The Barriers and Facilitators of Self-Management Among Adults with Type 2 Diabetes Mellitus: A Trans Theoretical Model (TTM)-Based Mixed Method Study in Iran
Received 7 September 2019
Accepted for publication 25 June 2020
Published 27 July 2020 Volume 2020:13 Pages 2687—2699
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 3
Editor who approved publication: Dr Konstantinos Tziomalos
Maryam Zare,1 Ali Tarighat-Esfanjani,2 Maryam Rafraf,2 Abdolreza Shaghaghi,3 Mohammad Asghari-Jafarabadi,4 Mahmood Shamshiri5
1Department of Nutrition, Khalkhal University of Medical Sciences, Khalkhal, Iran; 2Nutrition Research Center, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran; 3Department of Health Education and Promotion, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran; 4Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 5School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
Correspondence: Ali Tarighat-Esfanjani
Nutrition Research Center, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, 5166614711, Iran
Aim: This study planned to determine:( 1) the behavioral intention or profile of patients with type 2 diabetes mellitus (T2DM) based on the stages of the change model, and( 2) to explore the perceived facilitators and barriers of self-management (SM) in a sample of Iranian patients with T2DM.
Methods: This was a mixed method study, accomplished in two phases. In the quantitative phase, 246 subjects with T2DM participated. They were classified according to items such as regular use of blood-glucose-lowering drugs, having a healthy diet and performing physical activity to pre-action and action groups. Socio-demographic and anthropometric information were collected, and a phenomenological qualitative study was conducted, and data collection continued until saturation achieved by 10 subjects in pre-action and 12 subjects in action groups. Four focus group discussions in the field of SM were accomplished. Analysis of quantitative and qualitative data was conducted by the SPSS and MAXQDA software, respectively.
Results: The mean age and duration of illness among the subjects were 53.9± 7.1 and 6.9± 4.9 years, respectively. The barriers of SM in action and pre-action stages were as follows: lower socio-economic status, poor performance of treatment team, physical-intellectual factors and lack of planning to change. The facilitators stated in the pre-action and action stage in the field of SM were satisfaction from treatment, planning, belief in diabetes, treatment team’s support, nutritional knowledge, and religious beliefs.
Conclusion: This study indicated facilitator and barrier factors in SM based on TTM in action and pre-action groups. Healthcare professionals should consider these findings to improve the patients’ outcomes.
Keywords: diabetes mellitus type 2, self-management, healthy diet, exercise
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]