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The experiences of young people living with Type 1 diabetes in the Western Cape public health system : a thematic analysis
Thesis (MHumanRehabSt)--Stellenbosch University, 2024.
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Stellenbosch : Stellenbosch University
2025
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| _version_ | 1867613897053175808 |
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| access_status_str | Open Access |
| author | Oosthuizen, Sarah Ruth |
| author2 | Watermeyer, Brian |
| author_browse | Oosthuizen, Sarah Ruth Watermeyer, Brian |
| author_facet | Watermeyer, Brian Oosthuizen, Sarah Ruth |
| author_sort | Oosthuizen, Sarah Ruth |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description | Thesis (MHumanRehabSt)--Stellenbosch University, 2024. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/131879 |
| institution | Stellenbosch University (South Africa) |
| last_indexed | 2026-06-10T12:43:26.328Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2025 |
| publishDateRange | 2025 |
| publishDateSort | 2025 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/131879 The experiences of young people living with Type 1 diabetes in the Western Cape public health system : a thematic analysis Oosthuizen, Sarah Ruth Watermeyer, Brian Tomlinson, Mark Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Disability & Rehabilitation Studies. Diabetes in children -- Western Cape (South Africa) Diabetes -- Medical care -- Western Cape (South Africa) UCTD Thesis (MHumanRehabSt)--Stellenbosch University, 2024. ENGLISH SUMMARY: Introduction: There are no reliable statistics on type 1 diabetes (T1D) in South Africa, or much data on the experiences of children and young people (CYP) with T1D. Diabetes distress (DD) is an expected response to T1D, and has significant implications for clinical outcomes and wellbeing, negatively affecting self-management behaviours and acting as a barrier to improved care. When accurately detected, DD is easily treated within regular T1D care. Problem: Research from the Global North (GN) is well developed, but the cultural, socioeconomic and psychosocial contexts are too different to that of the South African population to assume applicability. Aim: The research aimed to investigate the experiences of a local sample of CYP with T1D who attend a public healthcare facility, Tygerberg Hospital in the Western Cape. Data were evaluated for DD and how this compares to established research in similar populations from the GN. It is anticipated that findings can inform the development of evidence-based healthcare and support to address DD within the South African context. Significance: T1D is expected to increase in South Africa, and CYP with T1D have high estimated morbidity and mortality rates. The dearth of local data limits informed healthcare responses within South Africa’s resource-constrained public healthcare environment, compounding the negative effects of socioeconomic disadvantage on CYP with T1D. Methods: The study took the form of an open-ended qualitative investigation using in-depth interviews and focus group discussions on a sample of 25 CYP (aged 8 to 18) with T1D. Data were analysed via reflexive thematic analysis and seven themes were generated around 1) T1D and emotions, 2) T1D and family relationships, 3) T1D and negative social perceptions, 4) T1D and food, 5) self-management, 6) healthcare experiences, and 7) hypoglycaemia. Results: The data suggested that DD is present in the sample population, although different in origins and experiences to DD emanating from the GN. The impact on both the self-management behaviours critical to T1D-care and the CYP’s wellbeing was found to be related to how DD is shaped by the social circumstances of the research population. The contextual descriptions of DD included novel experiences. Much of the localised experiences of DD are influenced directly by the impact of socioeconomic deprivations common to the majority of South African CYP, as described in food scarcity, restrictive dietary recommendations for T1D management and limited treatment options. These are compounded by resource-constrained public healthcare services, and schools that are ill-equipped to deal with the needs and negative experiences of the CYP with T1D in their care. Conclusion: While localised aspects of DD may share similarities with descriptions of DD emanating from the GN, the experiences thereof differ in important ways. The case for a thorough contextual description of DD through further research in the South African setting was made. It is anticipated that with targeted and contextualised DD interventions, improved self-management and metabolic outcomes, fewer dangerous and distressing glycaemic events, and overall better wellbeing and quality of life in the CYP with T1D can be achieved in South Africa. AFRIKAANSE OPSOMMING: Inleiding: Daar is geen betroubare statistieke oor tipe 1-diabetes (T1D) in Suid-Afrika nie – ook nie baie data oor die ervarings van kinders en jongmense (CYP) met T1D nie. Diabetesnood (DD) is 'n verwagte reaksie op T1D, en het beduidende implikasies vir kliniese uitkomste en welstand, wat ’n negatiewe uitwerking op selfbestuursgedrag het en 'n hindernis vir verbeterde sorg is. Indien dit akkuraat opgespoor word, kan DD maklik met gereelde T1D-sorg behandel word. Probleem: Navorsing uit die Globale Noorde (GN) is goed ontwikkel, maar die kulturele, sosio-ekonomiese en psigososiale kontekste verskil te veel van die van die Suid-Afrikaanse bevolking om hier toe te pas. Doel: Die navorsing het ten doel gehad om die ervarings van deelnemers aan 'n plaaslike steekproef van CYP met T1D by 'n openbare gesondheidsorgfasiliteit, Tygerberg-hospitaal in die Wes-Kaap te ondersoek. Data is geevalueer vir DD en hoe dit vergelyk met gevestigde navorsing in soortgelyke populasies van die GN. Daar word verwag dat bevindinge die ontwikkeling van bewysgebaseerde gesondheidsorg en ondersteuning kan inlig om DD binne die Suid-Afrikaanse konteks aan te spreek. Betekenis: Daar word verwag dat T1D in Suid-Afrika sal toeneem, en CYP met T1D het hoe geskatte morbiditeit en sterftesyfers. Die gebrek aan plaaslike data beperk ingeligte gesondheidsorgreaksies binne Suid-Afrika se hulpbronbeperkte openbaregesondheidsorgomgewing, wat die negatiewe uitwerking van sosio-ekonomiese benadeling op CYP met T1D vererger. Metodes: Die studie het die vorm aangeneem van 'n oop-einde kwalitatiewe ondersoek deur gebruik te maak van in-diepte onderhoude en fokusgroepbesprekings op 'n steekproef van 25 CYP (ouderdom 8 tot 18) met T1D. Data is ontleed via refleksiewe tematiese analise en sewe temas is gegenereer rondom 1) T1D en emosies, 2) T1D en gesinsverhoudings, 3) T1D en negatiewe sosiale persepsies, 4) T1D en kos, 5) selfbestuur, 6) gesondheidsorgervarings en 7) hipoglukemie. Resultate: Die data het aangedui dat DD teenwoordig is in die steekproefpopulasie, hoewel anders in oorsprong en ervaring as DD wat uit die GN voortspruit. Daar is gevind dat die impak op beide die selfbestuursgedrag, wat van kritieke belang vir T1D-sorg is, en die CYP se welstand verband hou met betrekking tot hoe DD deur die maatskaplike omstandighede van die navorsingspopulasie gevorm word. Die kontekstuele beskrywings van DD het nuwe ervarings ingesluit. Baie van die gelokaliseerde ervarings van DD word direk beı̈nvloed deur die impak van sosio-ekonomiese ontberings wat algemeen is vir die meerderheid van Suid-Afrikaanse CYP, soos beskryf in voedselskaarste, beperkende dieetaanbevelings vir T1D-bestuur en beperkte behandelingsopsies. Dit word vererger deur hulpbronbeperkte openbaregesondheidsorgdienste en skole wat swak toegerus is om die behoeftes en negatiewe ervarings van die CYP met T1D in hul sorg te hanteer. Gevolgtrekking: Terwyl gelokaliseerde aspekte van DD ooreenkomste kan he met beskrywings van DD wat uit die GN voortspruit, verskil die ervarings daarvan op belangrike maniere. Daar is ’n behoefte aan 'n deeglike kontekstuele beskrywing van DD deur middel van verdere navorsing in die Suid-Afrikaanse omgewing. Daar word verwag dat verbeterde selfbestuur en metaboliese uitkomste, minder gevaarlike en ontstellende glukemiese gebeure, en algehele beter welstand en lewenskwaliteit in die CYP met T1D in Suid-Afrika met geteikende en gekontekstualiseerde DD-ingrypings bereik kan word. Masters 2025-04-07T06:22:00Z 2025-04-07T06:22:00Z 2024-12 Thesis https://scholar.sun.ac.za/handle/10019.1/131879 Stellenbosch University xv, 145 pages : illustrations, maps, includes annexures application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Diabetes in children -- Western Cape (South Africa) Diabetes -- Medical care -- Western Cape (South Africa) UCTD Oosthuizen, Sarah Ruth The experiences of young people living with Type 1 diabetes in the Western Cape public health system : a thematic analysis |
| title | The experiences of young people living with Type 1 diabetes in the Western Cape public health system : a thematic analysis |
| title_full | The experiences of young people living with Type 1 diabetes in the Western Cape public health system : a thematic analysis |
| title_fullStr | The experiences of young people living with Type 1 diabetes in the Western Cape public health system : a thematic analysis |
| title_full_unstemmed | The experiences of young people living with Type 1 diabetes in the Western Cape public health system : a thematic analysis |
| title_short | The experiences of young people living with Type 1 diabetes in the Western Cape public health system : a thematic analysis |
| title_sort | experiences of young people living with type 1 diabetes in the western cape public health system a thematic analysis |
| topic | Diabetes in children -- Western Cape (South Africa) Diabetes -- Medical care -- Western Cape (South Africa) UCTD |
| url | https://scholar.sun.ac.za/handle/10019.1/131879 |
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