Persons with diabetes face multiple challenges as they manage their disease and its sequelae. Health care providers have traditionally labeled these persons as compliant/adherent or noncompliant/nonadherent. Such labels connote deviance and impose the provider's culture upon the person with chronic illness. Reframing the issue as """"""""self-management"""""""" allows one to investigate it from the person's own perspective. The overall aim of this three-year investigation is to generate a substantive grounded theory of self-management of diabetes. The specific research questions are: 1) What are the causal conditions that lead to the phenomenon of self-management of diabetes? 2) What are the behaviors or processes which persons identify as self-management of diabetes?3) What is the context in which self-management of diabetes occurs? 4) What are the action/interactional strategies taken to accomplish self-management of diabetes? 5) What are the intervening conditions which influence the action/interactional strategies taken to accomplish self- management of diabetes and 6) What are the consequences of self-management of diabetes? A nonprobability sample of approximately fifty persons with diabetes will be accessed. Study participants' experiences in managing their diabetes will be inductively explored via the use of intensive, semi- structured interviews, which will be audiotaped and transcribed verbatim. Data will be collected and analyzed concurrently, using the constant comparative method of grounded theory development. Preliminary analysis will yield tentative concepts which can be validated in later interviews. This concurrent analysis may also contribute to greater focus on key concepts and tentative hypothesized relationships between concepts. As concepts and relationships emerge, additional participants will be chosen on the basis of variables which may impact the concepts or their relationship, e.g., age, ethnicity, gender, education. After achieving saturation of the key concepts, these key concepts will be integrated into a substantive theory which will provide a concise framework for understanding the phenomenon of self-management of diabetes. Once the phenomenon of self-management of diabetes is understood from the perspective of persons living with it, then nurses can develop and test more realistic and effective psychoeducational and behavioral interventions designed to increase the ability of persons to manage their diabetes and its effect on their lives.
