Living with type 2 diabetes in a Thai population : excperiences and socioeconomic characteristics

by Wimonrut Boonsatean

Institution: Malmö University
Year: 2016
Posted: 02/05/2017
Record ID: 2099850
Full text PDF: http://hdl.handle.net/2043/20373


Type 2 diabetes is a matter of global concern, and has been shown to have an impact on an individual’s way of living, family, and social life. In addition, there is limited knowledge concerning the life experiences of Thai people with diabetes. The aim of this thesis was to explore the experiences of people with type 2 diabetes who live in partly low socioeconomic suburban areas of Thailand. Both qualitative analyses with 19 women of low socioeconomic status with diabetes and quantitative analyses, including 220 people with diabetes, were conducted in the suburban communities near Bangkok between 2012 and 2015. The thesis consists of the results of four studies described in four papers. In paper I the aim was to explore how Thai women of low socioeconomic status handled their lives with diabetes. The findings showed that the women went through many stages of changes in the process of adaptation in handling their vulnerable situation influenced by diabetes and socioeconomic status. A threatened loss of status was sometimes seen as a barrier to handling their disease, whereas empowerment by one’s family helped them to feel powerful and gave them a sense of hope in living with this disease. Paper II illuminated the life experience of Thai women of low socioeconomic status living with diabetes. The findings revealed that women confronted susceptible feelings such as worrying about an unpredictable future and fears of being a burden to their family. However, they were able to maintain a balance through empowerment via the inner and outer sources of their beliefs. In paper III the aims were to investigate and compare the illness perception and self-management among women and men with diabetes, examine the association between illness perception and self-management, and to investigate the psychometric properties of the translated instruments. Both Thai versions of the measurement tools (the revised illness perception, diabetic version questionnaire and the new revision of the diabetes self-management questionnaire) demonstrated acceptable content validity and reliability, including internal consistency, inter-rater, and test-retest reliability. The findings showed that the illness perception and self-management strategies among the women and men had similar patterns, except for three aspects of illness perception. Whereas the women more often perceived the consequences of diabetes and fluctuating symptoms, the men felt more confident about efficiency of the treatment prescribed by the healthcare professionals. Furthermore, the illness perception, especially the confidence in controlling diabetes by themselves and the confidence about treatment effectiveness, in both women and men showed a weak possitive association with many aspects of self-management strategies. Paper IV examined the illness perception and self-management of Thai people with diabetes according to their socioeconomic status, as defined by income and educational level. The participants of the low-income and low-education groups perceived more…