An Interpretive Descriptive Study on Exploring Barriers to, and Facilitators of, Diabetes Self-management: Perspectives From Dialysis Patients With Diabetes.

OBJECTIVES

Self-management is a key component of optimal diabetes treatment. Patients with coexistent diabetes and kidney failure that requires dialysis have an additional health burden, which complicates self-management practices. Limited studies have explored barriers and facilitators using qualitative methodology for patients in the context of kidney failure on dialysis. Our aim in this study was to understand barriers and facilitators to diabetes self-management among patients with kidney failure requiring dialysis therapy.

METHODS

An interpretive descriptive methodology was used to address the study objective. We conducted semistructured interviews with 14 participants.

RESULTS

Fourteen participants (7 men and 7 women), 45 to 84 years of age, participated in semistructured interviews. Analysis of 14 interviews identified perceived barriers to diabetes self-management that covered the following 5 themes: lesser stability and comfort; shortage of financial resources; physical limitations; health-care access and navigation; and medical complexity. Facilitators were grouped into 3 themes: greater health literacy and empowerment; supportive social environment; and motivation and optimism.

CONCLUSIONS

Findings from this study highlight the importance of further research in this domain to mitigate barriers and leverage facilitators, and to guide resource allocation to improve diabetes care and self-management education and support among patients with diabetes and on dialysis therapy.