Abstract
A diagnosis of type 1 diabetes in adulthood is a major disruption to habitual life and demands significant physical and psychosocial adaptation. The strategies employed during this adaptive phase may have an important impact on the future risk of diabetes complications and psychological well-being. To date, little consideration has been given to the experiences of adults following diagnosis, even though more than half of all cases of type 1 diabetes occur in adulthood. Therefore, to better understand and attend to the needs of adults at and following their diagnosis, this study aimed to explore the experience of being diagnosed with type 1 diabetes in adulthood. The study sought to elicit the underlying bio-psycho-social phenomena that may influence the process of adaptation when becoming a person with diabetes, to identify areas that could be targeted to facilitate a more positive adaptive process.Longitudinal semi-structured interviews were conducted with 30 adults (age range 20-67 years; 16 men; median diabetes duration 23.5 months) recruited from diabetes clinics in Denmark and the UK. A narrative approach was used to analyse the interview data thematically. The study findings were then synthesised to model potential pathways for intervention.
Study participants identified that adapting to diabetes was a multi-dimensional process occurring over a long period of time. Two overarching and interrelated elements were identified within this process: learning about diabetes and learning to live with diabetes. Learning about diabetes encompassed the technical skills and knowledge required to self-manage their treatment on a daily basis. Learning to live with diabetes involved recognising the uniqueness of diabetes in terms of its enduring and all-encompassing nature, and understanding the way diabetes influenced their self-identity, their social relationships and their engagement in the wider society. The findings suggest that most of the support provided to the participants in their early disease experience was focussed on learning about diabetes rather than how to live with it.
The failure to attend to patients’ emotional reactions to diabetes or equip them with the skills necessary for a life with diabetes, may lead to the development of unhelpful behaviours and a tendency to disassociate from diabetes. The findings of this study suggest that enhanced psycho-social intervention during this early ’fluid’ phase of the disease may be important in preventing the development of harmful emotional responses and the habituation of behaviours that may increase their risk of complications and reduce their short and long-term well-being. Such interventions need to be instigated from the point of diagnosis, with a focus on developing positive adaptive strategies and thinking styles.
| Date of Award | 1 Nov 2017 |
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| Original language | English |
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| Supervisor | Angus Forbes (Supervisor) & Jackie Sturt (Supervisor) |