Abstract
In resource-limited settings like Ethiopia, managing type 2 diabetes mellitus (T2DM) depends heavily on patients’ self-care. Yet, this process is often disrupted by a complex interplay of emotional, cultural, and systemic factors. Existing research has insufficiently captured how these forces shape the lived experiences of patients managing diabetes in such settings. Therefore, this study explored the lived experiences and perceived barriers of self-care practices among individuals with T2DM attending hospitals in the Wolaita Zone of South Ethiopia.A descriptive phenomenological approach grounded in Husserlian philosophy was employed. Data were collected through 12 in-depth interviews with T2DM patients and supplemented by two focus group discussions with additional 13 patients conducted between August and September 2024. Data were analysed manually using a five-step phenomenological approach, emphasizing meaning extraction and textual synthesis. Five interconnected themes emerged:1) Emotional disruptions following diagnosis, 2) Perceived disease severity and fear of complications, 3) Economic and infrastructural constraints, 4) Cultural and religious beliefs, and 5) systemic and interpersonal gaps in support. Patients described experiences of fear, hopelessness, and shock at diagnosis, compounded by medication inaccessibility, unaffordable diets, and traditional beliefs conflicting with biomedical guidance. Patients reported limited diabetes-specific knowledge and insufficient emotional and educational support from their families and the health system. Self-care practices among patients with T2DM in Ethiopia are shaped by deeply embedded emotional, socio-cultural, and systemic realities. Effective diabetes management requires interventions that extend beyond clinical knowledge provision, incorporating emotional support, culturally tailored education, and improved health system responsiveness. Multi-level collaboration between healthcare providers, policymakers, religious institutions, and community structure is critical for building sustainable, patient-centred self-care support systems.
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References
GBD. Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2019 (Results. Institute for Health Metrics and Evaluation, 2020).
Hancho, N. K. J. & Claude, K. O. IDF Diabetes Atlas. Int. Diabetes Fedration. 8, 1–150 (2017).
WHO. World Health Orgainzation, Diabetes, 5 April 2023 (Report, 2023).
Association, A. D. A. A. D.A. Improving care and promoting health in populations:. Standards of Medical Care in Diabetes (Diabetes Care, 2021).
ADCES K, L. An effective model of diabetes care and education: the ADCES7 Self-Care Behaviors. Association Diabetes Care. 47 (1), 30–53 (2021).
IDF. International Diabetes Federation,10the Edition. Diabetes Report 2000–2045. 2021;10.
Ketema, D. B. et al. Level of self-care practice among diabetic patients in Ethiopia: a systematic review and meta-analysis. BMC Public. Health BMC Public. Health. 20, 1–12 (2020).
Fisaha Haile Tesfay, C. Z., Alston, L., Backholer, K. & Bowe, S. J. Catherine M. Bennett. Epidemiology of Major Non-communicable Diseases in Ethiopia: A Systematic Review. Front. Public. Health (2022).
Letta, S., Aga, F., Yadeta, T. A., Geda, B. & Dessie, Y. Barriers to Diabetes Patients’ Self-Care Practices in Eastern Ethiopia: A Qualitative Study from the Health Care Providers Perspective. Diabetes, metabolic syndrome and obesity: targets and therapy. ;14:4335–49. (2021).
Berhe, K. K., Mselle, L. T. & Gebru, H. B. Barriers to self-care management among Type 2 diabetes patients in Tigray, Ethiopia: A qualitative study. J. Diabetes Metab. Disord. (2023).
Bekele, N. T., Habtewold, E. M., Deybasso, H. A. & Mekuria Negussie, Y. Poor self-care practices and contributing factors among adults with type 2 diabetes in Adama. Ethiopia Sci. Rep. 14 (1), 13660 (2024).
Getie, A. et al. Self- care practices and associated factors among adult diabetic patients in public hospitals of Dire Dawa administration, Eastern Ethiopia. BMC public. health. 20 (1), 1232 (2020).
Gurmu, Y., Gela, D. & Aga, F. Factors associated with self-care practice among adult diabetes patients in West Shoa Zone, Oromia Regional State, Ethiopia (BMC Health Services Research, 2018).
Belay, B., Derso, T. & Sisay, M. Dietary practice and associated factors among type 2 diabetic patients having followed up at the University of Gondar Comprehensive specialized hospital, northwest Ethiopia, 2019. J. Diabetes Metabolic Disorders. 20 (2), 1103–1110 (2021).
Abraham, C. & Sheeran, P. The health belief model. Cambridge Handbook of Psychology, Health and Medicine chapter 97–102 (Cambridge University Press, 2007).
Christensen, M., Welch, A. & Barr, J. Husserlian descriptive phenomenology: A review of intentionality, reduction and the natural attitude. J. Nurs. Educ. Pract. 7 (8), 113–118 (2017).
Bailey, J. First steps in qualitative data analysis: transcribing. Fam. Pract. 25 (2), 127–131 (2008).
Moustakas, C. Phenomenological research methods (SAGE Publications, Inc, 1994).
Colaizzi, P. F. Psychological research as the phenomenologist views it. In (eds Ronald, S., Valle & King, M.) Existential-phenomenological alternatives for psychology. New York: Oxford University Press. 6. (1978).
Tong, A., Sainsbury, P. & Craig, J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int. J. Qual. health care J. Int. Soc. Qual. Health Care. 19 (6), 349–357 (2007).
Kalra, S., Jena, B. N. & Yeravdekar, R. Emotional and Psychological Needs of People with Diabetes. Indian J. Endocrinol. Metabol. 22 (5), 696–704 (2018).
Balhara, Y. P. S. Diabetes and psychiatric disorders. Indian J. Endocrinol. Metabol. 15 (4), 274–283 (2011).
Debono, M. & Cachia, E. The impact of diabetes on psychological well being and quality of life. The role of patient education. Psychol. Health Med. 12 (5), 545–555 (2007).
Jiakponna, E. C., Agbomola, J. O., Ipede, O., Karakitie, L. & Ogunsina, A. J. Kaosara Temitope Adebayo, and Mary Oluwasayo Tinuoye. Psychosocial factors in chronic disease management: Implications for health psychology. International Journal of Science and Research Archive. ;02 (2024):117 – 28. (2024).
Peyrot, M. et al. Psychosocial problems and barriers to improved diabetes management: results of the Cross-National Diabetes Attitudes, Wishes and Needs (DAWN) Study. Diabet. Med. 22 (10), 1379–1385 (2005).
Zheng, Y., Ley, S. H. & Hu, F. B. Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nat. reviews Endocrinol. 14 (2), 88–98 (2018).
Chawla, A., Chawla, R. & Jaggi, S. Microvasular and macrovascular complications in diabetes mellitus: Distinct or continuum? Indian J. Endocrinol. Metabol. 20 (4), 546–551 (2016).
Team, N. C. D. Diabetes, a silent killer in Africa. WHO Africa region. (2023).
Butt, M. D. et al. Cost of Illness Analysis of Type 2 Diabetes Mellitus: The Findings from a Lower-Middle Income Country. Int. J. Environ. Res. Public Health. 19 (19), 12611 (2022).
Kumar, L. & Mohammadnezhad, M. Perceptions of patients on factors affecting diabetes self-management among type 2 diabetes mellitus (T2DM) patients in Fiji: A qualitative study. Heliyon Neth.. 8(6). (2022).
Bukhsh, A. et al. Type 2 Diabetes Patients’ Perspectives, Experiences, and Barriers Toward Diabetes-Related Self-Care: A Qualitative Study From Pakistan. Front. Endocrinol.. 11 534873 (2020).
Islam, S. M., Biswas, T., Bhuiyan, F. A., Mustafa, K. & Islam, A. Patients’ perspective of disease and medication adherence for type 2 diabetes in an urban area in Bangladesh: a qualitative study. BMC Res. Notes. 10 (1), 131 (2017).
Adejoh, S. O. Diabetes Knowledge, Health Belief, and Diabetes Management Among the Igala. Nigeria Sage Open.. 4(2), 2158244014539966 (2014).
Kifle, Z. D. B. B., Yimer Tadesse, T. & Woldeyohanins, A. E. Prevalence and associated factors of herbal medicine use among adult diabetes mellitus patients at government hospital, Ethiopia: An institutional-based cross-sectional study. Metabol Open. (2021).
Mekashaw Bayked, E., Haile Kahissay, M. & Demeke Workneh, B. Beliefs, perceptions, and tendencies of patients with diabetes towards folk-healing alternatives: A qualitative analysis. Cogent Social Sci. 8 (1), 2106650 (2022).
Mogre, V., Johnson, N. A., Tzelepis, F. & Paul, C. Barriers to diabetic self-care: A qualitative study of patients’ and healthcare providers’ perspectives. J. Clin. Nurs. 28 (11–12), 2296–2308 (2019).
Katz, I. et al. Managing type 2 diabetes in Soweto-The South African Chronic Disease Outreach Program experience. Prim. Care Diabetes. 3 (3), 157–164 (2009).
Keogh, K. M. et al. Psychological family intervention for poorly controlled type 2 diabetes. Am. J. Manag. Care. 17 (20), 105–113 (2011).
Thirsk, L. M. & Schick-Makaroff, K. Family interventions for adults living with type 2 diabetes mellitus: A qualitative meta-synthesis. Patient Educ. Couns. 104 (12), 2890–2899 (2021).
Gupta, S. K. L. P., Chakrapani, V., Rastogi, A. & Kaur, M. Understanding the diabetes self-care behaviour in rural areas: Perspective of patients with type 2 diabetes mellitus and healthcare professionals. PLoS One (2024).
Cometto G, Ford, N., Pfaffman-Zambruni, J., Akl, E. A., Lehmann, U., McPake, B., & Taylor, D. Health policy and system support to optimise community health worker programmes: an abridged WHO guideline. Lancet Global Health. 6 (12), e1397-e404 (2018).
Baker, R., Schmidt, U. & Frewer, A. The Declaration of Helsinki and the foundations of global bioethics. Ethical research: The declaration of Helsinki, and the past, present, and future of human experimentation. Declaration Helsink :47–58. (2020).
Acknowledgements
The first author extends his heartfelt appreciation for Walailak University for PhD. The scholarship grants me to continue PhD with number 03/2023, and Wolaita Sodo University College of Medicine and Health Sciences for administrative support. My especial thanks go to participants for their valuable time and sharing their experiences.
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This research was financially supported by the Walailak University Research Fund (No.CGS-RF-2024/16). The funders had no role in research design, data collection and analysis, decision to publish, and preparation of the manuscript.
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Conceptualization: T. A., C. S, C.N.L, A.W and E.W.Data curation: T. A, C. S., C.N.L and A.WFormal analysis-T. A, C.S, and SA.I., J.J, S.S., N.T.Funding acquisition: T. A. and C.S.Investigation: T. A, E.W, N.T, and J.JMethodology: T. A., C. S, C.N.L, AW, SS, and E.WProject administration: C.S.Resources: T. A and C.S, Software: T. A. C. S, and J.JSupervision: C.S, C.N.L, E.W, S.S, and A.W, Validation: C. S, C.N.L, E.W, A.W and SA. IVisualization-T. A, C.N.L, SA. I, and E.WWriting-Original Draft Preparation: T.A, C.S, NT, and EWWriting Review and Editing-T. A, C.N.L, and A.WAll authors read, approved, and agreed to the publication.
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Ethical clearance was obtained from the Walailak University Ethics Committee, Thailand (approval no. WUEC-24-264-01) and permissions from Wolaita Sodo University (reference no. CHSM-4/3579/20/1). Written informed consent was obtained from all participants; Confidentiality was maintained through the study. The research in this study adhered to the principles of the Declaration of Helsinki on human research ethics of the 1964 standard42.
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Ageru, T.A., Le, C.N., Wattanapisit, A. et al. Lived experience and perceived barriers to self-care among patients with type 2 diabetes mellitus in South Ethiopia: a descriptive phenomenological study. Sci Rep (2026). https://doi.org/10.1038/s41598-026-42142-6
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DOI: https://doi.org/10.1038/s41598-026-42142-6
