Type 2 diabetes is a chronic metabolic disorder characterized by elevated blood glucose and a high risk of micro- and macrovascular complications. Prognosis depends to a substantial degree on self-management, that is, the adoption of practices to stabilize blood glucose and stave off co morbidities. This research set out to compare the narratives of people with good and poor glycaemic control (defined as 3 recent HBAIC readings <7 and >10 respectively), and of men and women. Participants (N=32) were recruited from local diabetes hospital clinics, and interviewed using a biographic-narrative method. Interviews were analysed with the use of dialogical and phenomenological concepts including voice, emotional connection to truth, and time-space elaboration of narrative. As analysis proceeded, the search for differences in the talk of participant 'groups' shifted toward a situational understanding of health practice, as participants elucidated loci of time, space, and social context which made self-management (im)possible. Health psychological notions according to which internal psychological realities play a determining role in human action were thus questioned, and placed into their historical context. Chapter 1 outlines the thesis topic, and presents an argument for a critical health psychology. Chapter 2 presents a metasynthesis of previous qualitative research on type 2 diabetes self-management. Chapter 3 explores methodology, in particular interviewing technique and analytical approach to narrative. Chapters 4,5,6, and 7 present narrative analyses of the different 'groups', with the latter being a case study to explore in detail the changing ways in which self-management intertwines with a lived life. Chapter 8 brings strands of these analyses together, in particular to explore the importance of temporal and spatial disruptions to the experience of self-management throughout the narratives. And chapter 9 offers some tentative answers to the research questions, while discussing the findings in relation to current directions in UK health policy.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:582091 |
| Date | January 2012 |
| Creators | Gomersall, Timothy Philip |
| Publisher | University of Leeds |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
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