Introduction
As a chronic disease, diabetes has a marked influence on the physical, psychological, and social aspects of individuals. Type 1 is a form of diabetes mellitus that occurs due to diminished levels of insulin, loss of energy, and increased levels of glucose in the blood (Markowitz et al., 2019). Since type 1 diabetes is common among young people, it creates a lot of challenges in management. Limited experience and insufficient knowledge are the problems that complicate and hinder the successful implementation of self-management strategies. Patients need to understand the physiological mechanism, treatment and management interventions, long-term effects, educational materials, social reactions, and misconceptions regarding diabetes. Smith and Harris (2018) recommend the early diagnosis, consistent use of insulin, and stringent control of blood glucose as effective strategies to reduce the impact of diabetes on the health status of individuals. Hence, the assessment of patients’ knowledge and experiences would highlight their ability to manage diabetes using appropriate strategies and improve health status.
Statement of Purpose
The purpose of the study is to examine the perceptions that a patient with type 1 diabetes holds about this condition and its impacts on people. The study employed the qualitative approach in the collection, analysis, and interpretation of data collected through interviews of a patient with type 1 diabetes. The qualitative approach is appropriate in this study because it allows the interpretation of knowledge, experiences, and attitudes that patients with diabetes possess. As self-management is an integral aspect of the treatment of diabetes, individuals need to understand their conditions and make appropriate adjustments in their lifestyles. Management strategies such as regulating the intake of carbohydrates, physical activity, and monitoring of blood glucose levels would alleviate the effects of diabetes on the body (Smith, & Harris, 2018). The knowledge that people with diabetes possess determines their ability to manage and improve their health conditions. Health education is usually a critical strategy that healthcare providers employ in promoting the understanding of diabetes and its respective management interventions. Therefore, the analysis and interpretation of the interview transcript of a patient with type 1 diabetes would highlight their perceptions and the capacity to undertake self-management strategies.
Literature Review
Diabetes is an enduring condition that stems from the inability of the body to control the levels of blood sugar within the normal limits for utilization in the production of energy. Depending on the course, diabetes can either be type 1 or type 2. While type emanates from the deficiency of insulin, type 2 occurs due to the resistance of cells to insulin (Markowitz et al., 2019). Moreover, type 1 diabetes is common among children and young adults, whereas type 2 is prevalent among adults. Treatment interventions used in the treatment of type 1 and type 2 varies. In the management of this condition, doctors use insulin injections to supplement the deficiency in the body in type 1 diabetes and utilize glycemic agents in reducing resistance in cells. Hence, understanding the causes would enable doctors and patients to employ appropriate interventions in the management of diabetes.
Although type 1 diabetes is a rare form of this condition, it requires a set of interventions for effective management. The common interventions for type 1 diabetes are insulin injection, regulation of carbohydrates, healthy diet, and physical activity (Smith, & Harris, 2018; Turton et al., 2018). Insulin promotes the intake of glucose into the cells and utilization in the production of energy. Regulation of carbohydrates hinders a rapid increase in blood sugar levels and deteriorates outcomes of diabetes. A healthy diet and physical activity stimulate cells to increase metabolic rates and boost the utilization of blood glucose. These treatment and management interventions are effective because they have long-term therapeutic effects on diabetic patients.
As a chronic condition, diabetes requires consistent treatment and management interventions focused on controlling the level of blood glucose levels in the body. Diabetic complications, such as retinopathy and neuropathy, result in a poor quality of life among patients (Karam et al., 2018). Self-management skills are critical in the management of diabetes because they empower patients to change their lifestyles and adopt healthy behaviors. Rasoul et al. (2019) hold that health education is the best treatment intervention since it promotes healthy lifestyles and alleviates the short-term and long-term effects of diabetes. Therefore, knowledge about diabetes and self-management skills are integral in the treatment of diabetes.
Conceptual Framework
The epistemological premise of the study is that knowledgeable individuals determine their perceptions of diabetes and related impacts. According to Saldana and Omasta (2018), the epistemological basis of a research framework entails the construction of knowledge using diverse perceptions and experiences of people. As the conceptual framework, the qualitative study elucidates that knowledge of diabetes, feelings, treatment interventions, health education, long-term effects, social reactions, and misconceptions are vital factors that shape perceptions of diabetes and its impacts on patients. Markowitz et al. (2019) support the use of qualitative study in examining the experiences of patients with type 1 diabetes by analyzing and interpreting words and expressions in interviews. The analysis of different aspects of the conceptual framework would enhance understanding of the perceptions of diabetes and its impacts on diabetic patients.
Data Collection
The data was collected by interviewing a female patient with diabetes type 1 aged 33 years old. The patient has ample knowledge and experience with the management of diabetes because she was diagnosed six years ago and has successfully adhered to necessary treatment interventions. The interviewer allowed the patient to offer informed consent, seek clarification, and permit audio-recording of her responses for research purposes. The interview process entailed the administration of open-ended questions to direct dialogue and provide freedom to the patient. Markowitz et al. (2019) explain that the use of open-ended questions is effective in qualitative studies because it enables respondents to express their perceptions, experiences, and attitudes, as well as allows researchers to probe emerging themes. Thus, through the interview, the study managed to examine the patient and gather information related to knowledge of diabetes, feelings, treatment interventions, health education, long-term effects, social reactions, and misconceptions.
Data Analysis
Thematic analysis was used in the evaluation of interview transcripts of the patient with type 1 diabetes. Saldana and Omasta (2018) explain that qualitative analysis entails the condensation of large data, identification of patterns, unification of concepts, formulation of themes, understanding of social processes, and interpretation of themes. Multiple readings and the analysis of the interview transcript revealed the existence of major themes related to the perception of diabetes and its impacts on the patient.
The sequential steps employed in the thematic analysis are familiarizing with interview transcript, generating initial codes, identifying major themes, review of themes, defining these themes, and tabulation of results for interpretation (Maguire & Delahunt, 2017). Multiple readings in the first step enabled familiarization with the interview transcript, while the generation of initial codes in the second step permitted condensation and organization of data. The third step is the identification of major themes that relate to diabetes and its impacts on the patient. In the fourth and fifth steps, significant themes were reviewed and defined to meet the purpose of the study. Ultimately, the analysis of the relationships between interview transcripts, initial codes, and major themes was tabulated to provide a clear focus of thematic analysis.
Interpretation of Findings
The thematic analysis of the interview transcript generated codes that were summarized into seven major themes, namely knowledge of diabetes, feelings, treatment interventions, long-term effects, health education, misconceptions, and social reactions, as perceptions of diabetes and its impacts. The thematic analysis exposes that the patient has an excellent knowledge of diabetes. Since the patient has type 1 diabetes, she understands that her pancreas does not produce the required insulin to stimulate the intake of blood sugar into the cells and generate energy. Paschou et al. (2018) report that type 1 diabetes stems from the deficiency of insulin due to the degradation of beta cells of the pancreas by auto-antibodies. As insulin stimulates the intake of glucose by cells, its deficiency leads to lethargy and reduced activity of the brain. From the transcript, the patient is aware that type 1 diabetes does affect not only the production of insulin but also energy production in the body and subsequent effects on the physiology of the brain.
Regarding feelings, the patient demonstrates that she is sensitive to changes that occur in her body and ready to make appropriate adjustments to her lifestyle. When she was diagnosed with type 1 diabetes, the patient was relieved because she got an explanation of her feelings in her body, which represented vital signs and symptoms of her new condition. The patient started to understand that weight loss, frequent urination, and tiredness are some of the major symptoms of type 1 diabetes. The absence of insulin in the body creates a physiological hunger, deprives the body of energy production in cells, and causes persistent tiredness or fatigue.
Treatment interventions comprise a significant theme that is evident in the interview transcript. The patient understands treatment interventions for type 1 diabetes because she states that injecting insulin, rationing carbohydrates, eating a healthy diet, and performing physical activities augment the effectiveness of managing diabetes. According to Turton et al. (2018), the administration of insulin and the consumption of the low-carbohydrate diet ensure long-term management of diabetes because they avert a rapid increase in blood glucose levels. Moreover, Colberg et al. (2016) add that physical activity increases the use of energy, strengthens muscles, improves the activity of oxidizing enzymes, and enhances the sensitivity of body cells to low levels of insulin. Given that the patient applies these interventions in the management of type 1 diabetes, it implies her condition is stable.
The patient is aware of the long-term effects of diabetes since she notes blindness and neuropathy as two extreme conditions. Karam et al. (2018) hold that a chronic increase in blood sugar levels among patients with diabetes degrades nerves, resulting in retinopathy and neuropathy. While retinopathy causes blindness, neuropathy results in diabetic foot and vascular complications. In this aspect, it is apparent that the patient comprehends the long-term effects of diabetes, and she is ready to prevent or cope with them.
The comprehension, treatment, and long-term effects of diabetes originate from the appropriate health education that the patient receives. Following diagnosis, the patient states that she received health education from her doctor and reading materials from the hospital. Moreover, she got critical information from books, websites, and food labels, which enabled her to eat healthy diets and manage diabetes effectively. Rasoul et al. (2019) recommend the use of health education as an intervention to improve the self-management skills of patients with diabetes. However, one needs to be wary of sources of information because some websites or reading materials are not credible. The accessibility of reading materials and the dedication of the patient have empowered the development of self-management skills.
In the interview, the patient highlighted the existence of misconceptions about diabetes. The first misconception is that people confuse type 1 and type 2 diabetes because they present similar signs and symptoms. While an autoimmune degradation of the pancreas causes type 1 diabetes, the physiological deficiency of insulin due to the resistance of cells leads to type 2 diabetes (Smith & Harris, 2018). Another misconception is that diabetic patients should not take sugar because they have excess amounts in their blood. In times of strenuous activity or fasting, diabetic patients require sugar to boost their sugar levels and prevent the occurrence of hypoglycemia. When the patient interacts with people, she encounters varied social reactions. For instance, friends are concerned about health conditions as they fear violating dietary restrictions for people with diabetes. In this view, it is evident that people understand sugar or carbohydrates as having detrimental effects on diabetic patients.
Reflexivity
I have gained important skills in the qualitative analysis of the interview transcript and came up with major themes. Berger (2015) argues that reflexivity sanctions researchers to share the experience of respondents and limit the influence of personal bias. Specifically, I have learned how to code data by reading the transcript numerous times, noticing patterns and unifying sub-themes, and generating major themes, which explain social processes in the management of diabetes. The challenges encountered entailed the identification of sub-themes in the interview transcript and subsequent condensation to generate major themes that match with the literature.
Limitations
The qualitative data has two major limitations regarding the sample size and thematic analysis. One limitation is that since the interview script is of one patient, it has a low external validity to allow the generalization of findings to the population of patients with diabetes (Shanmuganandapala & Khanlou, 2019). Another limitation is that thematic analysis is a subjective process as it tends to introduce researchers’ biases into the interpretation of data and generation of findings.
Conclusion
The qualitative study was performed to determine perceptions of the patient with type 1 regarding knowledge and the capacity to undertake self-management strategies. Thematic analysis and interpretation of the interview transcript revealed seven major themes, which are knowledge, feelings, treatment interventions, health education, long-term effects, social reactions, and misconceptions of diabetes. Comparative analysis reveals that the patient understands diabetes and can undertake effective self-management to alleviate chronic effects, as well as improve quality of life.
References
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