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"Have to Fight the Demon": Veteran Type 2 Diabetes Mellitus Behavioral Self-Management and Diabetes Specific
Joanne Roman Jones1,2, Stephanie Hart3,4, Matthew J Crowley1,5
1Durham VA Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC, USA.
Objectives:
Diabetes mellitus Type 2 (T2DM) requires a set of life-long, complex self-management strategies that affect both physical and psychosocial aspects of daily life. This study aimed to assess how Veterans with T2DM describe self-management behaviors and to explore whether a framework of diabetes-specificrisk-taking behaviors (originally applied to adolescents with T1DM) is applicable to Veterans with T2DM.
Methods:
This study employed a secondary qualitative analysis of Veteran interviews (n = 36) using a priori codes based on the Summary of Diabetes Self-Care Activities (SDSCA) and the Diabetes-Specific Risk-Taking Inventory (DSRI) to explore self-management behaviors and to assess the applicability of diabetes-specific risk-taking behaviors among Veterans.
Results:
We identified themes aligned with each of the SDSCA a priori codes, along with an added code relating to medication, reflecting both self-management behaviors and diabetes-specific risk-taking behaviors: (1) diet: constant negotiation can involve purposeful risk-taking; (2) physical activity: intentional, but also avoided despite consequences; (3) blood-glucose monitoring: personal effort of monitoring can override risk-reduction; (4) foot care: preventing complications; (5) smoking: struggles and successes with quitting; and (6) medication: intent to adhere can be undercut by risk taking and lack of resources.
Conclusion:
Veterans described self-management behaviors that align with diabetes-specific risk-taking, suggesting that the DSRI framework has potential applicability to this population. Future work exploring diabetes-specific risk-taking behaviors will be critical to helping Veterans successfully manage their T2DM.
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