"Knowing Where I Am At": The Experience of Self-Monitoring Blood Glucose for People with Non-Insulin-Requiring Type 2 Diabetes.

<p>Eleven participants living with non-insulin-requiring Type 2 Diabetes (T2DM) discussed their self-monitoring blood glucose (SMBG) experience. All had been recently diagnosed (< 2 years) and treated for diabetes with a self-regulating SMBG guideline for primary care practice. Their digitally-recorded interviews and photographed logbooks were analyzed thematically and interpreted through the lens of numeracy literature to answer 2 questions: 1. What is the meaning of SMBG among people with non-insulinrequiring T2DM? 2. How do people with non-insulin-requiring T2DM perceive the function of SMBG in diabetes self-management? The meanings of SMBG were patient competence, "It is easy, just a little pin prick"; patient control, "I can control it. It doesn't control me"; and patient security, "It is not that way anymore." Three periods of lived time were observed: <em>Diagnosis</em> "The numbers say I have diabetes"; <em<Behavior change</em> "I just can't figure out why it does that"; and <em>Routine</em> "I make my numbers." Prominent numeracy functions emerged by time period. During <em>Diagnosis</em> primary numeracy functions included comparing SMBG results to target values. Participants expressed this experience as, "I am some kind of O.K." During <em<Behavior change</em> applied numeracy functions included taking medication correctly. SMBG readings were experienced as a clue to the diabetes mystery, sometimes confusing the participants, "I just don't know why it does what it does," or answering questions, "Now there is no question marks." Numbers motivated some people for action "The numbers get me out a walking" or restraint "If I didn't have the numbers, I would be tempted to cheat." During <em>Routine</em> interpretive numeracy functioned to aid the evaluation of the efficacy of participant's health behavior change. Numbers had taken on meaning helping a person to "know where I am at." Clinical implications are suggested including adjustments to the selfregulating SMBG guideline for primary care practice. Findings are discussed in relation to personal knowledge processes (Sweeny, 1994) and related SMBG research. Participants concluded that routine SMBG is essential to maintaining and restraining health behavior. This study provides a model for use of SMBG in diabetes selfmanagement and patient perspectives on SMBG during the 2 years following T2DM diagnosis.</p>

Name thesis:degree_name

PhD (Doctor of Philosophy)

Level thesis:degree_level

Dissertation - unrestricted

Discipline thesis:degree_discipline

Nursing

Year dc:date.issued

2010

Author dc:creator

• Brackney, Dana Elisabeth

• Numeracy
• Interpretive Description
• Personal Knowledge
• Type 2 Diabetes
• Self-Monitoring Blood Glucose (SMBG)
• Illness Experience
• Medicine and Health
• Social and Behavioral Sciences
• Sociology

Statement dc:rights

• Copyright by the authors.

Repository record dc:identifier

https://dc.etsu.edu/etd/1727

OAI identifier oai:identifier

oai:dc.etsu.edu:etd-3082