Identifying Barriers to Self-care in Patients with Type 2 Diabetes: A Qualitative Phenomenological Study

Abstract

Background: Diabetes is one of the most significant global health concerns, with its prevalence increasing worldwide, particularly in low- and middle-income countries. Diabetes significantly impacts healthcare systems due to the acute and chronic complications it causes. Self-care plays a crucial role in controlling and mitigating these complications and is an essential requirement for patients with diabetes. However, despite its importance, self-care practices among diabetic patients remain insufficient. Objectives: This study aimed to identify self-care barriers among patients with type 2 diabetes. Methods: This qualitative phenomenological study recruited twenty-seven patients with type 2 diabetes (aged 35 - 70 years) from the outpatient clinic of the Sanandaj Diabetes Association through a convenience sampling method. Qualitative data were collected via semi-structured interviews conducted in October and November 2024. Data analysis was performed using Clarke and Braun’s (2006) coding method, facilitated by MAXQDA 2020 software. Results: The mean age of the patients was 51.5 (9.61%). The majority of participants were female (n = 16, 59.3%). Regarding employment and marital status, most respondents were housekeepers (n = 11, 40.7%) and married (n = 24, 88.9%), respectively. Also, the most common educational level was elementary school (n = 8, 29.6%). Through the analysis of interview coding, 425 initial codes were extracted, leading to the identification of 18 secondary codes as barriers to self-care. These barriers were ultimately classified into five main categories: Economic, educational, social, individual, and psychological. Conclusions: This study has highlighted several barriers in self-care management for Iranian patients with type 2 diabetes, particularly related to economic, educational, social, individual, and psychological factors. These findings offer valuable insights that can contribute to the improvement of diabetes self-management education programs tailored to this population.