Personal constructs in adults with type 2 diabetes mellitus : a dependency grid analysis

• Main Author: Gillibrand, Warren Peter
• Published: University of Central Lancashire 2006
• Subjects: 616.89; R Medicine (General)
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.572310

This thesis presents an investigation into the personal constructs that people with type 2 diabetes use, to live and manage their condition. The approach adopted was underpinned by personal construct psychology, utilising qualitative and dependency grid methods to determine individual personal constructs in a multiple case series design. In the thesis a critical discussion is presented of current UK national policy and clinical guidelines in diabetes care. This found that gaps exist in the current evidence base, particularly in individual approaches and interventions provided by healthcare professional services. The synthesis of research literature in the experience of adults with type 2 diabetes showed that some common themes exist; achieving balance, normalising and psychological alterations. Furthermore the synthesis revealed that self-efficacy and personal model research studies in diabetes have found that these issues are influential in how people live and cope with their condition. Using a convenience sample of adults with type 2 diabetes, predominantly cared for in the community, a series of interviews were conducted in a sample of 23 participants. Ten participants completed all the stages of the research data collection and these are presented in the results as a case study series. The dependency grid technique required each participant to complete a series of grid ratings of constructs and elements associated with their living with type 2 diabetes. The results of the exploratory qualitative interviews were five major themes of family, relationships and interactions; social-life/activity; emotional changes/support; meaningful work/sense of worth; and making adiustments/diabetes functional activity. The themes were translated into the dependency grids as constructs and participants then rated people as elements against these constructs. The analysis of the ten case studies showed personal constructs associated with interdependence with family, friends and healthcare professionals. The interdependence identified had strong or weak associations with diabetes related constructs depending on how each individual participant had rated them. The findings suggest that people with type 2 diabetes do not always consider primary care services as appropriate for their needs and contrast this with the value they previously made to secondary care services. Each individual has developed their own level of interdependence with some type 2 patients with diabetes being self reliant or using family members/friends more than professional health services. Recommendations include further exploration of interdependence in type 2 diabetes. Limitations of the study include sample issues, and a methodological approach that is educative and lengthy in implementation.