Exploring Self-Management Practices among People with Comorbidity of Type 2 Diabetes Mellitus and Metabolic Syndrome at Atua Government Hospital

Abstract

Background: Type 2 Diabetes Mellitus (T2DM) and metabolic syndrome (MetS) are interrelated chronic conditions that pose significant public health challenges, particularly in sub-Saharan Africa, where obesity and sedentary lifestyles are prevalent. Limited research has holistically explored self- management practices for people living with T2DM and MetS. Aim: The study aimed to explore the self-management practices of people living with the comorbidity of T2DM and MetS. Methods: This study adopted a qualitative exploratory-descriptive design grounded in interpretivism. Conducted at Atua Government Hospital, the study purposively sampled 17 participants aged 35–70. Data were collected through semi-structured interviews, audio-recorded, and transcribed verbatim. Thematic analysis, which the Health Belief Model guided, identified six key themes: Knowledge Acquisition and Interpretation of T2DM and MetS, (2) perceived benefits and ambivalence towards self- management, Perceived challenges of managing T2DM and MetS, Self-efficacy in managing T2DM and MetS, Adaptive Strategies and Coping Mechanisms for Managing T2DM and MetS, and Expected clinical interventions to manage conditions better. Results: The study found varied understanding of T2DM and MetS among participants, ranging from poor knowledge to a clear understanding of the conditions. Self-management strategies, including medication adherence and lifestyle changes, were hindered by financial constraints, physical limitations, and insufficient clinician support. Social and family support, faith, and the NHIS aided coping; the study supported the assertion that effective self-management is vital in the prevention of metabolic complications, as was expressed by participants to improve glycaemic control and psychological well- being. Conclusion: There is a clear indication for extensive patient education, culturally customised healthcare practices, and policy support to improve access, affordability, and quality care for people with T2DM and MetS. Future research should investigate the role of culturally recognised traditional medicines and dietary behaviours. The impact of improved communication and customised care on treatment adherence and health outcomes also needs further exploration.