Table 1 Individual barriers of adherence to medical advices among diabetic patients
From: A phenomenological study on barriers of adherence to medical advice among type 2 diabetic patients
Theme | Categories | Codes | Patients’ remarks |
|---|---|---|---|
Individual barriers | Physiologic and physical factors | comorbidities | • I suffer from digestive problems so that I cannot eat stuff like legumes and vegetables. • I have anemia which prevents avoidance from some foods such as meat, rice and etc. • I suffer from respiratory disease which prevents me from exercising and walking. In case of long walking, my breath will be stopped. • I suffer from heart disease. I have problem adjusting my diet. • I have anemia and many foods which are recommended to me are not enough for my body’s needs. |
Physical weakness | • I cannot comply with the diet because I have physical weakness and I always feel hungry; however, as far as I can, I act on advice. | ||
Aging | • I can’t do physical exercise recommendations because I am old. My legs hurt and I can’t walk. | ||
Problems in chewing fiber foods | • I am not able to chew fiber foods such as fruit and vegetables. I refuse to eat them. | ||
Financial problems | Economic pressure | • Economic factors and financial problems make me feel stressed, and this leads to worsening diabetes and lack of control on my disease, and I can’t act on medical instructions. | |
Large number of family members | • The number of people in my family is large and I have to provide the cost of educating and clothing, which in turn leads to lack of attention to medical advice. • I have a lot of mouths to feed and I don’t have enough time for myself to act on medical advices. | ||
Low income people | • My husband is retired. I do not have the ability to prepare the recommended foods • I am retired. I do not have the financial power to buy the prescribed medications. | ||
Occupational factors | Type of Job | • I am a taxi driver. Because of my job, I am always behind the car and I can’t have enough exercise and mobility. • I am a government employee. I have been working for a long time, which leads to lack of mobility in my workplace. Also, I feel weak after long hours without calorie intake. | |
Attitudinal problems and lack of knowledge | Wrong believes | • I do not act on medical advice because I know that diabetes is not a threat to my life and it does not cause me any problem. | |
Self-treatment | • I use medicinal herbs to reduce my glucose and I do not need to use medications prescribed by a doctor. | ||
Social and family problems | Problems in adjusting with the diet and different tastes of people | • I can’t fit my diet with other family members. I have to consider the tastes of other family members in cooking. • My wife does not cooperate with me in preparing foods that help control my diabetes. • My family observes the given diet in the early stages of my disease to control my blood glucose, but over time, there was a problem in the taste and coordination of foods. • When I go to a party, I have to eat foods, although I know they cause problems for my health. |