All Title Author
Keywords Abstract


Perceived Symptoms in People Living with Impaired Glucose Tolerance

DOI: 10.1155/2011/937038

Full-Text   Cite this paper   Add to My Lib

Abstract:

The aim of the study was to identify symptoms in people with impaired glucose tolerance (IGT) and describe their experiences of living with the symptoms which they related to their condition. Twenty-one participants, from a cross-sectional population-based study, diagnosed as having IGT, were invited for an interview. The interviews were analyzed in two phases by means of a manifest and latent content analysis. The narratives included seven categories of symptoms (and more than 25 different symptoms) presented by the respondents. This study shows that symptoms such as the patient's own interpretation of different perceptions in the body must be considered, as well as signs and/or objective observations. Symptoms ought to be seen as complementary components in the health encounter and health conversation. The results of this study indicate that health professionals should increase their awareness of the balance between the implicit and the explicit bodily sensations that individuals communicate. Further studies are needed. 1. Introduction Living with impaired glucose tolerance (IGT) means living with an increased risk of developing diabetes mellitus type 2 (T2DM) and is preceded by a long period without symptoms, which is why IGT often remains undetected for a long period of time [1, 2]. At the same time, the prevalence of T2DM is predicted to increase in future decades [3–5], thus emphasizing the importance of identifying additional aspects of understanding what it means to live with IGT. The diagnosis of IGT is based on blood glucose level and determined by OGTT, an oral glucose tolerance test. Impaired glucose tolerance is defined as the two-hour value at OGTT 7.8–11.0?mmol/L and fasting plasma glucose <7?mmol/L according to WHO guidelines [6]. A significant number of patients with IGT already have typical diabetes complications at the time of diagnosing T2DM [7], but knowledge about their illness experiences such as emotional distress are rarely described [8]. Suitable prevention strategies are needed, including both symptoms and signs [9]. It is therefore of significance to describe if any symptoms are perceived by persons diagnosed with IGT. Symptoms refer to the patient’s own interpretation of different sensations in the body: illness, while signs on the other hand are related to objective observations: disease [10]. Signs are abnormalities in the structure and function of body organs and systems and can often be identified by signs of bodily disorder such as oedema, high blood glucose, or large amounts of urine [10]. Symptoms are a large focal

References

[1]  M. I. Harris, “Undiagnosed NIDDM: clinical and public health issues,” Diabetes Care, vol. 16, no. 4, pp. 642–652, 1993.
[2]  P. Evans, P. Langley, and D. P. Gray, “Diagnosing type 2 diabetes before patients complain of diabetic symptoms—clinical opportunistic screening in a single general practice,” Family Practice, vol. 25, no. 5, pp. 376–381, 2008.
[3]  A. F. Amos, D. J. McCarty, and P. Zimmet, “The rising global burden of diabetes and its complications: estimates and projections to the year 2010,” Diabetic Medicine, vol. 14, supplement 5, pp. S1–S85, 1997.
[4]  S. Wild, G. Roglic, A. Green, R. Sicree, and H. King, “Global prevalence of diabetes: estimates for the year 2000 and projections for 2030,” Diabetes Care, vol. 27, no. 5, pp. 1047–1053, 2004.
[5]  J. E. Shaw, R. A. Sicree, and P. Z. Zimmet, “Global estimates of the prevalence of diabetes for 2010 and 2030,” Diabetes Research and Clinical Practice, vol. 87, no. 1, pp. 4–14, 2009.
[6]  WHO, Guidelines for the Definition, Diagnosis and Classification of Diabetes Mellitus and It's Complications, 1998, http://www.who.int/diabetes/publications/Definition%20and%20diagnosis%20of%20diabetes_new.pdf.
[7]  R. J. Tapp, J. E. Shaw, P. Z. Zimmet et al., “Albuminuria is evident in the early stages of diabetes onset: results from the Australian Diabetes, Obesity, and Lifestyle Study (AusDiab),” The American Journal of Kidney Diseases, vol. 44, no. 5, pp. 792–798, 2004.
[8]  M. C. Adriaanse and F. J. Snoek, “The psychological impact of screening for type 2 diabetes,” Diabetes/Metabolism Research and Reviews, vol. 22, no. 1, pp. 20–25, 2006.
[9]  T. Yates, M. Davies, and K. Khunti, “Preventing type 2 diabetes: can we make the evidence work?” Postgraduate Medical Journal, vol. 85, no. 1007, pp. 475–480, 2009.
[10]  L. Eisenberg, “Disease and illness Distinctions between professional and popular ideas of sickness,” Culture, Medicine and Psychiatry, vol. 1, no. 1, pp. 9–23, 1977.
[11]  P. Salmon, “Conflict, collusion or collaboration in consultations about medically unexplained symptoms: the need for a curriculum of medical explanation,” Patient Education and Counseling, vol. 67, no. 3, pp. 246–254, 2007.
[12]  M. Hansson Scherman and O. L?whagen, “Drug compliance and identity: reasons for non-compliance: experiences of medication from persons with asthma/allergy,” Patient Education and Counseling, vol. 54, no. 1, pp. 3–9, 2004.
[13]  J. Tuomilehto, J. Lindstr?m, J. G. Eriksson et al., “Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance,” The New England Journal of Medicine, vol. 344, no. 18, pp. 1343–1350, 2001.
[14]  V. Adelsw?rd and L. Sachs, “The meaning of 6.8: numeracy and normality in health information talks,” Social Science and Medicine, vol. 43, no. 8, pp. 1179–1187, 1996.
[15]  J. Troughton, J. Jarvis, C. Skinner, N. Robertson, K. Khunti, and M. Davies, “Waiting for diabetes: perceptions of people with pre-diabetes: a qualitative study,” Patient Education and Counseling, vol. 72, no. 1, pp. 88–93, 2008.
[16]  R. J. Koopman, A. G. Mainous III, and A. S. Jeffcoat, “Moving from undiagnosed to diagnosed diabetes: the patient's perspective,” Family Medicine, vol. 36, no. 10, pp. 727–732, 2004.
[17]  M. C. Adriaanse, J. M. Dekker, A. M. Spijkerman et al., “Diabetes-related symptoms and negative mood in participants of a targeted population-screening program for type 2 diabetes: the Hoorn Screening Study,” Quality of Life Research, vol. 14, no. 6, pp. 1501–1509, 2005.
[18]  S. Andersson, I. Ekman, U. Lindblad, and F. Friberg, “It's up to me! Experiences of living with pre-diabetes and the increased risk of developing type 2 diabetes mellitus,” Primary Care Diabetes, vol. 2, no. 4, pp. 187–193, 2008.
[19]  M. C. Adriaanse, F. Pouwer, J. M. Dekker et al., “Diabetes-related symptom distress in association with glucose metabolism and comorbidity: the Hoorn Study,” Diabetes Care, vol. 31, no. 12, pp. 2268–2270, 2008.
[20]  K. E. Giel, P. Enck, S. Zipfel et al., “Psychological effects of prevention: do participants of a type 2 diabetes prevention program experience increased mental distress?” Diabetes/Metabolism Research and Reviews, vol. 25, no. 1, pp. 83–88, 2009.
[21]  C. A. Paddison, H. C. Eborall, D. P. French, et al., “Predictors of anxiety and depression among people attending diabetes screening: a prospective cohort study embedded in the ADDITION (Cambridge) randomized control trial,” The British Journal of Health Psychology, vol. 16, part 1, pp. 213–226, 2011.
[22]  L. A. Hiltunen and S. M. Kein?nen-Kiukaanniemi, “Does hyperglycaemia cause symptoms in elderly people?” Central European Journal of Public Health, vol. 12, no. 2, pp. 78–83, 2004.
[23]  E. W. Gregg, Q. Gu, D. Williams et al., “Prevalence of lower extremity diseases associated with normal glucose levels, impaired fasting glucose, and diabetes among U.S. adults aged 40 or older,” Diabetes Research and Clinical Practice, vol. 77, no. 3, pp. 485–488, 2007.
[24]  P. M?ntyselk?, J. Miettola, L. Niskanen, and E. Kumpusalo, “Persistent pain at multiple sites—connection to glucose derangement,” Diabetes Research and Clinical Practice, vol. 84, no. 2, pp. e30–e32, 2009.
[25]  K. I. Kjellgren, J. Ahlner, B. Dahl?f, H. Gill, T. Hedner, and R. S?lj?, “Perceived symptoms amongst hypertensive patients in routine clinical practice—a population-based study,” Journal of Internal Medicine, vol. 244, no. 4, pp. 325–332, 1998.
[26]  C. A. Larsson, B. Gullberg, L. R?stam, and U. Lindblad, “Salivary cortisol differs with age and sex and shows inverse associations with WHR in Swedish women: a cross-sectional study,” BMC Endocrine Disorders, vol. 9, article 16, 2009.
[27]  U. H. Graneheim and B. Lundman, “Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness,” Nurse Education Today, vol. 24, no. 2, pp. 105–112, 2004.
[28]  Y. S. Lincoln and E. G. Guba, Naturalistic Inquiry, Sage, Beverly Hills, Calif, USA, 1985.
[29]  K. Johannisson, “Hur skapas en diagnos? Ett historiskt perspektiv. I,” in Diagnosens Makt: Om Kunskap, Pengar och Lidande, G. Hallerstedt, Ed., Daidalos, G?teborg, Sweden, 2006.
[30]  L. Eisenberg and A. Kleinman, The Relevance of Social Science for Medicine, Reidel, Dordrecht, The Netherlands, 1981.
[31]  M. B. Ris?r, “Illness explanations among patients with medically unexplained symptoms: different idioms for different contexts,” Health, vol. 13, no. 5, pp. 505–521, 2009.
[32]  I. Ekman, J. G. Cleland, B. Andersson, and K. Swedberg, “Exploring symptoms in chronic heart failure,” The European Journal of Heart Failure, vol. 7, no. 5, pp. 699–703, 2005.
[33]  L. J. Kirmayer, D. Groleau, K. J. Looper, and M. D. Dao, “Explaining medically unexplained symptoms,” The Canadian Journal of Psychiatry, vol. 49, no. 10, pp. 663–672, 2004.
[34]  A. J. Hartz, R. Noyes, S. E. Bentler, P. C. Damiano, J. C. Willard, and E. T. Momany, “Unexplained symptoms in primary care: perspectives of doctors and patients,” General Hospital Psychiatry, vol. 22, no. 3, pp. 144–152, 2000.
[35]  C. Nimnuan, M. Hotopf, and S. Wessely, “Medically unexplained symptoms: an epidemiological study in seven specialities,” Journal of Psychosomatic Research, vol. 51, no. 1, pp. 361–367, 2001.
[36]  E. G. Mishler, The Discourse of Medicine: Dialectics of Medical Interviews, Ablex Publishing, Norwood, NJ, USA, 1984.
[37]  I. Ekman, J. G. Cleland, K. Swedberg, A. Charlesworth, M. Metra, and P. A. Poole-Wilson, “Symptoms in patients with heart failure are prognostic predictors: insights from COMET,” Journal of Cardiac Failure, vol. 11, no. 4, pp. 288–292, 2005.
[38]  K. S. Groven, M. Raheim, and G. Engelsrud, “‘My quality of life is worse compared to my earlier life’: living with chronic problems after weight loss surgery,” International Journal of Qualitative Studies on Health and Well-being, vol. 5, no. 4, 2010.
[39]  H.-G. Gadamer, The Enigma of Health: The Art of Healing in a Scientific Age, Polity Press, Cambridge, UK, 1996.
[40]  C. F. Dowrick, A. Ring, G. M. Humphris, and P. Salmon, “Normalisation of unexplained symptoms by general practitioners: a functional typology,” The British Journal of General Practice, vol. 54, no. 500, pp. 165–170, 2004.
[41]  F. Friberg and J. ?hlen, “Searching for knowledge and understanding while living with impending death—a phenomenological case study,” International Journal of Qualitative Studies on Health and Well-being, vol. 2, no. 4, pp. 217–226, 2007.
[42]  F. Friberg, E. P. Andersson, and J. Bengtsson, “Pedagogical encounters between nurses and patients in a medical ward—a field study,” International Journal of Nursing Studies, vol. 44, no. 4, pp. 534–544, 2007.
[43]  C. Skott, “Symptoms beyond diagnosis—a case study,” The European Journal of Cancer Care, vol. 17, no. 6, pp. 549–556, 2008.
[44]  P. Ric?ur, History and Truth, Northwestern University Press, Evanston, Ill, USA, 2007.
[45]  B. C. Martin, J. H. Warram, A. S. Krolewski, et al., “Role of glucose and insulin resistance in development of type 2 diabetes mellitus: results of a 25-year follow-up study,” The Lancet, vol. 340, no. 8825, pp. 925–929, 1992.
[46]  A. Hansson, F. Friberg, K. Segesten, B. Gedda, and B. Mattsson, “Two sides of the coin—general Practitioners' experience of working in multidisciplinary teams,” Journal of Interprofessional Care, vol. 22, no. 1, pp. 5–16, 2008.

Full-Text

comments powered by Disqus