Stakeholders’ perceptions of dietary and related self-management challenges and education programme preferences for type 2 diabetes adults

Objective: To inform the adaptation of an intervention from a primary healthcare setting to a tertiary setting, the dietary and related self-management challenges and education programme preferences of adults with type 2 diabetes (T2DM) were explored. Setting: A study was undertaken in a tertiary teaching hospital in Gauteng Province, South Africa. Methods: A qualitative approach was employed. Data were collected via focus-group discussions and open-ended self-administered questionnaires from a convenient purposive sample of T2DM patients (n = 28; 40–70 years) and health professionals (n = 10) respectively. Data were analysed using a thematic framework method. Results: Participants revealed diabetes-related knowledge deficits and struggle with adhering to diet, exercise, medication and appointment keeping as problems affecting patients. They also perceived multiple barriers to effective self-management (financial constraints, unsupportive social and physical environments and personal factors). Patients perceived the challenges to greatly impact on their quality of life and consequently the motivation to self-care appropriately. Participants desired an education programme in the form of monthly group meetings with approaches to enhance learning (e.g. use of examples from peers and the provision of education materials). Strategies for motivating and sustaining programme participation (e.g. testimonials from successful participants) were perceived as necessary. Involving family was seen as a key support for positive behaviour change. Conclusion: In adapting the intervention, the participants’ preferences for education need to be considered and the unique challenges addressed. In particular, strategies for enhancing the patients’ motivation and the self-efficacy to effectively self-manage are essential.