TY - JOUR
T1 - Im Going to Be Good to Me”
T2 - Exploring the Role of Shame and Guilt in Patients With Type 2 Diabetes
AU - Solomon, Ellen
AU - Salcedo, Venise J.
AU - Reed, Megan K.
AU - Brecher, Alison
AU - Armstrong, Elizabeth M.
AU - Rising, Kristin L.
N1 - Funding Information:
This study was funded by the Princeton University Office of the Dean of the College Senior Thesis Research Funding Program.
Publisher Copyright:
© 2022 by the American Diabetes Association.
PY - 2022
Y1 - 2022
N2 - OBJECTIVE | People with type 2 diabetes are likely to experience shame or guilt as they navigate through their disease. Previous research has shown that feelings of shame and guilt often exist within the clinician-patient relationship, often as a result of the complex care regimen required to achieve treatment goals. The purpose of this qualitative study was to explore patients’ experiences of shame and guilt in type 2 diabetes management and the impact their clinicians have on these experiences. METHODS | Semistructured interviews were used to explore patients’ experiences with shame and guilt. Interviews were audio-recorded, transcribed, and coded using directed content analysis. Demographic data were also obtained. RESULTS | We completed 20 interviews with people with type 2 diabetes (65% Black, 70% female). Participants exhibited feelings more consistent with guilt than with shame. All participants discussed how their clinicians affected these feelings. Patients who expressed feelings of guilt were able to recognize opportunities for behavior change without experiencing global devaluation, in which they linked their actions to an unchangeable aspect of their identity or personality, often describing their guilt as motivating of change. Unlike guilt, when patients experienced shame, they often exhibited global devaluation, in which they blamed their personality, experienced hopelessness, and increased maladaptive behaviors. CONCLUSION | Our findings highlight a notable difference between shame and guilt in the context of type 2 diabetes management. We believe that incorporation of an understanding of these nuances, along with ideal responses to both shame and guilt, will enhance clinicians’ ability to provide high-quality patient-centered care to people with diabetes.
AB - OBJECTIVE | People with type 2 diabetes are likely to experience shame or guilt as they navigate through their disease. Previous research has shown that feelings of shame and guilt often exist within the clinician-patient relationship, often as a result of the complex care regimen required to achieve treatment goals. The purpose of this qualitative study was to explore patients’ experiences of shame and guilt in type 2 diabetes management and the impact their clinicians have on these experiences. METHODS | Semistructured interviews were used to explore patients’ experiences with shame and guilt. Interviews were audio-recorded, transcribed, and coded using directed content analysis. Demographic data were also obtained. RESULTS | We completed 20 interviews with people with type 2 diabetes (65% Black, 70% female). Participants exhibited feelings more consistent with guilt than with shame. All participants discussed how their clinicians affected these feelings. Patients who expressed feelings of guilt were able to recognize opportunities for behavior change without experiencing global devaluation, in which they linked their actions to an unchangeable aspect of their identity or personality, often describing their guilt as motivating of change. Unlike guilt, when patients experienced shame, they often exhibited global devaluation, in which they blamed their personality, experienced hopelessness, and increased maladaptive behaviors. CONCLUSION | Our findings highlight a notable difference between shame and guilt in the context of type 2 diabetes management. We believe that incorporation of an understanding of these nuances, along with ideal responses to both shame and guilt, will enhance clinicians’ ability to provide high-quality patient-centered care to people with diabetes.
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U2 - 10.2337/DS21-0062
DO - 10.2337/DS21-0062
M3 - Article
AN - SCOPUS:85142481484
SN - 1040-9165
VL - 35
SP - 216
EP - 222
JO - Diabetes Spectrum
JF - Diabetes Spectrum
IS - 2
ER -