A qualitative study of problem solving and diabetes control in type 2 diabetes self-management

PURPOSE The purpose of this study was to explore and compare diabetes-related problem solving in urban African Americans in good and poor diabetes control. METHODS Two focus groups were conducted, one with participants in good diabetes control and one with participants in poor control. Based on a theoretical model, focus group interview questions were designed to elicit responses about 3 aspects of diabetes-related problem solving. (1) problem-solving orientation, (2) problem-solving process, and (3) transfer of past experience. Transcripts were analyzed using a qualitative data analysis software program, and expert panel members independently reviewed responses and coding. RESULTS The primary types of problems with diabetes self-management were similar in the good control and poor control groups. Predominant problem-solving themes in the good control group reflected a positive orientation toward diabetes self-management and problem solving, a rational problem-solving process, and a positive transfer of past experience. In contrast, predominant themes in the poor control group revealed a negative orientation, careless and avoidant problem-solving processes, and negative transfer of past learning to new situations. CONCLUSIONS The problem-solving model may help identify ineffective problem-solving patterns in persons with poor diabetes control. Empirical studies testing the model are warranted.