Personal constructs in adults with type 2 diabetes mellitus: a dependency grid analysis

Gillibrand, Warren Peter (2006) Personal constructs in adults with type 2 diabetes mellitus: a dependency grid analysis. Doctoral thesis, University of Central Lancashire.

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This thesis presents an investigation into the personal constructs that people with
type 2 diabetes use, to live and manage their condition. The approach adopted was
underpinned by personal construct psychology, utilising qualitative and dependency
grid methods to determine individual personal constructs in a multiple case series

In the thesis a critical discussion is presented of current UK national policy and
clinical guidelines in diabetes care. This found that gaps exist in the current evidence
base, particularly in individual approaches and interventions provided by healthcare
professional services. The synthesis of research literature in the experience of adults
with type 2 diabetes showed that some common themes exist; achieving balance,
normalising and psychological alterations. Furthermore the synthesis revealed that
self-efficacy and personal model research studies in diabetes have found that these
issues are influential in how people live and cope with their condition.

Using a convenience sample of adults with type 2 diabetes, predominantly cared for
in the community, a series of interviews were conducted in a sample of 23
participants. Ten participants completed all the stages of the research data collection
and these are presented in the results as a case study series. The dependency grid
technique required each participant to complete a series of grid ratings of constructs
and elements associated with their living with type 2 diabetes.

The results of the exploratory qualitative interviews were five major themes of family,
relationships and interactions; social-life/activity; emotional changes/support;
meaningful work/sense of worth; and making adiustments/diabetes functional activity.
The themes were translated into the dependency grids as constructs and participants
then rated people as elements against these constructs. The analysis of the ten
case studies showed personal constructs associated with interdependence with
family, friends and healthcare professionals. The interdependence identified had
strong or weak associations with diabetes related constructs depending on how each
individual participant had rated them.

The findings suggest that people with type 2 diabetes do not always consider primary
care services as appropriate for their needs and contrast this with the value they
previously made to secondary care services. Each individual has developed their
own level of interdependence with some type 2 patients with diabetes being self
reliant or using family members/friends more than professional health services.
Recommendations include further exploration of interdependence in type 2 diabetes.
Limitations of the study include sample issues, and a methodological approach that is
educative and lengthy in implementation.

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