness experience, Transition, Learning, Diabetes mellitus, Life world, Phenonenological hermeneutic, Lived body, Patient perspective, Illness and disease, Chronic illness, Lived experience
National Category
Nursing
Identifiers
URN: urn:nbn:se:esh:diva-8385Libris ID: 12090203ISBN: 978-91-7457-218-6 (print)OAI: oai:DiVA.org:esh-8385DiVA, id: diva2:1476480
Presentation
2011-02-02, Föreläsningssal 2, hus 18, plan 5, Danderyds sjukhus, Danderyd, 10:00
Supervisors
Available from: 2020-10-14 Created: 2020-10-14 Last updated: 2020-10-16Bibliographically approved
List of papers
1. Learning to live with illness: experiences of persons with recent diagnoses of diabetes mellitus
Open this publication in new window or tab >>Learning to live with illness: experiences of persons with recent diagnoses of diabetes mellitus
2011 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, no 3, p. 558-566Article in journal (Refereed) Published
Abstract [en]

Background: The process of learning to live with an illness is complex. By better understanding the learning process for persons with diabetes in the early stage of the illness, the role of the health care can be shown.

Aim: To reach an understanding of how learning to live with diabetes is experienced in the first 2 months after diagnosis.

Method: A qualitative descriptive design was used, and interviews were conducted. Thirteen participants with a recent diagnosis of diabetes were included and asked to narrate about their experience of living with diabetes. Qualitative inductive content analysis was used.

Findings: Four themes emerged: ‘taken over by a new reality’, ‘the body plays a role in life’, ‘different ways of learning’ and ‘the healthcare service as a necessary partner’.

Conclusion: People with short-term experience of the illness gained knowledge through personal resources such as their own experience and self-reflection. The learning process includes an inner dialogue between the self, the body and the life. Participants were concerned with grasping a new reality and understanding a different self and body where lifestyle changes and uncertainty were present. When health care was accessible and sensitive to their needs, those with short-term experience of diabetes chose the staff as key players in the early stages of their life with diabetes.

Keywords
Nursing, Qualitative content analysis, Interview, Patient learning, Patient education, Diabetes mellitus, Chronic illness
National Category
Nursing
Identifiers
urn:nbn:se:esh:diva-1219 (URN)10.1111/j.1471-6712.2010.00864.x (DOI)21244458 (PubMedID)
Note

Part of both Licentiate Theses and Doctoral Theses.

Title in Licentiate Theses: Learning to live with illness: experiences of people recently diagnosed with diabetes

Publication status in Licentiate Theses: Accepted

Available from: 2011-06-14 Created: 2011-06-14 Last updated: 2020-10-14Bibliographically approved
2. Learning to live with diabetes: integrating an illness or objectifying a disease
Open this publication in new window or tab >>Learning to live with diabetes: integrating an illness or objectifying a disease
2012 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 68, no 11, p. 2486-2495Article in journal (Refereed) Published
Abstract [en]

Aim: This paper is a report of a study of illuminating the meaning of ‘learning to live with diabetes’ 3 years after being diagnosed.

Background: A changed situation, for example, in relation to living with diabetes, raises a need to understand. How time for experience contributes to this learning process for people living with diabetes is not yet well understood. It would therefore seem valuable to ask people, who have had diabetes over a similar length of time, to narrate their experience in relation to daily life situations in order to understand better how learning is established.

Design: The study has a qualitative design.

Methods: A life world approach was used, with interviews being conducted with 13 people who had been diagnosed with diabetes 3 years earlier. Data were collected in 2007, and analyses were conducted using a phenomenological-hermeneutic method.

Findings: How a person experiences the physical body was found to be crucial in the learning process. If the body with its signals is understood it can be a tool for experiencing and understanding the world and oneself. Feeling insecure about one’s own needs, and not trusting or understanding bodily signs, made participants dependent on others to make decisions for them.

Conclusion: This study showed that duration of illness was ‘not’ of importance for the understanding of living with diabetes. Living with diabetes 3 years after being diagnosed meant to experience both an overall balance in one’s existence and a daily struggle.

Keywords
Chronic illness, Diabetes, Experiences, Interviews, Lived body, Lived experience, Nursing
National Category
Nursing
Identifiers
urn:nbn:se:esh:diva-2935 (URN)10.1111/j.1365-2648.2012.05947.x (DOI)22335357 (PubMedID)
Note

Part of both Licentiate Theses and Doctoral Theses.

Title in Licentiate Theses: Learning to live with diabetes : a balance or a struggle in the lived body

Publication status in Licentiate Theses: Submitted

Available from: 2014-03-11 Created: 2014-03-11 Last updated: 2020-10-16Bibliographically approved

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