You might be surprised to learn that type 2 diabetes is not just a personal health issue, but a rapidly rising global health emergency. With its prevalence increasing significantly worldwide, Thailand finds itself among the top countries in Asia grappling with this challenge. The dramatic increase in diabetes cases in Thailand is largely due to factors like unhealthy diets and a significant rise in obesity rates.
In the heart of Thailand, a study focused on storytelling and personal experiences has shed light on the complex journey of individuals grappling with type 2 diabetes and their struggles with controlling blood sugar levels. This study, led by Patcharee Numsang from Srimahasarakham Nursing College, and joined by colleagues Sakaorat Kraichan and Puangkaew Sarapoke from the same college, Professor Areewan Oumtanee from Chulalongkorn University, Suwakon Kurat from the College of Asian Scholars, and Rattana Sananok from Mahasarakham Hospital, provides an in-depth look at the daily lives and challenges faced by those with this condition. Published in the International Journal of Nursing Sciences, this research offers a rare glimpse into the personal experiences of eight Thai individuals living with this condition.
The researchers employed a storytelling-based qualitative approach, carefully selecting eight participants from a primary healthcare center in northeastern Thailand. Data collection spanned a few months at the end of 2021, utilizing individual detailed interviews, observational notes, and non-participatory observation. This method was chosen to thoroughly understand the experiences of the participants. Interviews were conducted at the participants’ homes, ensuring comfort and authenticity in their responses. The structured interviews were divided into two sections: personal and demographic details and experiences related to poor control of blood sugar levels and self-care management. Each interview lasted about an hour, with every word transcribed word for word to capture the essence of the participants’ stories and perspectives.
Patcharee Numsang explains, “In this study, it was found that persons with diabetes commonly have poor control of their blood sugar; for example, because of unhealthy lifestyle behavior due to their self-care practice and knowledge linked to diet, medication use, and exercise as misperception and a lack of concern regarding complications as well as beliefs related to culture.” The study finds that cultural influences and personal beliefs often overshadow medical advice, leading to poor dietary choices and inadequate self-care.
The study unveils that despite the abundance of medical knowledge and guidance available, many individuals struggle with the practical aspects of diabetes management. Inconsistent lifestyle practices, such as irregular medication intake and exercise routines, are common among participants.
Numsang further elaborates, “A person’s accurate understanding of their blood sugar control is likely to be critical for successful changes in behavior for diabetes self-care management as both illness understanding and self-management practices are linked to blood sugar control. Other studies on self-perception of blood sugar control have found that misperception is linked to high adherence to lifestyle regimen, level of family support, failure to control blood pressure, and experiencing diabetic complications.”
Participants also revealed a deep-rooted belief that diabetes is a hereditary condition, which they must accept as an inevitable part of life. This resignation often leads to a lack of proactive management of the disease, increasing the risk of complications. The study also highlights the psychological impact of diabetes, where daily stress from socioeconomic challenges further hinders effective blood sugar control.
Numsang and her team emphasize the critical role of healthcare professionals in addressing these challenges. They advocate for a more culturally sensitive approach to diabetes education and management. Tailoring interventions to align with individual beliefs and lifestyles can significantly improve diabetes care in Thailand.
The study concludes with a call for more comprehensive, culturally attuned strategies to support individuals with diabetes in managing their condition effectively. The insights from this research not only contribute to the existing body of knowledge but also offer practical guidance for healthcare providers aiming to improve diabetes care in culturally diverse settings.
Patcharee Numsang et al., 2023. “Failure to control blood sugar” experiences of persons with type 2 diabetes. International Journal of Nursing Sciences. DOI: https://doi.org/10.1016/j.ijnss.2023.09.004
About the Authors
Patcharee Numsang is a PhD Candidate at the Faculty of Nursing, Chulalongkorn University, Bangkok, and works at Srimahasarakham Nursing College, Faculty of Nursing, Praboromarajchanok Institute, Maha Sarakham, Thailand. Her research focuses on chronic diseases and adult nursing, including qualitative research (i.e., grounded theory, descriptive qualitative research) and quantitative research; for example, randomized controlled trials (RCTs), systematic review, and meta-analysis. Moreover, she feels interested in instrument development, R&D, and nursing practice guidelines. Therefore, these multiple experiences have enhanced her knowledge of caring for patients with chronic illnesses over the past thirty years, such as diabetes, hypertension, and kidney disease, as well as some issues in cancer and palliative care.
Assoc. Prof. Dr. Areewan Oumtanee is faculty member of Chulalongkorn University, Faculty of Nursing, Bangkok, Thailand. Her expertise areas are 1) nursing administration including leadership, nurse competency, nursing entrepreneurship; 2) qualitative research including phenomenology and grounded theory in nursing science; and 3) instrument development in nursing research. Her multifaceted contributions underscore her commitment to advancing nursing knowledge, shaping competent nursing professionals, and fostering a research-rich environment. Her dedication to nursing education, administration, and research significantly impacts the broader healthcare landscape in Thailand and beyond.
Suwakon Kurat is an instructor at the Faculty of Nursing, College of Asian Scholars, Khonkaen, Thailand. Her research focuses on chronic illness and adult nursing, and she has conducted research regarding health promotion, long-term care, delay renal impairment, and palliative care, such as diabetes management, health promotion of the adult and elderly, and the caring need response among terminally cancer patients.
Rattana Sananok is a head of Samukkee Primary Care Unit (PCU), Mahasarakham hospital, Thailand. Her research focuses on community of practice, community health care, and general practice. As the Chief at PCU, she has conducted clinical trials that help explain self-management and health promotion to influence healthcare; for instance, health promotion of the elderly and self-management behaviors among diabetes patients.
Sakaorat Kraichan is a Deputy Director of Srimahasarakham Nursing College, Faculty of Nursing, Praboromarajchanok Institute, Thailand. Her research focuses on leadership, teamwork, nursing administration, chronic illness, and elderly nursing. As an instructor, she has researched nurse preceptors, community-based, and health promotion of the elderly.
Puangkaew Sarapoke is an instructor at Srimahasarakham Nursing College, Faculty of Nursing, Praboromarajchanok Institute, Thailand. Her research focuses on chronic illness and adult nursing. As an instructor, she has researched applying the Moral Hospital Concept, the success of education quality assurance implementation, and health promotion of the adult and elderly.