Exploration of barriers to self-care practices among diabetic patients attending chronic disease clinic in an urban slum

Abstract

Background: Glycemic control in diabetes can be achieved by adopting self-care practices. It also leads to reduction of complications and improvement in the quality of life. Identification of barriers to adopting these practices can help devise strategies to overcome them. This study was conducted to understand the self-care practices among diabetics and the barriers affecting those practices among diabetics in the urban slum area. Materials and Methods: This qualitative study using Focus Group Discussions (FGDs) was conducted in a chronic disease Outpatient clinic in Mumbai, in November 2020. Four FGDs with 32 participants were conducted. Thematic analysis of the transcripts was done. Results: Three major themes were identified – living with diabetes, practices to maintain glycemic control, and potential barriers. Barriers for self-care practices were - confusing advice provided by family and doctors, feeling rejected (stigmatized), lack of motivation for exercise, complications of diabetes, lack of family cooperation, lack of knowledge on foot care, physical constraints, nonavailability of medications, lack of social and financial support, suboptimal knowledge regarding diabetes, and misconceptions. Conclusions: Motivating diabetic patients for regular physical activity by starting from simple indoor exercises to outdoor exercises are necessary. Counseling the family members on the complications of diabetes due to inappropriate dietary practices should be advocated. Improvement in doctor-patient communication and providing information on the foot care practices is the need of the hour.