The incidence of diabetes in the United Kingdom is increasing and its impact on health and social care costs is significant, with considerable personal consequence for the individual with diabetes. Current approaches to managing or preventing diabetes include education, self management and lifestyle change but the evidence suggests that some people are unwilling or unable to make lifestyle changes recommended for better health and wellbeing.
This qualitative study examined the potential role of occupational therapy, with its focus on individual and daily occupations, to enable people with diabetes to manage this condition in the context of their own lives. Using a process of intuitive inquiry, it comprised three separate studies all using semi-structured interviews. The first, designed to explore the lived experience of diabetes, involved seven people with a diagnosis of type 1, type 2 or pre-diabetes. Findings were shared with participants using a felted metaphor of charting a course of health and well-being through a choppy sea. The second study involved ten occupational therapists with type 1, type 2, gestational or pre-diabetes and examined the use of metaphor as a means of understanding the lived experience. In addition the potential role of occupational therapy was explored with participants. Using knowledge gained from studies 1 and 2, the third study involved five people with type 2 diabetes and used metaphor as a means of exploring difficulties and successes in diabetes self management. All three studies were then drawn together to consider the use of metaphor and the potential role of occupational therapy in diabetes self management.
From the findings a model of the occupation of diabetes self-management is proposed along with a framework for occupational therapy intervention in diabetes self-management that focuses on the professional belief of the impact of occupation on health and wellbeing and considers the individual in their particular life context.