Research Article

The Impact of an Internet-Based Self-Management Intervention (HeLP-Diabetes) on the Psychological Well-Being of Adults with Type 2 Diabetes: A Mixed-Method Cohort Study

Table 5

Domains, themes, su-themes, and illustrative quotes for the preintervention data.

Domains, themes, and subthemesIllustrative quotes

(1) Difficulties of Living with Diabetes
(1.1) Impact on psychological well-being
 (1.11) Worries about long term complications“I ask God, you want to take something, take a leg but let me have my eyes.” (P4)
 (1.12) Concerns about medication and related side-effects“you take medication, they treat one thing, they give you complications and the others, so… there’s other things that play up in my mind as well. Knowing, okay, this is treating these, but there’s side-effects as well.” (P1)
 (1.13) Desire for normality“that’s part of wanting to feel as normal as possible and to feel as normal as possible could involve a degree of pushing to one side what actually one needs to do to remain stable and to manage one’s condition.” (P5)
 (1.14) Managing by minimising concerns “it’s not treated at a deadly serious level, it’s treated lightly probably to disguise what’s going on underneath.” (P14)
 (1.15) Anger and self-criticism“I could be quite bad-tempered sometimes, and possibly…it might have been caused by…the thought of the diabetes. I could lose my temper.” (P6)
 (1.16) Feeling depressed and apathetic“… I’m not a depressing type of person, but it can make you feel down sometimes.” (P17)
(1.2) Difficulties with self-management
 (1.21) Battles with eating and weight“It’s a bit tricky because I like food and I like cooking, and so it’s…yes, it’s quite a challenge” (P11)
 (1.22) Difficulty controlling blood sugar levels“It has taken an awful long time, not to take too much insulin and therefore get hypos and/or, not take enough and my diabetes goes up.” (P3)
 (1.23) Lack of control or predictability“There are mysteries and disconnect between the prescribed treatment and the result.” (P14)
 (1.24) Difficulty sticking to a regime “And so my main problem - apart from the odd lapses when I completely forget to take my medication, is how to stick to a regime which is going to have a positive impact on my health.” (P5)
(1.3) Social pressures and impact on social roles
 (1.31) Pressure from others“My children are very supportive; they just said, dad, you can’t have that, or they will ask at a restaurant, and now it’s…got too much sugar in, you just can’t have it. So, it’s quite nice. Sometimes a bit of a pain in the butt” (P8)
 (1.32) Impact on role in family“It contributes to one’s constant feeling of failure as a father, that you’re not bringing up your child properly, but… if you can’t rush out and do things.” (P7)
 (1.33) Impact on work role and hobbies“We both love going to museums and art galleries and stuff and now I can’t. I cannot walk round an exhibition, I’m too tired.” (P4)
 (1.34) Impact on social life and society“Often I’m faced with big meals and lots of drink, and often you can get away with it. Often you’d find you’d be giving offence if you don’t.” (P9)
(2) Hopes for HeLP-Diabetes
(2.1) Changing diet and losing weight“Hints on how I can lose weight and control my diabetes more.” (P3)
(2.2) Help with moods“That, Managing my Feelings – that looked quite interesting. That was something that has made me feel quite happy, actually.” (P19)
(2.3) Learning from other people with diabetes“The forum, if I go there, they have the same situation, so we can share, we can give some information, we can help each other.” (P13)
(2.4) Wanting to learn more about diabetes“Because I want to learn more, learn what I can do, the effects of it and whatever, you know, because I don’t want to be ignorant or that, I want to know about this thing and know as much as I can about it.” (P2)