Barriers to diabetes self-management in the North Shoa Zone, Ethiopia: a qualitative study with patients and healthcare providers

Abstract

BACKGROUND: Despite advanced behavioral interventions and programmes, many patients face complex barriers leading to poor self-care. Understanding these complex challenges and obstacles is crucial for promoting effective behavior change and empowering patients to manage their conditions independently. This study explored barriers to diabetes self-management among patient and health care provider. METHODS: A qualitative exploratory study was conducted in the North Shoa Zone from July 1 to July 30, 2024. The study included 20 diabetic patients and five health care providers selected with the maximum variation sampling method. Relevant data were collected from participants using interview guides and were recorded, translated and analyzed using ATLAS.ti v25 software. A thematic framework was employed to identify key codes, subthemes, and principal themes concerning the challenges and barriers associated with diabetes self-management behavior. RESULTS: In this study, the challenges and barriers to diabetes self-management behaviors were categorized into individual, interpersonal and community levels, including eight different subthemes. The key challenges and barriers identified include inadequate self-care knowledge, socioeconomic constraints, inadequate guidance, psychological factors such as low motivation and stress, limited social support, cultural influence and limited access to resources. CONCLUSIONS: The main challenges and barriers to diabetes self-management fall on the individual, interpersonal and community levels. Addressing these issues requires integrated behavioral interventions, mental health support, stress management, and stronger community partnerships and helps individuals establish and achieve personal health goals.