The essence of eating: a phenomenological study of type 2 diabetes

Abstract

Diabetes is a chronic illness affecting over 16 million Americans. Type 2 diabetes accounts for approximately 90-95% of cases in the United States and its prevalence increases with age. As the percent of the population over age 60 increases, we can expect diabetes to present even greater challenges to the health care system.

Medical nutrition therapy is an integral component of diabetes care and management. However, both patients and primary care providers identify following diet regimens as one of the most challenging components of diabetes care. The manner in which people acquire, select, prepare and consume foods reflects a complex personal interaction.

The purpose of this study was to gain an in-depth understanding of how individuals with type 2 diabetes living in rural northwest Colorado personally experience the meaning of food and eating and the underlying themes that account for these meanings. This qualitative study used a phenomenological framework to guide the research. Individual semi-structured interviews were conducted with nine women between the ages of 65 and 88.

Verbatim transcript analysis revealed eight underlying themes used to develop the textural descriptions of their experiences with eating. These themes included: memories associated with food, food as a source of social interaction, should/shouldn’t syndrome, changing dietary behavior, use of dietary supplements, relationships with medical personnel, adjusting to diabetes and co-morbidities, and rural values of independence.

The essence of eating varied among individuals; it also evolved within an individual over time. Factors in addition to health motivated food choice. Each participant presented herself as a distinct entity and expressed a diverse set of opinions and thoughts across each theme. This variance limited correlations and interrelationships. Nonetheless, all participants exhibited a strong sense of independence, self-sufficiency, and desire for control.

These results may help health care providers better understand how rural older women with diabetes approach eating, thus improving their ability to help patients develop approaches to diet management that work.