Experience of diabetes self-care and well-being among adults with type 2 diabetes in South Ethiopia: a qualitative descriptive study

Abstract

BACKGROUND: Type 2 diabetes mellitus (T2DM) poses an escalating challenge in resource-limited settings where daily self-care practices are often compromised. The everyday realities of individuals with T2DM in Sub-Saharan Africa remain insufficiently understood. This study explored self-care experiences among adults with T2DM in South Ethiopia, focusing on factors shaping their daily lives and well-being. METHOD: A qualitative descriptive design with reflexive thematic analysis was employed. In-depth interviews were conducted with 21 purposefully selected participants (12 patients, 9 providers) from three hospitals in South Ethiopia. Provider interviews provided complementary contextual information about health system barriers. Well-being, from participants' perspectives, was defined by the ability to maintain daily activities, fulfill family roles, and sustain hope. RESULTS: Analysis of patient interviews yielded four major themes capturing the experience of self-care: 1) Navigating daily self-care routines (medication intake, diet management, self-monitoring, and foot care); 2) Multilevel barriers eroding well-being (medication stock-outs, economic constraints, cultural beliefs, lack of support, knowledge gaps, provider training deficits); 3) Education and counselling as sources of empowerment (building knowledge, instilling hope); and 4) Envisioning supportive environments (continued counselling, medication availability, peer support). Healthcare provider interviews provided complementary contextual information about health system barriers. CONCLUSION: For individuals with T2DM in South Ethiopia, self-care involves daily negotiation shaped by economic hardship, cultural factors, and health system limitations. Empowering patients through tailored support, continued counselling, peer support network, and reliable healthcare systems is essential for enhancing their health and well-being.