Publication:

Barriers and facilitators of self-management behaviours among adults with type 2 diabetes in Harare, Zimbabwe: a grounded theory study

Background Improving self-management in patients with type 2 diabetes can decrease complications, encourage healthier lifestyles, and enhance quality of life. While guidelines specify key self-management practices for optimal glycaemic control, many patients find it difficult to adhere to them, especially in developing countries. This study sought to identify the barriers and facilitators impacting diabetes self-management among adults with type 2 diabetes. Gaining insight into these factors is essential for developing patient-centred strategies that effectively help improve health outcomes.

Methods The study was guided by Charmaz’s constructivist grounded theory. It employed two sampling methods: purposive and theoretical. Initially, purposive sampling involved selecting eight adults with type 2 diabetes to generate themes for further exploration. As categories emerged from data analysis, theoretical sampling was used to refine underdeveloped categories. A total of twenty-eight face-to-face semi-structured interviews were conducted.

Results Data analysis revealed that living with type 2 diabetes involves engaging in self-management practices. Key facilitators included: receiving social support, being motivated to make changes, taking responsibility for the illness, and building a patient-healthcare professional relationship. On the other hand, barriers compromised: having financial difficulties, experiencing societal stigma, having health illiteracy, and experiencing food insecurity.

Conclusions Patients with type 2 diabetes encounter various barriers and facilitators in managing their condition. The analysis highlighted how interpersonal, social, and economic factors affect their self-management behaviours for diabetes. These findings emphasise the need for interventions that are contextualised, culturally sensitive, and tailored to individual patients.