Indigenous application of self-management: A concept analysis

To report an analysis of the concept of self-management in the context of type 2 diabetes, examining how it has been defined, understood, and applied within Indigenous contexts and grounded in Indigenous ways of knowing.

Concept analysis.

Keywords and Medical Subject Headings for self-management, type 2 diabetes, and Indigenous Peoples were used to search six databases for articles published in English from January 2002-May 2026.

The six steps of Rodgers' evolutionary concept analysis guided the search, with specific attention to how the concept of self-management was defined, applied, and understood in Indigenous contexts. The analysis focused on studies involving Indigenous Peoples living in Canada, the United States, Australia, and New Zealand and examined attributes, antecedents, and consequences of the concept of self-management as applied in Indigenous contexts.

After full text screening, a total of 15 articles were included in the final concept analysis. Antecedents of the self-management of type 2 diabetes from an Indigenous perspective included self-determination, cultural continuity, impact of colonization, problem solving skills, and respect for traditions. Attributes were classified into seven categories: physical function, cognitive ability, spirituality, cultural connection, access to care, knowledge regarding diabetes, and social support. Consequences of the self-management of type 2 diabetes among Indigenous Peoples were classified into two categories that included wholistic well-being and cultural resiliency.

Findings from this concept analysis highlight that "self-management," as defined in Western biomedical literature, is a relatively recent construct. However, Indigenous Peoples have long engaged in practices of balance, wellness, and collective responsibility for health that align with and expand beyond this concept. Situating type 2 diabetes self-management within Indigenous contexts underscores the importance of Indigenous perspectives of health and well-being while acknowledging the ongoing harmful effects of colonial violence on these practices.

Self-management from an Indigenous perspective is complex, with strong socio-historical underpinnings. This concept analysis informs a broad wholistic approach to education when discussing the self-management of type 2 diabetes with Indigenous Peoples. This approach must focus on physical function, cognitive ability, spirituality, cultural connection, access to care, education, and social support. Integrating Indigenous perspectives into self-management approaches can support more culturally safe, relational, and contextually relevant care for individuals living with type 2 diabetes.No Patient or Public Contribution.