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Abstract

Background: Diabetes prevalence rate in Malaysia has risen much faster than expected. The prevalence of diabetes in Malaysia is above average when compared to the estimation by the International Diabetes Federation (IDF) for all regions in the world and has already reached the projected prevalence for the year 2030. The latest Malaysian National Health and Morbidity survey (2011) indicated that the prevalence of diabetes is 15.2% for population above the age of 18 years old. Various studies in Malaysia have demonstrated poor diabetic self-management among patients and high complications. Research on diabetes in Malaysia has mainly adapted a biomedical and epidemiological approach. Thus far, research in Malaysia has failed to assess patients’ personal beliefs about their illness. This study employs a mixed- methods approach that triangulates findings from two data collection methods to gain a coherent insight into illness beliefs among Malaysian Type 2 diabetes patients using a psychological approach grounded in self-regulatory theory.

Aims: Study 1 was conducted to investigate: (1) the cognitive representations of illness among patients suffering from type 2 diabetes in Malaysia, (2) the emotional representations of illness among patients suffering from type 2 diabetes in Malaysia, and (3) the management/coping styles adopted by patients suffering from type 2 diabetes in Malaysia. Study 2 was conducted to investigate the relationships between patients’ illness perceptions and their adherence to self-care regimens. As Malaysia is a country with diverse ethnicity, the secondary aim of this study is to determine whether there are cultural differences in the way in which patients with type 2 diabetes from different ethnic groups conceptualise their illness and treatment.

Method: In study 1, data was obtained by conducting semi-structured one-to-one interview with participants. The data obtained was analysed using principals of grounded theory. In study 2, data was obtained using structured questionnaires. Participants were required to fill in 3 questionnaires (demographic questionnaire, IPQ-R Diabetes questionnaire and summary of diabetes self- care activities). Data were analysed using SPSS version 22.0. Various analyses, such as descriptive analysis and Pearson correlations, were conducted. Group differences were examined by a Kruskal–Wallis H test.

Results: Study 1 found that patients adopted positive cognitive representation, such as determination. The findings also suggest that patients viewed their relationship with their healthcare provider positively, which supported disease management. Patients with determination and good health provider support adopted problem based coping. Some patients had negative emotional representations towards diabetes, such as fear. In addition, patients’ management of diabetes was affected by various psycho-social factors, such as the lack of understanding of family and stress. All patients expressed that Malaysian food culture had a negative impact of diabetes management. This study also revealed that some patients adopted emotional focused coping, specifically by keeping their diabetic status a secret.

Results of Study 2 indicated there was a strong negative correlation between the self-care total score and consequences subscale, personal control subscale, treatment control subscale and emotional representation subscale. There was a significant negative correlation between the self-care total score and illness cohesion subscale. There was also a significant negative correlation between the self-care total score and identity subscale. This study also found that there was a difference in the ways in which different ethnic groups conceptualise their illness.

Publication Type:	Thesis (Doctoral)
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Departments:	School of Health & Psychological Sciences > Psychology Doctoral Theses School of Health & Psychological Sciences > School of Health & Psychological Sciences Doctoral Theses

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