Social barriers and enablers to Type 2 diabetes self-management: the role of capital (#36)
People diagnosed with Type 2 Diabetes Mellitus (T2DM) experience difficulties making the necessary lifestyle changes. Traditional approaches to self-management focus upon individual capacity to make lifestyle change. Several studies have been conducted on the adoption of lifestyle changes in people with T2DM however few have focused on the extent people are influenced by social, cultural and economic factors in regards to making lifestyle changes. This study aims to explore the role of social influences on adoption of lifestyle change related to diet and activity for people with T2DM. A qualitative exploratory methodology was used. 28 participants with T2DM, from a lower socio-economic region of Adelaide, South Australia were recruited and semi structured interviews conducted. All interviews were audio recorded, transcribed verbatim, emerging codes identified by research team and NVivo9 used to manage data. This study used Bourdieu to provide a theoretical frame (Bourdieu 2000). Participants often had sufficient cultural capital to access and assess health information however they frequently lacked the economic capital and social networks to affect health outcomes. Relationships with health professionals in particular, were identified as problematic resulting in misconceptions, lack of access to services, poor continuity of care and disenfranchisement. Bourdieu (2000) argues self-management is a function not only of habitus, resulting in the performance of health behaviours rooted in cultural and class background, but also of access to capital in the form of economic resources, social networks, health knowledge and prestige. As such, encounters with health professionals may result in the imposition of values and behaviours outside of the understanding and experiences of the patient and contrary to behaviours which have symbolic value in their social networks. As a consequence participants enter relationships with health professionals at a disadvantage leading to difficulties in getting needs met and poorer health outcomes.
- Bourdieu, P 2000, Pascalian meditations, Polity press, Cambridge.