Health Information Behavior In Diabetes Patients:a Grounded Theory Study

Objectives Self-management as one of the best ways for diabetes behavior intervention has been widely accepted in the world.The issue of unsatisfied self-management status of diabetes patients has not been solved,although studies of diabetes self-management intervention has been ongoing.WHO predicted that information is the way to the health,and also a prerequisite for changing behaviors.Currently,most diabetes self-management education dominated by health care providers lacking of the voice from diabetes patients.Few studies explored the process of diabetes patients seeking,gathering and using health information.Purpose The purpose of this study is to explore the process of health information seeking and using behavior in diabetes self-management,identify the conditions for health information behavior in diabetes patients and problems,and build a theoretical model of health information seeking behavior in diabetes patients.Methods This study used grounded theory through convenience sampling and theoretical sampling to recruit diabetes patients who live in the urban and rural areas in Shanghai,Henan and Zhejiang province.We used intensive interview to explore the experience from receiving information to using information.Finally we recruited 30 diabetes patients and finished 40 intensive interview,among whom some of the participants received two and more interviews.All the records of interview were transcribed word by word and documented.We used open coding,axial coding and selective coding to code the data,and do the dimensional analysis and constant comparative analysis to emerge the categories.We build the model of health information behavior in diabetes patients.Literature review and writing memos were throughout the study.Results We explored diabetes patient health information behavior(the core category),that is a dynamic and cycle process beginning with receiving initial information,followed by perceiving/judging information,active seeking information,passive receiving information,intentional avoiding information,active using information and temporary not using information,and ending up with transforming into self-management behavior or not.In this model,receiving initial health information is a starting point,perceiving/judging information is a middle stage that influence diabetes patients taking different health information seeking and using behavior.Based on perceiving/judging information,diabetes patients seek information may influenced by perceiving inconsistency between information and need,negative of diabetes,self-efficacy and self-responsibility.Diabetic patients may avoid information by virtue of denying diabetes,fearing or resisting threatening information.Patients may receive information passively because of lacking motivation.If diabetes patients satisfied with information,they will use information actively: obeying to information,self-adjusting information and making joint medical decisions.If not,they will not use information temporarily: knowing but not doing anything,ignoring information and storing information.In the different context,diabetes patients may seek information continuously supported by self-efficacy,and being a diabetes selfmanagement expert.Diabetes patients may decrease seeking information because of insufficient motivation,and degenerate self-management behavior.Patients may pause seeking information due to lacking motivation,and stop self manage themselves.Conclusions This study constructed the model of health information seeking behavior in diabetes patients,providing theoretical and practical guidance for medical institutions,health care providers,and policy makers to develop tailored and effective diabetes health education intervention program,promoting diabetes patients change and maintain self-management behavior permanently.