Maintaining behavioral changes: A descriptive account from individuals with type 2 diabetes
Type 2 diabetes is a serious metabolic disorder occurring in over 90% of the people in the United States diagnosed with diabetes. The standard treatment for type 2 diabetes requires individuals to self-manage a diet, exercise, and self-monitoring of blood glucose (SMBG) to control blood glucose levels and reduce the onset of serious complications. Although there is a plethora of literature addressing the difficulty individuals have to maintain these three behaviors, few studies exist describing how these behaviors are sustained. ^ This descriptive qualitative study was designed to learn how individuals with type 2 diabetes maintained behavioral changes of diet, exercise, and SMBG beyond an initial 6-month period and to identify obstacles, strategies, lapses, relapses, and factors facilitating maintenance. The concept of maintenance, the last stage of change in a series of five within the Transtheoretical Model of Change (TTM) (Prochaska, Norcross, & DiClemente, 1994) begins after changes have been sustained for 6 months. The processes of behavior reinforcement, stimulus control, helping relationships, and self-efficacy are used as facilitating factors. ^ In-depth interviews (May, 1991) were used to elaborate on maintenance behavior. Five informants, who had self-reported on a previous diabetes study that they had maintained behaviors, were interviewed. One-to-two in-depth taped interviews lasting 1–2 hours with 1–2 follow-up phone calls were conducted. Within and between case analyses were completed based on the research questions. ^ Similar behaviors were found among the informants. Informants adapted their behaviors to their personal circumstances. SMBG was used as a feedback mechanism to reinforce positive and negative behavior. Consistent with the TTM, behavior reinforcement, stimulus control, helping relationships, and self-efficacy were used. ^ The findings further indicated the informants' acceptance of responsibility, adaptability, persistence, and determination in self-managing diabetes. Also, fear of complications emerged as a powerful factor. Educators and practitioners when caring for clients in maintenance should consider these findings. ^
Psychology, Behavioral|Health Sciences, Nursing
Rosemary Fedrigon Hall,
"Maintaining behavioral changes: A descriptive account from individuals with type 2 diabetes"
Dissertations and Master's Theses (Campus Access).