Objectives: Diabetes is a chronic disease where patient's ability for self management is very important. Patients are every day taking decisions how to integrate treatment recommendations into their lives without impacting the quality of life. The aim of this study was to explore participants' perceived barriers to adherence to treatment.
Methods: A qualitative study with five focus groups of patients with Type 2 diabetes and one group of experts on diabetes mellitus was performed in the central area of Slovenia. The transcribed text was independently analysed by principles of grounded theory with codes merging into themes and categories.
Results: Time changes patients' attitudes toward disease. Good education about the disease and their own experience with the disease help patients to adapt to different life situations and to regain control in their life. Family and friends are not always supportive to diabetes treatment. Some patients deny having disease in social encounters because they feel stigmatised. Diabetes also challenges patient's working ability and financial welfare. Patients also emphasise that mutual trust with physician and his true interest in patients' problems is very important for good results of medical care. They refuse universal advice and expect that the doctor helps them to develop self-management skills and coping with the disease. Additional prerequisites for good self management are also adequate organisation of life and adequate personal characteristics of the patients.
Discussion: This study offers additional insights into patients' views of the barriers to adherence. Patients feel empowered for occasional departure from recommended treatment in some social and life situations. Better medical care could be the result of good balance between social expectations of the patients, treatment and working demands on one side and individualised support of the physician with patients' own capacity to rearrange life on the other side.
