Personal understandings of illness among people with type 2 diabetes

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Abstract
Background. Professionals and patients understand the experience of illness from different worlds. Professionals’ explanatory models focus on aetiology, diagnosis, pathophysiology and treatment, while patients’ explanatory models are more focused on consequences and influences on daily life. The differences between patients and professionals in their understanding often result in conflicting expectations about treatment, priorities and outcomes of care. Aim. The aim of this study was to describe personal understandings of illness among people with type 2 diabetes in Sweden. Method. A sample of 44 patients, 47–80 years, diagnosed with type 2 diabetes within the last 2 years, was recruited from four health care centres. Narrative thematic interviews were used covering the areas of developing, coping with and living with diabetes. Qualitative content analysis was performed. Findings. The findings were formulated into six categories: image of the disease, meaning of the diagnosis, integration of the illness, space for the illness, responsibility for care and future prospects. Conclusions. The findings demonstrate that patients’ personal understanding of illness is an important complement to the traditional professional view of diabetes. They could serve as a foundation for development of health history interviewing, as well as development of systems of documentation. Patients’ personal understandings of diabetes in their daily lives are considered to be an important shared source of information for planning meaningful care.