[Exploratory study on the positive participation in the DMP Type-2 Diabetes Mellitus in Westphalia Lippe]

This exploratory study, carried out on behalf of an association of German health insurers, the AOK Bundesverband, examined the positive, subjective effects on patients participating in the Westphalia Lippe DMP Type-2 Diabetes Mellitus ('Curaplan', started June 2003) in terms of coping with diabetes and handling the disease. A two-stage qualitative method was selected: First, 250 respondents were questioned using 15-20 minutes half-structured telephone interviews; approximately 40% of the interviewed reported a subjective improvement related to participation in the Curaplan program. In a second step, in-depth interviews were then carried out with 50 of the respondents who had reported a profit from the program. Analyses proceeded in a phenomenon-oriented fashion according to a differentiation and a general psychological-coping perspective. At a differentiation level, eight modes of coping with the illness were reconstructed, for each of which respondents identified a specific improvement. These were: "Consistent/rational commitment", "Discovery-oriented acceptance of challenge", "Search for illness-mediated compromise", "Anxious quest for increased control", "Blinkered denial", "Hopelessness", "Inability to cope and insecurity", "Selfless low prioritization of disease". At a general level, five central positive dimensions of participation were observed: "Relationship/not being alone", "Meaning/importance", "Knowledge/consciousness", "Ability to manage/competence gain", as well as "Happiness/optimism". These dimensions complemented and supported one another. The results are not statistically representative but contribute to optimized implementation through psychological understanding of the best cases. Further studies should examine correlations of subjective processes with objective variables.