Aim and purpose
It is well known that type 1 diabetes is burdensome in terms of the demand for ongoing disease management, the threat of complications and the impact on social relations (1). As the working population with type 1 diabetes spends one third of their time at work, diabetes management in work life is therefore expected to significantly impact the overall care and quality of (work) life with diabetes. While the bulk of previous research has demonstrated the impact of diabetes on so-called industry outcomes, such as absenteeism and disability days (e.g. 2-3), only a small number of studies have looked at the behaviour or attitudes of people with diabetes in work life (e.g. 4). This PhD study (2015-2018) explores work life from the perspective of people with type 1 diabetes and the aims are:
- To explore how type 1 diabetes affects and interacts with work life socially, psychologically and physically in relation to disease burden, identity and social practices in work life
- To establish a research-based framework for developing relevant and realistic support strategies for people with diabetes in relation to work life
Design, method and theory
Applying symbolic interactionism (5) as the overarching methodology, I focus on the meaning making and practices of people with type 1 diabetes in exploring illness behaviour in work life. The study design is made up of 40 explorative interviews with people with type 1 diabetes followed by a cross-sectional survey based on questionnaire data linked with medical records data (data collection in autumn 2016). As a part of the survey I will be validating a Danish translation of an Australian self-report measure of perceived and experienced stigma for use with adults with type 1 diabetes.
Target group Adults with type 1 diabetes of working age (18-70 years old).
The explorative interviews indicate that people with type 1 diabetes experience tension between the demands of work life and the demands of routinized diabetes management. In balancing these demands they have to stretch available resources to appear as ‘good workers’ while sustaining themselves as ‘good patients’. Many interviewees struggle in reconciling diabetes and work life and they worry about their future workability as well as their health. Building on this knowledge the survey analysis will examine how work-related factors, diabetes-related factors and psychosocial factors are associated with work-related diabetes distress among the working population with type 1 diabetes. Diabetes is expected to be a bigger issue at the workplace in the future with implications for the individual person with diabetes, the workplace as well as the wider society. Knowledge about which factors impact on the quality of work life in people with type 1 diabetes is therefore relevant to guide future interventions.
Supervisors from Steno Diabetes Center Copenhagen are research manager Ingrid Willaing and senior researcher Bryan Cleal while researcher Kasper Olesen provides statistical guidance. Principal academic supervisor is Professor Tine Tjørnhøj-Thomsen from the National Institute of Public Health, University of Southern Denmark. Dr. Jessica Browne from the Australian Centre for Behavioural Research in Diabetes is collaborator on the validation of stigma measure.
Sources 1: Rubin, R.R. & Peyrot, M. (1999). Quality of life and Diabetes. Diabetes Metab Res Rev;15:205-218
2: Breton, M.-C. et al. (2013). Burden of Diabetes on the Ability to Work. A systematic review. Diabetes Care; 36: 740-749
3: Ruston, A., Smith, A. & Fernando, B. (2013). Diabetes in the workplace – diabetic’s perceptions and experiences of managing their diabetes at work: a qualitative study. BMC Public Health, 13: 386
4: Hinder, S. & Greenhalgh, T. (2012). ‘This does my head in”. Ethnographic study of self-management by people with diabetes. BMC Health Services Research 12: 83
5: Blumer, H. (1969). Symbolic Interactionism: Perspective and Method. New Jersey: Prentice- Hall