The process of managing the dietary regimen in elderly people with diabetes

The objective of this study is to describe the dietary habits of overweight elderly people with Type II diabetes; a social psychological process which identifies strategies used to adhere to a weight loss dietary regimen is described. Twenty informants were recruited through physicians who practice at a private, non-profit hospital in the San Francisco Bay Area in the United States. The sample ranged in age from 65 to 85 years (mean 72.5). Interviews which lasted about 1 hour were conducted in the hospital or at home and were tape-recorded and transcribed. The qualitative data from the transcripts were analysed using constant comparative analysis (Glaser with the integration of the meanings and interpretations of a dietary regimen with prior beliefs and dietary habits; and with an image of someone who has not achieved a perceived ‘ideal weight’. Strategies used by elderly people with diabetes in the process of struggling involved ‘figuring it out,‘forging a fit, and ‘coming to terms on one's own. Conditions which eased the process of struggling were: the quality of health care available (information and support), mobility of the informant, the disease course and complications, and other multiple chronic illnesses. The notion of ‘compliance’ or ‘adherence’ must be re-examined. If self-care is what health professionals are promoting, then the strategies presented here, such as supplementing information, tailoring the regimen and protesting change may well be what eased these informants’ struggles. Process-oriented research is needed to increase our understanding of the effects of social interaction on health behaviours. Interventions must include an ongoing assessment of the individual's perception of the meaning of the disease within the social context of their own world.