ArticleJournal of advanced nursing2025
Understanding Self-Care Patterns in Adults With Type 1 Diabetes: Insights From a Mixed Methods Study.
Article in Journal of advanced nursing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
aimThe aim of this study was to explore self-care among adults with type 1 diabetes (T1D) to (1) characterise possible self-care profiles in adults with T1D; (2) explain self-care maintenance, monitoring and management within the self-care profiles; and (3) develop a typology of self-care in adults with T1D.
designMixed-methods study with explanatory sequential design.
methodsParticipants (n = 200) completed a validated self-care survey. Cluster analysis of survey data was performed to identify self-care profiles. Then, semi-structured individual interviews were performed with a nested sample (n = 20) stratified by these profiles. Directed content analysis was applied to transcript data to describe self-care within profiles. Findings were integrated via joint display to develop a typology of self-care in adults with T1D. DATA SOURCES: A total of 200 adults with T1D were recruited from a diabetes centre in a large, urban US city from 6/2022 to 11/2022 (quantitative phase) and a nested sample (n = 20) from 12/2022 to 4/2023 (qualitative phase).
resultsWe identified three self-care profiles: Expert, Inconsistent and Novice. Expert self-care was characterised by a steadfast and holistic approach to maintaining health, the use of internal and external cues to monitor for health changes and informed management decision-making when health changes were detected. Inconsistent self-care was characterised by the capability to maintain health, often limited by low health prioritisation, a lack of perceived need for greater effort and compulsive management decision-making. Novice self-care was characterised by difficulty maintaining health and limited skill development in more advanced self-care processes, including monitoring for and managing health changes.
conclusionsThis study identified an Expert-Inconsistent-Novice typology of self-care in adults with T1D, aligning with previous research and suggesting a stable typology across conditions. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Characterising self-care among adults with T1D may facilitate aligning support with individual needs. IMPACT: Progression towards Expert self-care may offer clinically meaningful improvements in glycaemic control and reduced risk for diabetes complications. REPORTING
methodGood Reporting of A Mixed Methods Study (GRAMMS) Checklist. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
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