Abstract
Background
Epidemiological and health economic analyses highlight that lost productivity at work among people with diabetes represents a significant social and individual burden. The reasons for this have been investigated in relation to type 1 diabetes (T1D), but less is known about the relationship between lost productivity at work and type 2 diabetes (T2D). How do people with T2D experience work and what, if any, challenges do they meet?
Aim
This study explores how individuals with type 2 diabetes (T2D) experience and manage the demands of diabetes with the demands of work. Furthermore, the study identifies what measures could be applied to alleviate negative challenges associated with managing T2D in the context of work.
Method
Data were acquired in 20 individual interviews and three workshops, with a total of twenty participants. Interview participants were recruited from a local municipality in the capital region of Denmark. Workshop participants were recruited from a diabetes clinic in Copenhagen. Eligibility criteria were; age (25-65 years), T2D diagnosis and work experience within the last five years. People recruited for workshops had one or more complication of T2D.
Individual interviews were semi-structured and organized around a thematic question guide. Analysis of interviews was based on a phenomenological approach, in which the lived experiences, including thoughts and emotions, of the interlocutor are in focus.
The workshops were organized in accordance with principles from ‘Design Thinking’. Dialogue tools were used to facilitate different exercises and involvement of participants.
Results
All participants affirmed that work was important for general well-being. Some also believed that work structured their day in a way which was supportive of good diabetes management.
In the initial round of individual interviews, participants did not recognize that diabetes had influenced their work life. For these participants, diabetes and work were two entirely disparate domains. However, these individuals were mostly untroubled by their diabetes, being well-regulated and with no complications.
In the workshops approximately half our participants denied that diabetes had any impact on work life. Yet while explicit links between diabetes and work life were infrequently articulated, a number of participants highlighted issues in which the influence of diabetes could be inferred. At its most extreme, one participant bemoaned walking a lot at work while having no feeling in his feet, simultaneously rejecting that diabetes had impacted on his work life.
The challenging and negative experiences which did emerge were similar to those highlighted in relation to work and T1D e.g. medication, food consumption, exercise. Discrimination and stigma were mentioned by a very small number of participants. In short, there was no indication of work-related challenges specific to T2D.
Discussion
In contrast to studies conducted among people with type 1 diabetes, people with T2D seemed generally less inclined to acknowledge that diabetes had any impact on their work lives. In fact, a number of participants appeared to actively disassociate their experiences at work from their diabetes. Nearly all participants had disclosed their diabetes at work, so individuals were not compelled to conceal the condition. In fact the dissociation between work and diabetes appeared to be related to a more general strategy for living with T2D. A large number of participants appeared to consider diabetes in isolation from other domains of their life, as something which could be managed and otherwise ignored.
While such compartmentalization of diabetes may be a strategy for living with the condition, it may have unforeseen consequences. It can limit people perceiving strains and stresses which can occur when balancing the demands of diabetes management and work. Failure to perceive problems may, in turn, delay remedial action. This suggests a potential for intervention, providing people with T2D information and resources to understand better how the condition will manifest itself in all aspects of their lives. It is unclear, however, how or where such an intervention could occur. Current clinical guidelines and patient education courses for people with T2D do not address the topic of work. Yet given the centrality of work in an individual’s life, it can be argued that if we truly strive to provide patient-centred care for people with type 2 diabetes we must do more to enable them to apprehend and relate to the their condition in a life-perspective that takes work into account.
No conflict of interest
Epidemiological and health economic analyses highlight that lost productivity at work among people with diabetes represents a significant social and individual burden. The reasons for this have been investigated in relation to type 1 diabetes (T1D), but less is known about the relationship between lost productivity at work and type 2 diabetes (T2D). How do people with T2D experience work and what, if any, challenges do they meet?
Aim
This study explores how individuals with type 2 diabetes (T2D) experience and manage the demands of diabetes with the demands of work. Furthermore, the study identifies what measures could be applied to alleviate negative challenges associated with managing T2D in the context of work.
Method
Data were acquired in 20 individual interviews and three workshops, with a total of twenty participants. Interview participants were recruited from a local municipality in the capital region of Denmark. Workshop participants were recruited from a diabetes clinic in Copenhagen. Eligibility criteria were; age (25-65 years), T2D diagnosis and work experience within the last five years. People recruited for workshops had one or more complication of T2D.
Individual interviews were semi-structured and organized around a thematic question guide. Analysis of interviews was based on a phenomenological approach, in which the lived experiences, including thoughts and emotions, of the interlocutor are in focus.
The workshops were organized in accordance with principles from ‘Design Thinking’. Dialogue tools were used to facilitate different exercises and involvement of participants.
Results
All participants affirmed that work was important for general well-being. Some also believed that work structured their day in a way which was supportive of good diabetes management.
In the initial round of individual interviews, participants did not recognize that diabetes had influenced their work life. For these participants, diabetes and work were two entirely disparate domains. However, these individuals were mostly untroubled by their diabetes, being well-regulated and with no complications.
In the workshops approximately half our participants denied that diabetes had any impact on work life. Yet while explicit links between diabetes and work life were infrequently articulated, a number of participants highlighted issues in which the influence of diabetes could be inferred. At its most extreme, one participant bemoaned walking a lot at work while having no feeling in his feet, simultaneously rejecting that diabetes had impacted on his work life.
The challenging and negative experiences which did emerge were similar to those highlighted in relation to work and T1D e.g. medication, food consumption, exercise. Discrimination and stigma were mentioned by a very small number of participants. In short, there was no indication of work-related challenges specific to T2D.
Discussion
In contrast to studies conducted among people with type 1 diabetes, people with T2D seemed generally less inclined to acknowledge that diabetes had any impact on their work lives. In fact, a number of participants appeared to actively disassociate their experiences at work from their diabetes. Nearly all participants had disclosed their diabetes at work, so individuals were not compelled to conceal the condition. In fact the dissociation between work and diabetes appeared to be related to a more general strategy for living with T2D. A large number of participants appeared to consider diabetes in isolation from other domains of their life, as something which could be managed and otherwise ignored.
While such compartmentalization of diabetes may be a strategy for living with the condition, it may have unforeseen consequences. It can limit people perceiving strains and stresses which can occur when balancing the demands of diabetes management and work. Failure to perceive problems may, in turn, delay remedial action. This suggests a potential for intervention, providing people with T2D information and resources to understand better how the condition will manifest itself in all aspects of their lives. It is unclear, however, how or where such an intervention could occur. Current clinical guidelines and patient education courses for people with T2D do not address the topic of work. Yet given the centrality of work in an individual’s life, it can be argued that if we truly strive to provide patient-centred care for people with type 2 diabetes we must do more to enable them to apprehend and relate to the their condition in a life-perspective that takes work into account.
No conflict of interest
| Originalsprog | Engelsk |
|---|---|
| Publikationsdato | dec. 2017 |
| Antal sider | 1 |
| Status | Udgivet - dec. 2017 |
| Begivenhed | IDF Congress 2017: Shape the future of diabetes - ADNEC congress center, Abu Dhabi , Abu Dhabi , Qatar Varighed: 4 dec. 2017 → 8 dec. 2017 https://www.idf.org/our-activities/congress/idf-2017-abu-dhabi.html |
Konference
| Konference | IDF Congress 2017 |
|---|---|
| Lokation | ADNEC congress center, Abu Dhabi |
| Land/Område | Qatar |
| By | Abu Dhabi |
| Periode | 04/12/2017 → 08/12/2017 |
| Internetadresse |