Identifying barriers and facilitators to self care in young adults with type 2 diabetes

• Published in: Diabetic medicine 2024-04, Vol.41 (4), p.e15229-n/a
• Main Authors: Wong, Sabrina K. W., Soon, Winnie, Griva, Konstadina, Smith, Helen Elizabeth
• Format: Article
• Language: English
• Subjects: Adult; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - psychology; Diabetes Mellitus, Type 2 - therapy; Diet; Exercise; Humans; Physical activity; Population studies; qualitative methods; Qualitative Research; Research Design; Self Care - psychology; self‐management; type 2 diabetes; Young Adult; Young adults
• ISSN: 0742-3071; 1464-5491
• DOI: 10.1111/dme.15229

Aims There is a rising trend of young‐onset type 2 diabetes (YOD) occurring before the age of 40 years. Lower adherence to self care behaviours (diet, physical activity and taking medication) contributed to poorer glycaemic control and higher risk of complications. Young adults with YOD face unique challenges, and our study aimed to identify the main barriers and facilitators of self care behaviours in this population. Methodology A qualitative study was conducted in the National Healthcare Group Polyclinics, Singapore, using in‐depth semi‐structured interviews. Maximal variation sampling was employed to include participants with YOD of varied age, ethnicity, educational levels and marital status. Thematic analysis was conducted, and barriers and facilitators were identified and mapped to domains of the theoretical domains framework. Results Twenty‐one participants aged 22–39 years were interviewed. We found patterns of intentions, self care behaviours and mindsets that were associated with different barriers and facilitators. Four patterns were identified and were named according to mindsets: avoidant, indifferent, striving and activated. In addition, experience of stigma and self‐blame from having type 2 diabetes in young adulthood was common across all mindsets, contributing to poorer self care behaviours and increased psychological burden. Conclusion Our study identified key barriers and facilitators of diet, physical activity and medication adherence in young adults with type 2 diabetes. Understanding barriers and facilitators, as related to mindsets, intentions and behaviours, will support a more individualised care approach.