Scandinavian Journal of Public Health, 2010; 38: 788–793 ORIGINAL ARTICLE Reasons for participation in group-based type 2 diabetes self-management education. A qualitative study LISBETH Ø. RYGG 1,2 , MARIT BY RISE 1 , BORGHILD LOMUNDAL 1 , HILDE STRØM SOLBERG 1 & ASLAK STEINSBEKK 1 1 Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway, and 2 Helse Nord-Trøndelag Hospital Trust Levanger, Norway Abstract Aims: To investigate reasons for participating in group-based diabetes self-management education (DSME) for patients with type 2 diabetes. Methods: A qualitative study using focus groups and individual semi-structured interviews was conducted with 22 patients attending seven different groups in Central Norway. Results: Patients with diabetes described two main reasons for attending DSME; experiencing practical problems and feeling insecure. These reasons differed by affecting the patients in two ways – practically or emotionally. Practical problems and feeling insecure both originated from lack of or contradictory information and from lack of contact with other patients with diabetes. This affected the patients’ everyday lives in important areas such as diet, medication, social settings and lifestyle changes. Conclusions: The underlying reason for participating in a DSME was the participants’ experience of having insufficient information about their diabetes, which led to practical problems and emotional insecurity. Being aware of the patients’ reasons for participating can help professionals keep a focus which is more consistent with patients’ needs. Key Words: Diabetes mellitus type 2, patient education, qualitative research, self-management Introduction In 2007, it was estimated that 246 million (7.3%) of the world’s adult population had diabetes – com- pared with 194 million in 2003 [1]. Type 2 diabetes amounted to about 85% to 95% of all diabetes cases in developed countries. Most of the treatment for type 2 diabetes is handled by the patients themselves, and some have considered 99% of the treatment as self-care [2]. Many type 2 diabetes patients struggle to manage lifestyle changes [3], and self-management is influ- enced by how they understand the disease [4]. Psychosocial problems could also represent barriers against effective self-care for patients in many parts of the world [5]. Such problems lead to poor adherence to the recommended regimen, such as diet and exercise [6,7]. Group-based diabetes self-management education (DSME) is a way to help patients cope with their everyday life and has been recommended for patients with chronic diseases [8]. DSME for patients with type 2 diabetes focuses on nutritional intake, lifestyle modification and on improving self-management skills. The goal is thus to provide information and thereby help patients manage their disease [9]. As DSME are not usually built upon patients’ everyday experience, the focus might easily be turned to the providers’ idea of what is important. A programme could thereby neglect areas which are important to the patients, thus possibly limiting the gain they would get from participating. Some studies have investigated patients’ experi- ences with DSME, highlighting different preferences for education styles and the benefit of group educa- tion [10]. Investigating patients’ experiences might Correspondence: Lisbeth Ø. Rygg, Department of Public Health and General Practice, Norwegian University of Science and Technology Medisin teknisk forskningssenter, N-7489 Trondheim, Norway. E-mail: lisbeth.rygg@ntnu.no (Accepted 16 July 2010) ß 2010 the Nordic Societies of Public Health DOI: 10.1177/1403494810382475