Awareness of cardiovascular risk among persons with type 2 diabetes: a qualitative study

ABSTRACT

Purpose

To describe the process of becoming aware of and acting on personal cardiovascular (CVD) risk in type 2 diabetes (T2D).

Method

A purposive sample of 14 persons living with T2D participated in semi-structured, open-ended, in-dept interviews. The interviews were analysed with grounded theory.

Result

The analysis identified the core category “Balancing emotions, integrating knowledge and understanding to achieve risk awareness and act on it.” Five categories describe the movement from not being aware of the risk of cardiovascular disease (CVD) to becoming aware of this risk and taking action to reduce it. Persons with T2D need to transform their knowledge and experience of CVD risk and incorporate it in their individual situations. Emotional and existential experiences of CVD risk can lead to awareness about the severity of the condition and contribute to increased motivation for self-management. However, an overly high emotional response can be overwhelming and may result in insufficient self-management.

Conclusion

Persons with T2D seemed not to fully grasp their increased risk of CVD or recognize that self-management activities were aimed at reducing this risk. However, their awareness of CVD risk gradually increased as they came to understand the severity of T2D and became more emotionally and existentially engaged.

KEYWORDS:

• Cardiovascular risk
• type 2 diabetes
• primary health care
• risk awareness
• patients’ experiences
• qualitative

Acknowledgments

We would like to thank Margareta Persson who has been involved and contributed ideas to the design of the study. We thank all participants of the study for giving us their time. We thank diabetes nurses at the primary healthcare centres for assistance of recruiting participants to this study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Authors’ contribution

Conceived and designed the study: LJ, KHÄ.

Performed the data collection: LJ, KHÄ.

Analysis of data: Conducted by LJ, KHÄ, ALS. JO and ML contributed to analysis and interpretation of the results.

Wrote the first draft: LJ, ALS, KHÄ.

Revised draft: All authors have read and approved the final manuscript.

Supplemental material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/17482631.2023.2294512

Additional information

Funding

The study is funded by a regional agreement between Region Västerbotten and Umeå University (ALF), VISARE NORR fund and the Swedish Diabetes fund.

Notes on contributors

Lena Jutterström

Lena Jutterström, Associate professor, with clinical employment at Department of Nursing, Umeå university. Specialist nurse in primary health care, diabetes nurse with a research focus on type 2 diabetes and person-centred self-management support.

Anna-Lena Stenlund

Anna-Lena Stenlund, PhD-student, Department of nursing, Umeå university. Specialist nurse in intensive care with a research focus in cardiovascular risk in type 2 diabetes.

Julia Otten

Julia Otten, Assistant professor, with clinical employment at Department of public health and clinical medicine. Section of medicine, Umeå university. Endocrinologist with research focus on type 2 diabetes

Mikael Lilja

Mikael Lilja, Associate professor, affiliated at Department of public health and clinical medicine Section Family medicine. Medical doctor with clinical experiences in primary healthcare with a research focus on diabetes and cancer in primary health care.

Karin Hellström Ängerud

Karin Hellström Ängerud, Associate professor, with clinical employment at Department of Nursing, Umeå university. Registered nurse with a research focus on cardiovascular nursing.