The Subjective Construction of Disease Control among Older Adults with Type II Diabetes

Abstract

While the development and progression of some chronic conditions is predominately beyond the control of the individual, diabetes, one of the most prevalent chronic conditions, is largely considered a controllable disease. Although diabetic control is well-defined within the medical community and associated literature, little is known about how the diabetic population themselves understand this concept. In order to address this gap in the literature, in-depth secondary qualitative analyses were conducted of interviews with 83 (European-American, n=42; African-American n=41) older adults (³50 years) diagnosed with diabetes. Inductive content analysis of 4,237 pages of interview data revealed an explanatory framework of five themes describing varied understandings of diabetes control: (a) glycemic control, (b) treatment adherence, (c) asymptomatic, (d) level of pharmaceutical need, and (e) illusory. Analyses also revealed several management approaches coinciding to oneÕs conceptualization of control: (a) reactive, (b) informed, (c) medicinal reduction, (d) fatalistic. Furthermore, race and gender differences emerged from the data. Results demonstrate that among those with diabetes, the term control is multifaceted and its meanings extend the standard clinical definition of this concept. Findings inform clinical practice, psychometric assessment, and refine research in this area.