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Living with diabetes: Development of learning patterns over a 3-year period
Ersta Sköndal University College, Department of Health Care Sciences. Karolinska institutet, Institutionen för neurobiologi, vårdvetenskap och samhälle.
Ersta Sköndal University College, Department of Health Care Sciences. Karolinska institutet, Institutionen för neurobiologi, vårdvetenskap och samhälle.
Karolinska Institutet.
Umeå universitet.
2014 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 9, 24375Article in journal (Refereed) Published
Abstract [en]

Background: Learning involves acquiring new knowledge and skills, and changing our ways of thinking, acting, and feeling. Learning in relation to living with diabetes is a lifelong process where there is limited knowledge of how it is experienced and established over time. It was considered important to explore how learning was developed over time for persons living with diabetes.

Aim: The aim of the study was to identify patterns in learning when living with diabetes, from recently being diagnosed, and over a 3-year period.

Materials and methods: A longitudinal qualitative descriptive design was used. Thirteen participants, with both type I and type II diabetes, were interviewed at three different occasions during a 3-year period. Qualitative content analysis was used in different steps in order to distinguish patterns.

Findings: Five main patterns of learning were identified. Two of the patterns (I and II) were characterized by gradually becoming comfortable living with diabetes, whereas for one pattern (IV) living with diabetes became gradually more difficult. For pattern V living with diabetes was making only a limited impact on life, whereas for Pattern III there was a constant management of obstacles related to illness. The different patterns in the present study showed common and different ways of learning and using different learning strategies at different timespans.

Conclusion: The present study showed that duration of illness is not of importance for how far a person has come in his own learning process. A person-centered care is needed to meet the different and changing needs of persons living with diabetes in relation to learning to live with a lifelong illness.

Place, publisher, year, edition, pages
2014. Vol. 9, 24375
Keyword [en]
Activities of daily living, Chronic illness, Knowledge, Problem-solving self-care, Self-management
National Category
Nursing
Identifiers
URN: urn:nbn:se:esh:diva-4029DOI: 10.3402/qhw.v9.24375PubMedID: 25030359OAI: oai:DiVA.org:esh-4029DiVA: diva2:745680
Available from: 2014-09-11 Created: 2014-09-11 Last updated: 2015-06-26Bibliographically approved
In thesis
1. Living with diabetes: a lifelong learning process
Open this publication in new window or tab >>Living with diabetes: a lifelong learning process
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Living with diabetes, as a lifelong illness, is interlaced with learning and to face continual changes. However, the role of time in this learning process is not yet well understood. The overall aim of the thesis was to gain a deepened understanding of learning to live with diabetes for those recently diagnosed and over a three year period. The thesis, involving four studies where qualitative inductive content analysis (I, III) and phenomenological hermeneutical interpretation (II, IV) were used, has a lifeworld approach and a qualitative and longitudinal design. Thirteen persons, recently diagnosed with diabetes (type I or II), were interviewed on three different occasions over a three year period. All interviews focused on the experience of living with diabetes and situations where diabetes had to be taken into account. The aim of study I was to reach an understanding of how learning to live with diabetes is experienced in the first 2 months after diagnosis. The findings revealed to be taken over by a new reality, with a body that played a role in life with the health care service as a necessary partner. The aim of study II was to illuminate the meaning of learning to live with diabetes three years after being diagnosed. The findings revealed learning as making decisions through use of different sources of information and as solving the life-puzzle – a delicate balance to create a desired life. The aim of study III was to identify patterns in learning when living with diabetes, from recently being diagnosed, and over a 3-year period. In the findings five patterns were identified illuminating different learning processes emerging over time. A longer time living with diabetes did not per se mean increased satisfaction in living well with illness or increased confidence in understanding one’s own needs. The aim of the IV study was to illuminate the meanings of trigger situations in learning to live with diabetes. The findings revealed trigger situations, such as being encumbered by vulnerability and temporality in unsustainable situations with an unpredictable body and a life involving new concerns for the future. The thesis conducted that learning was an informal and ongoing everyday process in life. Time living with diabetes meant both an increased mastery of a changed life situation, but also increased difficulties in achieving well-being and with a dependency on health care. Hence, health care interventions must adhere to the individual’s needs and not be based on duration of illness. Understanding the body and the role of health care, as well as what facilitates and hampers learning, changed with time. It is therefore important that health care personnel illuminate the individual understanding and experiences of those living with diabetes as this was found to be important for the learning process as well as for their sense of well-being.

Place, publisher, year, edition, pages
Stockholm: Karolinska institutet, 2015. 81+bilagor p.
Keyword
Diabetes, Lifelong illness, Learning process, Transition, Self-management, Triggers, Lifeworld
National Category
Nursing
Identifiers
urn:nbn:se:esh:diva-4751 (URN)978-91-7549-814-0 (ISBN)
Public defence
2015-03-06, Aulan, Stigbergsgatan 30, Stockholm, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2015-06-26 Created: 2015-06-26 Last updated: 2015-06-26Bibliographically approved

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