Diabetes management behaviours of young adults towards psychological well-being
Significant numbers of young adults living with type 1 diabetes experience diminished psychological well-being due to non-adherence to the strict diabetes self-management care plan required. This study explored psychosocial variables underpinning psychological well-being for young adults living with well-controlled type 1 diabetes in the greater Gauteng province, South Africa. The role of the psychosocial variables such as a personal model of diabetes, meaning, and social support were explored in an attempt to better understand these variables and the relationship thereof towards psychological well-being within blood glucose levels (HbA1c) that were reported to be within the near-normal range. A multi-methods research methodology was applied from a predominantly qualitative paradigm. The life stories of eight young adults, living with well-controlled type 1 diabetes, were explored in order to gather qualitative data on the psychosocial variables influencing their diabetes management behaviours and psychological well-being. Thereafter, semi-structured interviews were conducted with six young adults living with well-controlled type 1 diabetes, to determine the relationships between the previously identified psychosocial variables and diabetes management behaviours. The aim was to develop an in-depth understanding of how and why these psychosocial variables shape diabetes management behaviours, as well as the mechanisms that are used to make sense of living with type 1 diabetes. Quantitative data was also analysed to supplement the understanding of the relationships between the psychosocial variables and the young adult’s diabetes management behaviours. The quantitative data was obtained from validated, psychometrically sound instruments, measuring diabetes management (DSMP-SR), psychological well-being (PHI), the personal model of diabetes (IPQ-R), meaning (MLQ) and social support (M-DSSQ). Finally, a case study of a young adult living with well-controlled type 1 diabetes was explored in order to assess the validity of previous findings relating to the psychosocial variables as well as the relationships thereof towards the diabetes management behaviours and psychological well-being of the individual. Ultimately, the study aimed to put forth a meaningmaking framework that would encapsulate the meaning-making process for young adults living with type 1 diabetes. The psychosocial variables influencing diabetes management behaviours were conceptualised and situated in context, allowing for the psychological well-being of young adults living with type 1 diabetes, to be viewed in an integrated way. Emergent themes were, firstly, the experiences of developing an autonomous identity while living with the challenges of managing type 1 diabetes; secondly, the emotional distress that the young adults experienced mainly due to practises linked to the restrictive meal plan and the overall loss of their dreams and aspirations they held for their future; and finally, the diabetes management activities as well as social support that they experience as very personal, frustrating, and challenging, resulting in this diabetes journey to be experienced as incredibly lonesome. Despite young adults experiencing emotional distress, they still managed to uphold near-normal blood glucose levels, which made it necessary to explore the proposed meaning-making framework for these young adults. The outcome of such a meaning-making process was seen in the creation of a new, normal way of living with type 1 diabetes. A new way of living that left room for diabetes selfcare, taking responsibility for self-care, and the deliberate use of coping- or meaning-making efforts. Moreover, this research highlighted the cognitive complexity of diabetes management behaviours that need to take place on a daily basis in order to manage the condition effectively.
- Humanities