Fears and worries associated with hypoglycaemia and diabetes complications: perceptions and experience of Hong Kong Chinese clients

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Abstract
Aim. This paper reports the second phase of a study that explored the perceptions and experience of Hong Kong Chinese insulin‐treated clients who demonstrated fear of hypoglycaemia and worry about diabetes complications. Background. The first phase of the study, a descriptive survey ( n = 120), identified 15% of respondents as simultaneously sustaining fears and worries associated with hypoglycaemia and diabetes complications. Although a small percentage, given the increasing number of clients using insulin treatment, this finding suggests a pocket of clients suffering from undesirable emotional health. However, a search of the literature identified few studies exploring Chinese clients' perceptions and experience in this area. Design. The second phase of the study employed a purposive sampling method and semi‐structured interviews to collect data from 13 participants experiencing these fears and worries. Findings. Two researchers independently used content analysis to code and categorize data. Six categories identified were: the influence of perceptions of glycaemic control on emotion, hypo‐ and hyperglycaemia as a constant threat, keeping optimal glycaemic control or maintaining a working life, financial and psychological burden of blood glucose self‐monitoring, being alone with the threat and finally distancing as the coping method. An overriding issue, a sense of losing control, emerged from the findings that described participants' perceptions and experience. This issue and two major health needs, developing self‐efficacy and emotional support from nurses, were drawn from the findings for discussion. It is suggested that self‐efficacy theory can be adopted as a conceptual framework to guide nursing practice for enhancing clients' capacity to exercise control over diabetes self‐management. Conclusions. Findings obtained from the second phase of the study illuminated those from the first phase. Implications for nursing practice were identified, including facilitating both technical and psychosocial self‐efficacy, assessing clients' total life situation, strengthening competence in counselling skills and forming alliances with clients.