The Complex Nature of Diabetes Management: Addressing Beliefs, Support, and Access Through Qualitative Study

Abstract

Background Diabetes self‐management in primary care is shaped not only by individual behavior but also by the interaction of diabetes‐related beliefs, family support, health literacy, and access to healthcare services. Understanding how patients, family caregivers, and healthcare providers interpret and respond to these interconnected factors is essential for developing culturally responsive, family inclusive, and nurse‐led diabetes care. Materials and Methods A qualitative descriptive study was conducted in three primary healthcare clinics in Yogyakarta, Indonesia. Data were collected through in‐depth interviews with nine adults living with Type 2 diabetes mellitus and six family caregivers, as well as focus group discussions with six healthcare providers. Participants were recruited using purposive sampling. Interviews and discussions were conducted in Bahasa Indonesia, transcribed verbatim, translated into English, and analyzed using constant comparative methods with OpenCode 4.0 software. Reporting followed the Consolidated Criteria for Reporting Qualitative Research. Results Three interconnected themes were identified: diabetes‐related beliefs shaping self‐management, family support in diabetes self‐management, and access to responsive healthcare services. Beliefs about food, medication, symptoms, and coping influenced dietary practices, medication adherence, symptom interpretation, emotional responses, and care‐seeking. Family members supported self‐management through encouragement, reminders, food preparation, information sharing, and material assistance, although some advice reflected informal sources. Access to monitoring, medication support, education, staff responsiveness, and mobile communication helped sustain care and correct misconceptions. Conclusion Diabetes self‐management was negotiated through the interaction of beliefs, family support, and healthcare access rather than individual behavior alone. Nurse‐led, family‐inclusive, culturally tailored education is needed to address misinformation, medication concerns, symptom recognition, emotional distress, and continuity of care.

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