Concerns of Physicians and Nutritionists on Self-Management of Diabetes Mellitus among the Tamils Living in the Batticaloa District: A Qualitative Study

Abstract

Plausible reasons for the steady increase in the prevalence of Diabetes Mellitus (DM) in Asian countries may include poor lifestyle, rapid urbanization, lack of knowledge and unsatisfactory attitude and practices towards disease among patients with DM. The purpose of this study was to explore the lived experiences of physicians and nutritionists treating Tamils with DM living in Batticaloa District Sri Lanka, with regards to their attitudes and to understand their culturally acceptable practices in self-management of DM. Two consultant physicians and two nutritionists who treat Tamil patients with DM were recruited voluntarily. Descriptive qualitative methodology was used to explore the lived experiences of physicians and nutritionists. The data were collected by in-depth interview by using audio recording and verbatim transcripts were analyzed on the basis of content analysis. The results show that Tamil patients with DM have poor diabetic self-management practices mainly due to ignorance of diet habits, ignoring dietary advice, changing of lifestyle, reduced physical activity, reduced relaxation, non-compliance, delay in seeking treatment and ignorance of self-care. The analysis also revealed that healthy eating, being physically active and risk reducing behaviors of patients would facilitate better self-management of DM among Tamils. The findings of current study indicate that self-management of DM among Tamils largely depends on their attitudinal changes. All the interviews of physicians and nutritionists revealed that controlling DM is not easy unless sincere commitment of time and effort is taken by patients. Ignorance, poor dietary habits and lifestyles have impacts on Tamil patients with DM. The finding would contribute to better self-management of the disease among Tamils if they adhere to the acceptable practices by modifying lifestyles and changing the attitudes and practices which will enable health care workers to assist diabetics for better self-management.