Abstract
The purpose of this study was to develop a grounded theory from the patient and support person perspective on how biopsychosocial and spiritual factors influence DKA hospital readmissions. This grounded theory study sampled participants from one Southeastern US academic medical center who had been admitted with DKA. Semi-structured interviews were conducted over a 10-month period from 2016 to 2017. Participants were interviewed until thematic saturation was reached. Participants included 13 patients and 6 support persons, majority Black, African Americans. Analysis led to the overarching theme of Putting the Pieces Together. This consists of the subthemes of contextual life factors and action strategies that participants attributed to their cycle of readmissions for DKA. Results are not generalizable to all patients who experience DKA but are a reflection of the experiences of a predominately non-Hispanic Black/African American subset of the larger population. This study supports the need for equal importance to be placed on addressing the patient’s availability of a support system that promotes patient agency, supports their cultural beliefs, and respects the contextual factors that influence diabetes management and may break or maintain the readmission cycle. Healthcare systems must develop processes that ensure community and family support systems are available to patients and understand the importance of their role in disease management.
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Forbes, T.H., Hodgson, J., Crespo, J. et al. Putting the Pieces Together: An Exploration of Diabetes Ketoacidosis Readmissions. Contemp Fam Ther 42, 436–445 (2020). https://doi.org/10.1007/s10591-020-09551-9
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DOI: https://doi.org/10.1007/s10591-020-09551-9