Enablers of and Barriers to Effective Diabetes Self-Care in Iran: A Qualitative Study

Abstract

Introduction

Self-care behaviors are the most important factor in diabetes management, and improving such behaviors is the cornerstone in helping patients to manage their illness. The current study aimed to determine interfering factors in the self-care process in patients with diabetes.

Methods

The present qualitative study with content-analysis design was performed from March 2017 to April 2019 in Mashhad, Iran. Data collection was started with sampling and continued until saturation. Data were collected through semistructured interviews. Participants comprised 21 patients with diabetes (adults with type 1 or 2 diabetes) aged 31–60 years. Data analysis was performed using the Landman method and MaxQDA 10 software.

Results

Qualitative content analysis showed that patients' self-care behavior was influenced by different factors and conditions. In the current study, four key themes facilitating or preventing self-care behaviors in patients with diabetes were extracted: accessibility, environmental factors, behavioral habits, and personal factors.

Conclusion

A range of personal and environmental factors may play an important role in the formation of self-care behaviors in patients with diabetes, and providing medical, welfare, and social support to such patients can facilitate self-care behavior formation in them. On the other hand, by removing perceived barriers, patients may be better able to adhere to self-care behaviors.

Keywords:

• interventional conditions
• self-care
• diabetes
• qualitative

Ethics and Consent Statement

The current study was based on a research project approved by the Ethics Committee of Mashhad University of Medical Sciences (IR.MUMS.REC.1398.006). All procedures performed in the study were in accordance with the ethical standards of the institutional and/or national research committee and with those of the 1964 Declaration of Helsinki and its later amendments or comparable ones. All project participants were informed of the study objectives prior to the interview, completed a written consent form, and were assured of confidentiality. This research project was funded by Mashhad University of Medical Sciences.

Acknowledgments

The authors would like to express their gratitude and appreciation to all respected professors, clinics, comprehensive health centers, and participants in this study, and wish blessings upon each of these dear ones. The authors give thanks to the many colleagues whose vignettes about dilemmas of improving quality shaped this paper and to the anonymous reviewers for their suggestions. The authors alone are responsible for the content and writing of the paper.

Disclosure

The authors report no conflicts of interest in this work.