Perceptual systems of the self-management of students living with diabetes mellitus: an IQA approach

Abstract

The main purpose of this investigative study was to gain knowledge surrounding the perceptions of students’ self-management living with diabetes mellitus (DM) in a tertiary institute. DM is a chronic and metabolic disease that is defined by elevated blood glucose levels over a long period of time. One in ten people are living with DM and since 1980, the number of DM patients increased from 108 million to 425 million in 2017. When DM is uncontrolled the consequences could lead to polyuria, weight loss, polyphagia, overeating and blurred vision. The general research objective of this study was to make use of the Interactive Qualitative Analysis (IQA) to construct and describe a cognitive mind map of the perceptions of self-management of students living with DM on the NWU Potchefstroom campus. Self-management has been defined as “an ability and process that individuals use in conscious attempts to gain control of his or her disease”. DM care responsibilities increase when one enters the life stage of “after high school”. Tertiary education could raise concerns for adolescents who are not prepared for new independence and challenges, especially students with DM. An analysis of the participants’ mind map representing students living with DM on the NWU Potchefstroom campus, reveals eight main components (affinities) namely, Social awareness and acceptance, Food available on campus, Keeping insulin cool, Independent lifestyle, Adjusting by cooking, Hurdles in the academic environment, Causes of changing blood sugar and Adapting to effects of changing blood sugar. Participants completed an Affinity Relationship Table (ART) to add richness and in-depth descriptions of the meaning of the affinities. The final perceptual system is an informative representation of the self-management of students living with DM. The system reflects barriers towards compliance with self-management of students living with DM. The system produced four recognisable loops or cycles namely The Ignorance loop, The Revision loop, The Developing loop and The Self-management Loop. These loops created pathways through the system for the students to find a way to better self-management living with DM. The pathway leads from the primary driver, Social awareness and acceptance, to the primary outcome, Adapting to effects of changing blood sugar. In this pathway, the four feedback loops were present and had to have connections with each other to complete the way for the primary driver to the primary outcome. The connections where feedback loops overlapped played an important role as they support the potential for the student to move out of the one feedback loop to the other or for the student to get stuck in a negative cycle in the loop and have the potential of slipping back to previous loops. This study was the first to be done on the perception of students’ self-management living with DM on the NWU Potchefstroom campus and provide new and previously unknown information in the format of a perceptual system and model to probably benefit students living with DM.