Perceptions of Diabetes Self-Care Management among Older Singaporeans with Type 2 Diabetes: A Qualitative Study

Background: Given the global shift in aging populations and the associated increasing prevalence of diabetes, it is critical to explore new approaches in diabetic self-care management. In Singapore, what has been overlooked to date is an in-depth, contextually based examination of the needs, expectations, and barriers faced in self-care management by older adults with Type 2 diabetes. Purpose: This study aimed to explore the experiences of older Singaporeans with Type 2 diabetes in diabetes self-care management to understand their perceived needs, expectations, and barriers associated with their diabetes self-care management. Methods: A descriptive qualitative approach using focus group discussions was adopted. Purposive sampling was used to recruit older adults with Type 2 diabetes from Singapore's three main ethnic groups, namely, Chinese, Malay, and Indian, through the diabetes centers of two hospitals. Four focus groups, including two groups of Chinese, one group of Malays, and one group of Indians, were conducted. Thematic analysis was used to analyze the data set for emerging themes that relate to the experiences of participants with diabetes self-care management. Results: The four major themes related to the experiences of participants with diabetes self-care management that emerged were as follows: (a) "Diabetes is genetic, destined, and not serious; complication, let it come"; (b) "Diabetes self-care is difficult"; (c) "I don't know diabetes"; and (d) "Doctor and nurses are important facilitators of self-care management." Conclusions/Implications for Practice: Findings have important implications in Singapore as well as in other Asian countries where populations are also aging and diabetes prevalence is increasing. The findings provide new culturally focused insights for clinical patient education within the Southeast Asian context to improve diabetes self-care management of older adults.